chlorhexidine dihydrochloride: clinical use

Prescribing considerations

• Confirm the product and intended site because chlorhexidine formulations are not interchangeable.
• Restrict the cream to minor skin trauma or minor-surgery antisepsis; avoid extensive skin application.
• Reassess persistent or worsening infection.
• Check for previous reactions to chlorhexidine-containing products or medical devices.
• Cetyl alcohol, stearyl alcohol and wool fat may cause local contact reactions.

Contraindications and cautions

• Known hypersensitivity to chlorhexidine or another product component
• Application where the preparation could contact a perforated eardrum

Monitoring

• Local irritation, dermatitis, urticaria or sensitisation
• Persistent or worsening infection
• Immediate respiratory or cardiovascular features of hypersensitivity
• Eye pain, inflammation or visual disturbance after accidental exposure

Clinical pharmacology

Chlorhexidine dihydrochloride is a biguanide antiseptic with membrane-disrupting, concentration-dependent inhibitory and bactericidal effects. Absorption through intact adult skin is minimal. Activity persists in blood and pus but may be reduced by organic material.

Formulation and product differences

• The selected product is a cutaneous cream, not an oral, throat, surgical-preparation or wash formulation.
• It contains white soft paraffin, liquid paraffin, wool fat, cetyl alcohol and stearyl alcohol.
• Do not extrapolate indications, administration or precautions from products containing different salts, vehicles or additional active ingredients.