Chlorhexidine: instructions for use, formouthwash, with angina, in gynecology

Update: October 2018

Chlorhexidine is a popular local drug.
antiseptic that is successfully used as a universal
disinfectant and antimicrobial agent, and is especially popular in
countries of the former Soviet Union.

The chemical compound chlorhexidine has been discovered in the UK
in 1950, and already in 1954 the first skin antiseptic appeared on
base of this substance. In the future, the substance began to be added to
urological lubricants, impregnate catheters, implants,
overalls of medical personnel. Included in the series
mouthwashes and toothpastes. Widely applied in
veterinary medicine.

It is noteworthy that for the period of commercial use and
numerous studies of chlorhexidine not confirmed
the possibility of the formation of chlorhexidine-resistant microorganisms.
However, the use of Chlorhexidine can cause
bacterial resistance to antibiotics. The drug belongs to
group of budget drugs remains available for
broad masses of the population.

Фармгруппа: антисептик для местного применения.

Composition, physico-chemical properties, price

The drug is present in the pharmaceutical market in several drugs.
forms, each of which is characterized by its scope.
In addition to the products described below, registered in Russia,
there are creams, gels, ointments with the same acting
component.

Solution 0,05 %

(aqueous solution of chlorhexidine)

Spray

Candles

(Commercial name – hexicon)

Основное вещество:

0.5 mg of chlorhexidine digluconate in 1 ml of solution

25 mg of chlorhexidine solution 20% in 1 bottle 16 mg of chlorhexidine digluconate in 1 supp.

Вспомогательные вещества:

Purified water to the desired volume

Ethyl alcohol 95% – 718.5 ml; purified water, to obtain
solution volume 1 l
Polyethylene oxide 400, polyethylene oxide 1500

Физико-химические свойства:

Liquid, clear solution

Colorless, transparent sometimes slightly opalescent liquid with
alcohol odor
Vaginal suppositories of white or yellowish color,
torpedo-shaped, the surface is slightly marble.

Упаковка, цена:

Available in various types of packaging (plastic, glass
vials), with or without dispensers.

Price: 0.05% solution 100 ml: 10-15 rubles.

On 70 and 100 ml in bottles / bottles with a nozzle or a cap with
spray.

Price 100 ml: 98 rubles.

1 or 5 supp. In the cell contour packaging. 1, 2 each
packaged in a pack.

Price: №10 – 270-280 rubles.

pharmachologic effect

The instructions for use of chlorhexidine indicated that the drug
has a local antiseptic effect, to a greater extent
bactericidal. Changes the properties and composition of cell membranes
microorganisms. Cations formed during the dissociation of salts
active ingredient, begin to react with the shell
bacterial cells having a negative charge. Lipophilic
antiseptic groups promote membrane disaggregation
microorganisms that have a lipoprotein structure, and lead to
imbalance of osmotic balance, loss of phosphorus and potassium from
bacteria cells. The destruction of the cytoplasmic membrane in the end
leads to the death of bacteria.

Solution хлоргексидина биглюконата эффективен в отношении
a wide range of microorganisms: Trichomonas vaginalis,
Bacteroides fragilis, Neisseria gonorrhoeae, Gardnerella vaginalis,
Chlamidia spp., Treponema pallidum, Ureaplasma spp. Moderate
It affects individual strains of Pseudomonas spp. and Proteus
spp. Viruses (except herpes virus) and fungal spores are resistant to
the action of the drug.

It has a long antibacterial effect, can be used
for antiseptic treatment of the surgical field and the surgeon’s hands,
since after treatment the active substance remains some
time on the skin. Preserves antimicrobial activity in purulent
environment, blood, but at the same time efficiency decreases a little.

Pharmacokinetics

Local application has no systemic effect – the drug does not
absorbed into the bloodstream.

Indications

Solution

Application in gynecology:

  • trichomonas colpitis;
  • itching of the vulva;
  • cervical erosion;
  • prevention of sexually transmitted diseases: gonorrhea, trichomoniasis,
    syphilis, chlamydia, ureaplasmosis.

In dentistry and ENT practice:

  • gingivitis;
  • aphthae;
  • stomatitis;
  • alveolitis;
  • periodontitis;
  • disinfection of prostheses (partially removable, removable);
  • angina;
  • postoperative hygiene in dental and
    ENT departments.

As a local antiseptic for:

  • обработки ран, в т.h, ожоговых поверхностей;
  • дезинфекция кожи, в т.h, операционного поля;
  • treatment of hands of medical staff, surgeon;

Also used for дезинфекции рабочих поверхностей,
equipment, instruments, thermometers that do not allow
heat treatment.

Spray

  • Hygienic treatment of the hands of the surgeon and other medical staff in
    institutions of different profiles;
  • Treatment of the skin area of ​​injection, surgical fields,
    elbow bends (skin) in donors;
  • Disinfection of small-area surfaces of medical products
    (for example, ENT, dental instruments) for infections
    different etiology (bacterial, fungal, viral) in
    Health facilities;
  • Hygienic treatment of the skin of the hands of catering workers, food
    industry, utilities.

Suppositories

  • Prevention of sexually transmitted diseases: syphilis,
    chlamydia, trichomoniasis, ureaplasmosis, gonorrhea, genital
    herpes;
  • Prevention of infectious-inflammatory complications
    in gynecology and obstetrics (before childbirth, abortion,
    surgical treatment, before and after the installation of the spiral intrauterine,
    before and after diathermocoagulation (cauterization) of the cervix, before
    performing an intrauterine examination;
  • Treatment of bacterial vaginosis;
  • Therapy of colpitis (including mixed, trichomonas,
    non-specific).

Contraindications

  • Hypersensitivity to existing or auxiliary
    components.
  • Dermatitis, allergic reactions at the site of application.

Pregnancy, lactation

Not contraindicated in lactation and pregnancy.

special instructions

It is prescribed with caution for the treatment of children. At random
ingesting any form of chlorhexidine – produce immediately
washing the stomach with plenty of water, then take
adsorbent.

Spray can not be applied to the mucous membranes and wounds. Solution and
spray is not allowed for contact with the auditory nerve and the brain
shells. At random попадании на данные участки следует
rinse the preparation thoroughly under running water. If spray got into
eyes – also wash with water and drip albutside.

The drug is incompatible with alkalis, soap and other anionic
compounds (gum arabic, colloids, carboxymethylcellulose, sodium
lauryl sulfate, saponins). Does not apply simultaneously with other
antiseptics.

Do not forget that chlorhexidine is a medicinal
drug, not a means of hygiene, so use it to
daily rinsing of the mouth and teeth, as well as douching
can not. There are strict indications for which such a procedure
appropriate and necessary, and should be followed. If a
use chlorhexidine uncontrollably is fraught with violation
microflora balance, the development of dysbacteriosis and allergic
reactions.

Dosage

Solution

  • Prevention of sexually transmitted diseases. Used no later than
    2 hours after breaking the condom, unprotected intercourse.
    About 2-3 ml are injected into the urethra
    funds for women – 2-3 ml in the urethra and 5-10 ml –
    additionally in the vagina (chlorhexidine in the form of douching).
    The skin around the genitals is also necessarily processed.
    Urination can be carried out no earlier than 2 hours after
    drug administration.
  • In gynecology. Used as a douching
    relevant evidence. Carry out in a horizontal position
    squeezing a few drops of the drug into the vagina from the bottle. After
    procedures need to lie down for 5-10 minutes.
  • In inflammatory diseases of the urinary tract in men and
    women. In the urethra injected 2-3 ml of the solution once or twice in
    day 10 days in a row.
  • For the treatment of skin injuries, wounds, burns, the solution will be applied.
    in the form of an application, which is left for 1-3 minutes.
  • For gargling with sore throat, tonsillitis, pharyngitis.
    Recommendations for rinsing – before the procedure
    rinse mouth with warm water. Then take 10-15 ml of solution
    and thoroughly gargle them for about 30 seconds. Within 60 min
    after the procedure can not eat and drink. Dilute chlorhexidine not
    necessary – 0.05% solution is suitable for the procedure.
  • In dentistry. To rinse teeth, to rinse
    periodontal canal, fistula, abscess. Also used for
    treatment of the gums after the periodontal flap surgery.

Spray

  • For hygienic processing of medical staff brushes ~ 5 ml spray
    spread on the hands and rubbed for 2 minutes.
  • To handle the surgeon’s hands, first carefully wash the hands with warm
    running water and soap for at least 2 minutes, dried with sterile
    gauze cloth. Already on dry skin apply a means of 5 ml
    at least 2 times, rubbed for 3 minutes.
  • For the treatment of the elbow bends (skin areas) or
    surgical field, the skin is rubbed twice, sequentially, with
    using sterile gauze pads moistened abundantly
    drug. After окончания обработки следует обождать 2 минуты.
    Before surgery, the patient takes a shower, changing clothes. During
    processing field of the skin in one direction wipe
    sterile swab, irrigated spray. After окончания обработки
    need to wait 1 min.
  • For disinfection of small surfaces (tables, armrests
    chairs, equipment) they are wiped with a sterile cloth moistened with
    means. Норма расхода – 100 мл на 1 м2.
  • Disinfection tools. Before machining
    remove visible eye contamination by wiping wipes,
    rinsing under running water with a ruff in compliance
    antiepidemic regime. They are then immersed in a container with
    with a solution to completely fill the cavities and channels, with
    exposure depending on the specifics of treatment. Solution для
    disinfection under conditions Storage under cover is valid for 3
    days.

Suppositories

  • For the prevention of STIs – 1 suppository once in the vagina.
    A prerequisite – after intercourse should pass no more than 2
    h
  • For the treatment of vaginosis, colpitis – 1 suppository twice each.
    day, 7-10 days in a row.

Side effects

Itching and some allergic reactions are possible.
reactions that take place after drug withdrawal.

Автор: врач-гигиенист, эпидемиолог

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