cetrimide + chlorhexidine digluconate: clinical use

Prescribing considerations

• Confirm the lesion is suitable for self-care rather than requiring wound assessment or other treatment.
• Avoid ocular migration, especially during procedures involving the head, face or neck or when the patient cannot report exposure.
• Consider sensitisation from chlorhexidine or excipients when dermatitis develops.

Contraindications and cautions

• Hypersensitivity to either active ingredient or any excipient.
• Possible previous allergic reaction to chlorhexidine-containing products or devices.

Monitoring

• Routine laboratory monitoring is not required for limited cutaneous use.
• Review persistent or worsening symptoms, local dermatitis, widespread rash or suspected hypersensitivity.
• After ocular exposure, assess urgently for corneal injury or visual disturbance.

Clinical pharmacology

Chlorhexidine is a broad-spectrum antiseptic that damages microbial membranes. Cetrimide is a cationic surfactant with antiseptic activity. Systemic absorption through skin is minimal.

Formulation and product differences

• The cream contains cetostearyl alcohol, parabens and fragrance allergens, which can cause local or delayed allergic reactions.
• It is incompatible with anionic substances such as soap.
• The cream is supplied in tubes and has a stated in-use shelf life after opening.