chlorhexidine dihydrochloride + lidocaine hydrochloride: clinical use

Prescribing considerations

• Confirm symptoms are suitable for local symptomatic treatment; fever or suspected bacterial infection may require further assessment and treatment.
• Avoid uninterrupted, repeated or long-term use.
• The selected sugar-free lozenge contains sorbitol and aspartame.

Contraindications and cautions

• Age younger than 12 years
• Hypersensitivity to chlorhexidine, lidocaine, other amide local anaesthetics or an excipient
• Hereditary fructose intolerance because the formulation contains sorbitol
• Avoid or obtain specialist advice in phenylketonuria because aspartame supplies phenylalanine

Monitoring

• Assess persistent or worsening symptoms rather than repeatedly continuing treatment.
• Watch for hypersensitivity, excessive mouth or throat numbness and impaired swallowing.
• With prolonged exposure, check for removable brown tooth discolouration.

Clinical pharmacology

Chlorhexidine is a cationic antiseptic active against Gram-positive and Gram-negative bacteria and some fungi. Lidocaine blocks voltage-gated sodium channels, interrupting sensory nerve impulses. Chlorhexidine absorption after oral topical use is insignificant; some lidocaine may be absorbed through the mucosa or after swallowing.

Formulation and product differences

• The selected product is a lemon-flavoured compressed lozenge for oromucosal use.
• It is sugar-free and contains sorbitol, aspartame, acesulfame K, magnesium stearate and lemon flavouring.

Lozenge

Route: Oromucosal

Strengths: 5 mg + 1 mg