How is chlorhexidine bigluconate used?

Chlorhexidine

- a medicinal product, an antiseptic, in finished dosage forms used in the form of bigluconate (Chlorhexidini bigluconas). Chlorhexidine has been successfully used as a topical antiseptic and disinfectant for over 60 years.

Effective against gram-positive and gram-negative bacteria (Treponema spp., Neisseria gonorrhoeoae, Ureaplasma spp., Bacteroides fragilis, Chlamydia spp.), protozoa (Trichomonas vaginalis), viruses[2] and fungi. It affects bacterial spores only at elevated temperatures. It is stable, after treatment of the skin it remains on it in a certain amount sufficient to exhibit a bactericidal effect.

Composition and release form

Name – Chlorhexidine. Available in the form of a solution for external use of 0.05% and 20%. And also in the form of suppositories, gels, sprays and ointments.

• A solution of 0.05% Chlorhexidine is provided in a polymer bottle with a nozzle or glass bottles of 100 ml. The packaging for the drug is cardboard type. This cardboard package contains 1 bottle.

A solution of 20% Chlorhexidine is available in polymer bottles with a cap, containing 100 or 500 ml.

Components of the drug

Chlorhexidine digluconate 0.05% consists of:

• chlorhexidine bigluconate in the amount of 0.5 mg,
• additional fillers and substances.

Chlorhexidine bigluconate 20% consists of:

• chlorhexidine digluconate in the amount of 0.2 g,
• additional fillers and substances.

The composition of gels, ointments, suppositories and sprays of chlorhexidine includes:

• the active substance is chlorhexidine,
• Excipients,
• lidocaine.

Pharmacological effect

Chlorhexidine bigluconate - this salt is used as an antiseptic - affects microorganisms differently, and this depends on the type of microbes.

1. Mushrooms . The effect of the drug on pathogenic and opportunistic fungi is very similar to the effect on bacteria. By destroying the cell wall, the antiseptic penetrates the cytoplasmic membrane of the fungus and irrevocably destroys the cell.
2. Bacteria . The positively charged Chlorhexidine molecule binds to the bacterial cell wall, which has a negative charge. As a result, destabilization and damage to the cell wall occurs. Interestingly, this process only takes about 20 seconds. However, the role of the antiseptic does not end there. The drug penetrates the cell and attacks the internal cytoplasmic membrane of the bacterium, as a result of which the contents simply flow into the cytoplasm. The cell dies. High concentrations of chlorhexidine digluconate may cause hardening or congealing of the cytoplasm.
3. Biofilm . It is a complex collection of microorganisms growing on hard organic (such as dental plaque) or inorganic surfaces. Biofilms are characterized by structural heterogeneity, genetic diversity, and complex interactions within the conglomerate. The matrix protects the cells within it, which makes biofilm microorganisms particularly resistant to antibacterial drugs. Most antiseptics are unable to act within the complex structure of the biofilm. Chlorhexidine broke out from the orderly row of powerless relatives and proved its exceptional abilities. The drug can prevent the adhesion (sticking) of microorganisms to a solid surface, as a result of which the growth and development of biofilm stops.
4. Other microorganisms . Unlike many antiseptics, Chlorhexidine solution demonstrates high effectiveness against other microbes, for example, bacterial spores and protozoa. It is assumed that it also acts against viruses covered with an additional shell: herpes simplex virus, HIV, cytomegalovirus, influenza virus. Non-enveloped viruses are resistant to Chlorhexidine. These include ARVI pathogens rotavirus, adenovirus and enteroviruses.

Indications for use

Chlorhexidine bigluconate is intended for therapeutic measures in the fight against pathologies caused by pathogens susceptible to its action:

Solution 0.1% (0.05 and 0.2):

• is prescribed for preventive purposes after surgical interventions and for injuries in dentistry and laryngootorhinological organs.
• when disinfecting damaged mucous membranes of the mouth and genitals.
• treatment of integuments to prevent infection after manipulations in surgical, obstetric and gynecological practice.
• as an antiseptic for wound areas, scratches, abrasions, cuts and burns.
• to protect against viruses penetrating through the urethrogenital system.
• for gargling.

Solution 0.5%:

• for processing surfaces, devices and instruments for medical purposes in a state heated to 750C.

1% solution:

• preventive measures for burn injuries of the epidermis.
• for disinfecting and cleaning the hands of doctors and staff before surgery.

There is also a solution with a concentration of 5 and 20% for preparing a composition using alcohol, glycerin or water.

Recommendations for treatment with chlorhexidine

To prevent diseases after accidental sexual intercourse, take 3 ml for men and 2 ml for women of a 0.05% solution of the drug and treat the contact areas. It is recommended to do this no later than 2 hours after sexual intercourse. Do not urinate for two hours after using the product.

If the patient experiences urinary retention, then 3 ml of a 0.05% solution is injected into the bladder canal, and the procedure is repeated 2 times a day. The next day, chlorhexidine is not administered. The length of the treatment course is 10 days.

In the treatment of diseases of the ear, nose, throat and dental ailments, rinsing or spraying the mouth and larynx is prescribed. To do this, take a 0.1% or 0.05% solution and rinse it several times a day. Long-term use of the drug chlorhexidine for sanitation of the oral cavity can lead to problems with taste perception , this happens due to changes in the functioning of taste buds. Some patients experience a build-up of tartar and a change in the color of the tooth enamel.

Prescription during pregnancy and lactation

The drug Chlorhexidine, if necessary, can be used to treat pregnant women. During the clinical trials, no teratogenic or embryotoxic effect of the drug on the child’s body was revealed, even if the solution was used in the first weeks of pregnancy.

Chlorhexidine solution can be used by pregnant women immediately 1-2 weeks before birth to sanitize the birth canal and treat colpitis, vaginitis, and thrush.

The drug Chlorhexidine biglukont can be used externally and topically for nursing mothers. To do this, it is not necessary to interrupt lactation.

Contraindications[ | ]

Hypersensitivity to the components of the drug, dermatitis, allergic reactions. The simultaneous use of iodine preparations is undesirable to avoid the development of dermatitis. You should not use chlorhexidine solutions for treating the conjunctiva and for rinsing cavities.

With caution[ | ]

Use with caution in children.

Chlorhexidine is used to prevent STDs only as an emergency measure (broken condom, casual sexual contact). Regular and repeated instillations of chlorhexidine into the urethra can cause chemical burns (especially with individual hypersensitivity to the drug), which can ultimately lead to such a serious complication as urethral stricture [ source not specified 1566 days

].

Chlorhexidine is ototoxic to the inner ear and can cause deafness if the middle ear is damaged and the drug comes into contact with the oval window.[8]

Dosage and method of administration

As indicated in the instructions for use, Chlorhexidine bigluconate solution is used externally, topically.

Solution for local and external use 0.2%, solution for external use 0.05%

Apply 5-10 ml of the drug to the affected surface of the skin or mucous membranes of the oral cavity, genitourinary organs by irrigation or with a tampon and leave for 1-3 minutes. Frequency of application – 2–3 times a day.

To prevent sexually transmitted diseases, the contents of the bottle are injected into the vagina for women (5-10 ml) or into the urethra for men (2-3 ml), women (1-2 ml) for 2-3 minutes. It is recommended not to urinate for 2 hours after the procedure. The drug should also be used to treat the skin of the genitals, pubis, and inner thighs.

Solution for local and external use 0.5%

5–10 ml of the drug in the form of rinses, applications or irrigations are applied to the affected surface of the skin or mucous membranes and left for 1–3 minutes. Frequency of application – 2–3 times a day.

Medical equipment and work surfaces are treated with a clean sponge moistened with a solution or by soaking.

Solution for local and external use 1%

The skin of postoperative wounds is treated with a solution using a clean swab.

Before treating with the drug, the surgeon’s hands are thoroughly washed with soap and dried, after which they are washed with 20–30 ml of solution. Postoperative wounds are treated with a clean swab.

Working surfaces and medical instruments are treated with a clean sponge moistened with a solution or by soaking.

Solution for local and external use 5%

Dilution of the concentrate is carried out based on the calculation of the concentration of the prepared solution.

Special instructions[ | ]

Vaginal suppositories. Toilet of the external genitalia does not affect the effectiveness and tolerability of vaginal suppositories, since the drug is used intravaginally.

Solution and gel. Avoid getting the drug inside the wound of patients with open traumatic brain injury, spinal cord injuries, or perforation of the eardrum. If the solution gets on the mucous membranes of the eye, they should be quickly and thoroughly rinsed with water. Safety Data Sheets (MSDS) for chlorhexidine digluconate.

Contact of hypochlorite bleaches on fabrics that have previously been in contact with chlorhexidine-containing products may cause brown stains. The bactericidal effect increases with increasing solution temperature. At temperatures above 100 °C the drug partially decomposes.

Aqueous solutions of chlorhexidine salts can decompose (especially when heated and alkaline) to form trace amounts of 4-chloroaniline, which has carcinogenic properties.

Case described [ where?

] development of methemoglobinemia and cyanosis in premature infants who were in the incubator due to poisoning with 4-chloroaniline [
source not specified 708 days
]. The incubator was equipped with a humidifier containing a solution of chlorhexidine, which, when heated, can decompose to 4-chloroaniline.

Compatibility with other drugs

When using the drug, it is necessary to take into account interactions with other medications:

1. Ethyl alcohol enhances the bactericidal effect.
2. Does not combine with anionic compounds, in particular soap.
3. Not compatible with chlorides, carbonates, phosphates, sulfates, borates, citrates.
4. Under the influence of the drug, the sensitivity of microorganisms to the influence of neomycin, kanamycin, chloramphenicol, and cephalosporin increases.
5. If the pH of the medium exceeds 8, a precipitate forms. If hard water was used when preparing the solution, its bactericidal effect is reduced.

Reviews

We invite you to read reviews from people who have used Chlorhexidine bigluconate:

1. Ulyana. I have been using Chlorhexidine for a very long time, the main purpose of use is to treat the skin. I have a problem type, acne and rashes often appear. Every evening I wipe my face with a 0.05% solution and apply cream. I like that the product quickly dries out pimples and prevents them from spreading further. All my girlfriends use it too and are happy with it.
2. Victoria. A good disinfectant, especially after squeezing and opening pimples, because it does not stain or burn. Some people use it to completely get rid of acne, but so far Metrogyl suits me. And you can wipe your face in the hot summer with chlorhexidine to prevent acne.
3. Alexander. Last week I had a tooth removed. Until the crown was installed, they were told to leave it until it healed and to carefully rinse your mouth with Chlorhexidine once a day in order to kill possible microflora and not cause another infection. The drug has a slightly bitter taste, but does not cause unpleasant feelings or discomfort when used. I've been rinsing it for three days now, and it seems to be healing.

Difference between Chlorhexidine bigluconate and Chlorhexidine

These two drugs are often compared to each other. Is there a difference between them?

They do not differ in scope. In addition, both drugs have the same effect in terms of duration of action.

Therefore, use for the purposes for which the drug is needed will lead to the same result.

• Excellent disinfectant.
• Due to the identical composition, it acts similarly to Chlorhexidine.

The concept of hydrogen peroxide is known to everyone. The Latin name is almost never used in everyday life. Therefore, many are interested in the question: Is Chlorhexidine bigluconate hydrogen peroxide or not? To answer the question, you need to familiarize yourself with the composition.

Chlorhexidine bigluconate formula: C22H30CL2N10. His lat. name Chlorhexidine bigluconate. The formula of hydrogen peroxide is: H2O2, and lat. name Hydrogen peroxide. Are they identical? Is chlorhexidine bigluconate a peroxide? Hardly. However, it is a fact that they have very similar effects.

Both one and the other drug are antiseptics that are used externally. What is hydrogen peroxide and Chlorhexidine bigluconate used for?

The instructions for use of the latter contain, first of all, recommendations on how to successfully fight infections. The drug has a bactericidal and disinfectant effect and is able to stop the growth of cells of harmful microorganisms.

Hydrogen peroxide is an oxidant, a reactive form of oxygen. H2O2 generates free radicals, acting as an oxidizing agent. In addition, after the reaction, no substances remain except water and oxygen. Thus, purification from pus or blood occurs faster. However, at the same time, the wound healing period increases. The fact is that it has a destructive effect on cells. Therefore, it is only permissible to use it as a treatment once first, to disinfect the area.

Which is better: Chlorhexidine or Miramistin?

Many people are convinced that these are the same medications. In fact, they do belong to the same class of antiseptics. What is the difference between Chlorhexidine and Miramistin is in the active substances contained in the preparations.

Miramistin is not a complete analogue of Chlorhexidine. It has a pronounced antifungal and antiviral effect. Therefore, there are some differences in the indications for use of this drug. Miramistin is not contraindicated for people suffering from dermatitis.