Chlorhexidine Gluconate [0.2%]

• Oral Hygiene:
  Prevention and treatment of gingivitis and periodontitis by reducing oral bacterial load.
• Preoperative Skin Antisepsis:
  Skin preparation before surgery to reduce microbial flora.
• Wound Cleansing:
  Cleaning and disinfection of minor wounds, burns, and abrasions.
• Mouth Rinse:
  Adjunctive therapy for plaque control in patients with poor oral hygiene or after dental procedures.
• Disinfection of Medical Devices:
  Used to disinfect surgical instruments and surfaces.
• Off-label Uses:
  Vaginal antisepsis, catheter site cleaning, and other topical antiseptic applications.

• Oral Rinse:
  Use 10-15 mL of 0.2% solution, rinse for 30 seconds twice daily after brushing teeth. Do not swallow.
• Skin Antisepsis:
  Apply directly to intact skin preoperatively or for wound cleansing. Allow to dry naturally.
• Wound Care:
  Apply with sterile gauze to affected area, usually once or twice daily.
• Special Populations:
  Use cautiously in pediatric patients and avoid ingestion.
• Duration:
  Typically 2 weeks for oral rinses unless otherwise directed.

Chlorhexidine gluconate is a cationic bisbiguanide antiseptic that binds to negatively charged bacterial cell walls, disrupting membrane integrity. This causes leakage of intracellular components, leading to cell death. At lower concentrations, it is bacteriostatic, while at higher concentrations (such as 0.2%), it is bactericidal against a broad spectrum of Gram-positive and Gram-negative bacteria, as well as some fungi and viruses. It also exhibits residual antimicrobial activity due to its ability to adsorb to oral mucosa and skin.

• Absorption:
  Minimal systemic absorption when used topically or as an oral rinse.
• Distribution:
  Confined primarily to the site of application with strong binding to oral mucosa and skin.
• Metabolism & Elimination:
  Not systemically metabolized; eliminated mostly unchanged via saliva or rinsed away.
• Half-life:
  Not applicable due to minimal systemic absorption.

• Pregnancy:
  Considered category B or safe for topical use; systemic absorption negligible. Use only if clearly needed.
• Lactation:
  Safe for use during breastfeeding; no significant systemic absorption or excretion into milk.

• Topical antiseptic
• Antimicrobial mouth rinse

• Known hypersensitivity or allergy to chlorhexidine or any formulation excipients.
• Avoid ingestion.
• Not intended for use in the ear canal with a perforated eardrum.

• Avoid swallowing oral rinse to prevent systemic toxicity.
• Possible staining of teeth and tongue with prolonged oral use.
• May cause altered taste sensation, usually transient.
• Use cautiously in patients with oral mucosal lesions or ulcerations.
• Rare risk of severe hypersensitivity reactions including anaphylaxis.
• Avoid contact with eyes and ears.

Common:

• Oral mucosa irritation or dryness.
• Taste alteration (dysgeusia).
• Teeth and tongue staining with prolonged use.

Rare/Serious:

• Hypersensitivity reactions including rash, swelling, and anaphylaxis.
• Allergic contact dermatitis with skin application.

• No significant systemic drug interactions due to minimal absorption.
• Concurrent use with anionic toothpaste or mouthwash may reduce efficacy; separate usage by at least 30 minutes.

• Recent dental guidelines emphasize limiting duration of use (typically 2 weeks) to reduce staining and resistance.
• WHO and infection control bodies continue to recommend chlorhexidine for preoperative skin antisepsis and oral hygiene adjunct.
• New formulations improving taste and reducing staining are under investigation.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from freezing and direct sunlight.
• Keep container tightly closed.
• Avoid contamination by not touching applicators or dropper tips.