benzalkonium chloride + chlorhexidine dihydrochloride + isopropyl myristate + liquid paraffin: clinical use

Prescribing considerations

• Confirm the formulation and whether leave-on use, washing or both are required.
• Check for previous chlorhexidine hypersensitivity.
• Counsel about eye avoidance, slipping and fire hazards, particularly for smokers, oxygen users and people with reduced mobility.
• Cetostearyl alcohol can cause local contact reactions.

Contraindications and cautions

• Known hypersensitivity to any ingredient
• Possible history of an allergic reaction to chlorhexidine

Monitoring

• No routine laboratory monitoring is specified.
• Review response and assess new or worsening irritation, contact dermatitis or hypersensitivity.
• Reassess worsening suspected infection that may require separate treatment.
• Consider an individual fire-risk assessment where residue may accumulate on fabrics.

Clinical pharmacology

The emollient oils enter the stratum corneum and form an occlusive barrier that reduces transepidermal water loss. Benzalkonium chloride and chlorhexidine provide local antiseptic activity; systemic exposure after skin use is expected to be low.

Formulation and product differences

• Dermol Cream is a thicker, higher-oil emulsion and includes glycerol among its excipients.
• Dermol 500 Lotion is a lower-oil, non-greasy cutaneous emulsion suitable for leave-on use and washing.
• Dermol Wash is designed for washing at a sink, in a bath or shower, including hand washing, and may also be left on.
• Dermol 200 is presented as a shower emollient but can also be applied directly.
• All selected formulations contain cetostearyl alcohol.