Chlorhexidine bigluconate: instructions for use for aqueous and alcoholic solutions. Chlorhexidine Bigluconate: why, when and how is the product used? Chlorhexidine bigluconate aqueous solution

Chlorhexidine bigluconate: instructions for use and reviews

Chlorhexidine bigluconate is an antiseptic drug.

Release form and composition

Dosage forms of Chlorhexidine bigluconate release:

solution for local and external use: slightly opalescent or transparent, slightly yellowish or colorless, odorless (in bottles or jars with a dropper cap of 100 ml);
solution for external use 0.05%: transparent or slightly opalescent, colorless, odorless (in bottles or cans of 100 ml).

Composition of 1000 ml solution for local or external use (0.2%, 0.5%, 1% or 5%, respectively):

active substance: chlorhexidine bigluconate 20% - 10, 25, 50 or 250 ml;

Composition of 1000 ml solution for external use 0.05%:

active substance: chlorhexidine solution 20% for the preparation of dosage forms - 2.5 ml (corresponds to the content of chlorhexidine bigluconate - 500 mg);
auxiliary component: purified water - up to 1000 ml.

Pharmacological properties

Pharmacodynamics

Chlorhexidine digluconate is a disinfectant and antiseptic. The drug against gram-positive and gram-negative bacteria exhibits both bactericidal and bacteriostatic effects, depending on the concentration used. Shows activity against pathogens of sexually transmitted infections (genital herpes, gardnerellosis), gram-positive and gram-negative bacteria (ureaplasmosis, chlamydia, trichomoniasis, gonococcus, treponema pale). Does not affect fungi, microbial spores, acid-fast forms of bacteria.

The drug is stable, after processing the skin (postoperative field, hands) remains on it in a small amount, sufficient for the manifestation of a bactericidal effect.

In the presence of various organic matter, secretions, pus and blood retains its activity (slightly reduced).

In rare cases, it causes irritation of the skin and tissues, and allergic reactions. Does not have a damaging effect on objects made of metals, plastic and glass.

Pharmacokinetics

Characteristics of Chlorhexidine Bigluconate:

suction: from gastrointestinal tract practically not absorbed; C max ( maximum concentration in blood plasma) after accidental ingestion of 0.3 g of the agent is achieved after 30 minutes and is 0.206 μg per 1 liter;
excretion: 90% is excreted through the intestines, less than 1% is excreted by the kidneys.

Indications for use

genital herpes, syphilis, gonorrhea, trichomoniasis, ureaplasmosis, chlamydia (for the prevention of sexually transmitted infections; no later than 2 hours after intercourse);
cracks, scuffs (for disinfection skin);
infected burns, purulent wounds;
fungal and bacterial diseases skin and mucous membranes genitourinary organs;
alveolitis, periodontitis, aphthae, stomatitis, gingivitis (for irrigation and rinsing).

wounds and burn surfaces (for treatment);
infected scuffs, skin cracks and open mucous membranes (for processing);
sterilization of medical instruments at a temperature of 70 ° C;
disinfection of working surfaces of equipment and devices, including thermometers, for which it is undesirable heat treatment.

disinfection of devices, working surfaces of medical equipment and thermometers for which heat treatment is undesirable;
treatment of the surgeon's hands and operating field before surgery;
disinfection of the skin;
burn and postoperative wounds (for treatment).

The drug is used for the preparation of alcohol, glycerol and aqueous solutions with concentrations of 0.01–1%.

Contraindications

Absolute:

dermatitis;
allergic reactions (solution for external use 0.05%);
individual intolerance to the components contained in the preparation.

Relative (diseases / conditions in the presence of which the appointment of Chlorhexidine bigluconate requires caution):

childhood;
pregnancy;
lactation period.

Instructions for the use of Chlorhexidine bigluconate: method and dosage

Chlorhexidine bigluconate solution is applied topically, topically.

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

On the affected surface of the skin or mucous membranes of the oral cavity, urogenital organs, by means of irrigation or a tampon, apply 5-10 ml of the drug and leave for 1-3 minutes. Frequency rate of application - 2-3 times a day.

For the prevention of sexually transmitted diseases, the contents of the bottle are inserted through the nozzle into the vagina of women (5-10 ml) or into urethra for men (2-3 ml), for women (1-2 ml) for 2-3 minutes. It is recommended not to urinate for 2 hours after the procedure. Also, the drug should be used to treat the skin of the genitals, pubis, internal surfaces thighs.

Solution for local and external use 0.5%

5-10 ml of the preparation in the form of rinsing, applications or irrigation is applied to the affected surface of the skin or mucous membranes and left for 1-3 minutes. Frequency rate 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 treatment with the drug, the surgeon's hands are thoroughly washed with soap and wiped dry, after which they are washed with 20-30 ml of solution. Postoperative wounds treated with a clean swab.

Work surfaces and medical instrument 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.

Side effects

During the period of application of Chlorhexidine bigluconate, the development of photosensitization, dermatitis, dryness and itching of the skin, and allergic reactions is possible. In the treatment of pathologies oral cavity possible taste disturbance, tartar deposition, staining of tooth enamel. After using the solution for 3-5 minutes, hand skin stickiness is possible.

Overdose

There are no data on chlorhexidine bigluconate overdose.

special instructions

If the solution gets on the mucous membranes of the eyes, immediately rinse them thoroughly with water.

It is important not to allow the agent to enter the wound during perforation. eardrum, damage spinal cord, open traumatic brain injury.

It should be borne in mind that if hypochlorous bleaching agents get on fabrics that were previously in contact with preparations containing chlorhexidine, brown stains may appear on them.

The drug is used in a neutral environment; if the pH ranges from 5 to 8, the difference in activity is small; if pH> 8, a precipitate forms. The bactericidal properties of the drug are somewhat reduced by hard water, and increased by an increase in temperature. Partial decomposition of the agent is observed at temperatures> 100 ° C.

Application during pregnancy and lactation

Chlorhexidine bigluconate is used with caution during pregnancy and lactation.

Childhood use

Chlorhexidine bigluconate is prescribed with caution to children.

Drug interactions

Chlorhexidine bigluconate is pharmaceutically incompatible with alkalis, soap and other anionic compounds (carboxymethylcellulose, gum arabic, colloids); compatible with products containing a cationic group (cetrimonium bromide, benzalkonium chloride).

Chlorhexidine bigluconate increases the sensitivity of bacteria to cephalosporins, neomycin, kanamycin, chloramphenicol. Its effectiveness is enhanced by ethanol.

Analogs

Chlorhexidine bigluconate analogs are Chlorhexidine, Hexicon and Amident.

Terms and conditions of storage

Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.

Shelf life is 2 years.

Chlorhexidine is an antiseptic drug.

Release form and composition

Chlorhexidine dosage forms:

: light yellow or colorless, slightly opalescent, odorless or with a faint odor (in light-protective glass or polyethylene bottles of 0.025; 0.05; 0.07; 0.1; 0.2; 0.5 or 1 liter);
: transparent, colorless, slightly opalescent, with a characteristic alcoholic odor (in bottles of 0.025; 0.05; 0.1; 0.5 or 1 l, 1 bottle in a cardboard box);
vaginal suppositories: white with a yellowish tinge or white, torpedo-like with possible marbling of the surface (in contoured cell packs, 5 pcs., in a cardboard box 2 packs);
: transparent, slightly opalescent, colorless, with an alcoholic odor (in vials or bottles with a spray device, 0.07 or 0.1 l each).

1 bottle with a solution for local and external use contains:

active substance: chlorhexidine bigluconate solution 20% - 0.0025; 0.01; 0.025; 0.05; 0.25 l (corresponds to the content of chlorhexidine bigluconate - 0.5; 2.5, 10 or 50 g);
auxiliary component: purified water - up to 1 liter.

Composition of 1 liter of alcohol solution for external use:

active substance: chlorhexidine bigluconate solution 20% - 0.025 l (corresponds to the content of chlorhexidine bigluconate - 5 g);
auxiliary components: ethyl alcohol 95% (ethanol) - 0.7185 l; purified water - up to 1 liter.

Composition of 1 vaginal suppository:

active substance: chlorhexidine bigluconate solution 20% - 0.08 g (corresponds to the content of chlorhexidine bigluconate - 0.016 g);
auxiliary components: macrogol-400 - 0.121 g; macrogol-1500 - 2.299 g.

1 bottle with alcohol spray for external use contains:

active substance: chlorhexidine solution for the preparation of dosage forms 20% - 0.025 l (corresponds to the content of chlorhexidine bigluconate - 5 g);
auxiliary components: ethyl alcohol 95% (ethanol) - 0.7185 l (583 g); purified water - up to 1 l (281 g).

Indications for use

Solution for local and external use

Solution 0.05 and 0.2%:

sexually transmitted infections: genital herpes, syphilis, gonorrhea, trichomoniasis, ureaplasmosis, chlamydia (for prevention, no later than 2 hours after intercourse);
scuffs, cracks in the skin (for disinfection);
fungal and bacterial diseases of the mucous membranes and skin of the genitourinary organs, infected burns, purulent wounds;
application in dentistry: alveolitis, periodontitis, aphthae, stomatitis, gingivitis (for rinsing and irrigation).

Solution 0.5%:

wounds and burn surfaces, infected scuffs, cracks in the skin and open mucous membranes (for processing);
for sterilization of medical instruments (at a temperature of 70 ° C);
for disinfection of equipment and working surfaces of devices, including thermometers, for which heat treatment is undesirable.

Solution 1%:

for disinfection of working surfaces of medical equipment, thermometers, devices for which heat treatment is undesirable;
for the treatment of the hands of the surgeon and the operating field before the operation;
for skin disinfection;
for the treatment of burns and postoperative wounds.

A solution of 5% is used to prepare an alcohol, glycerol or aqueous solution with a concentration of 0.01–1%.

Solution for external use alcohol

hygienic treatment of the hands of surgeons and medical staff;
treatment of the skin of the elbow bends of donors, skin of the injection and surgical field;
disinfection of product surfaces in health care facilities medical purpose, small in area, including dental instruments, heat treatment of which is undesirable;
hygienic treatment of hands in medical institutions, medical personnel of institutions of various profiles and purposes.

Vaginal suppositories

sexually transmitted infections: genital herpes, syphilis, gonorrhea, trichomoniasis, ureaplasmosis, chlamydia and others (for prevention);
in gynecology and obstetrics with infectious and inflammatory complications: before intrauterine examinations, abortion, childbirth, surgical treatment gynecological diseases, before and after diathermocoagulation of the cervix, installation intrauterine device(for prevention);
bacterial vaginosis, colpitis (including nonspecific, mixed and Trichomonas).

Spray for external use alcohol

hygienic treatment of the elbow bends of donors, the hands of surgeons and medical personnel, the skin of the operating and injection field;
disinfection of surfaces of medical devices, small in area (including dental instruments);
with bacterial infections (including tuberculosis and nosocomial infections), fungal (candidiasis, dermatophytes) and viral origin in medical institutions;
hygienic hand treatment of medical personnel of institutions for various purposes and profile;
hygienic hand treatment of employees of enterprises Catering, Food Industry, utilities.

Contraindications

Solution for local and external use

dermatitis;

Conditions in which the solution is prescribed with caution:

childhood;
pregnancy;
breast-feeding.

Solution for external use alcohol

dermatitis;
individual intolerance to the components of the antiseptic agent.

Conditions in which an alcohol solution is prescribed with caution:

childhood;
pregnancy;
lactation.

Vaginal suppositories

childhood;
individual intolerance to the components of the antiseptic agent.

Conditions in which suppositories are prescribed with caution:

pregnancy;
lactation.

Spray for external use alcohol

allergic reactions;
dermatitis;
individual intolerance to the components of the antiseptic agent.

The spray is used with caution in children.

Method of administration and dosage

Solution for local and external use

A solution of 0.05 and 0.2% is applied by means of a tampon or irrigation in an amount of 5-10 ml on the affected surface of the mucous membranes or skin of the genitourinary organs, oral cavity for 1-3 minutes. Frequency rate of application - 2-3 times a day.

For the prevention of sexually transmitted diseases, 2–3 / 1–2 ml of the solution is injected into the urethra for men / women by means of a nozzle, and 5–10 ml of the agent for women into the vagina for 2-3 minutes. You must not urinate for 2 hours after the procedure. The skin of the genitals, pubis and inner thighs should be treated.

A solution of 0.5% for rinsing, irrigation and application, 5-10 ml by means of irrigation or tampons, is applied for 1-3 minutes to the affected surface of the mucous membranes or skin with exposure. Frequency rate of application - 2-3 times a day.

Before processing the working surfaces and medical instruments, a clean sponge is moistened (soaked) in the solution (also for a 1% solution).

A solution of 1% in an amount of 20-30 ml is used to treat the hands of the surgeon (previously washed with soap and dried). A clean swab is used to treat the skin of postoperative wounds.

The 5% solution is a concentrate and is used for dilution in accordance with the required concentration of the resulting solution.

In case of accidental contact with the mucous membranes of the eyes, rinse quickly and thoroughly with water.

Alcohol solution and spray for external use

The solution and alcohol spray are applied externally.

Dosage:

hygienic treatment of the hands of medical personnel: 5 ml of solution / spray is applied to the hands and rubbed for 2 minutes;
treatment of surgeons' hands: for pre-washed warm water with soap (for 2 minutes) and dried with a sterile gauze napkin, apply 5 ml of the product and rub in at least 2 times (you cannot wipe your hands with a towel after processing);
treatment of the elbow folds of donors or the operating field: with sterile gauze swabs abundantly moistened in a solution / spray, wipe the skin sequentially 2 times, leave for 2 minutes. Further, before the operation, the patient takes a bath / shower and changes clothes;
treatment of the operating field: wipe the skin in one direction with a sterile swab moistened with a solution / spray, leave for 1 min (2 min - for a spray);
disinfection of tables, equipment, armrests of chairs and other surfaces (small in area): they are treated with a cloth soaked in a solution / spray. The consumption of the product is determined based on the calculation of 100 ml of solution / spray per 1 sq. M. area.

When disinfecting the surfaces of medical devices with cloths soaked in water, visible contaminants are removed before processing. Before processing, the internal channels are washed with water using a syringe or a brush, wearing rubber gloves and an apron.

Containers, napkins and rinsing water used for rinsing should be disinfected by boiling or disinfectants according to the regimens used for tuberculosis / viral parenteral hepatitis in accordance with the current instructive and methodological documents. After removing the contamination, the product is completely immersed in an alcohol solution, filling the channels and cavities with it. If the product is detachable, disassemble it before immersion.

To avoid evaporation and a decrease in the concentration of alcohol, the container with the solution is tightly closed with lids.

Products for disinfection, previously washed from contamination, can be treated with the solution many times over 3 days (if the used antiseptic is stored in a tightly closed container that does not allow changes in alcohol concentration). The appearance of flakes and cloudiness of the solution / spray are the reason for their replacement.

Vaginal suppositories

Suppositories are administered intravaginally in the supine position.

Daily dose - 1 pc. 2 times a day. The duration of treatment is 7-10 days with a possible increase (if necessary) up to 20 days.

For sexually transmitted infections (for prevention), 1 pc is prescribed. no more than 2 hours after intercourse.

Side effects

Solution for local and external use

photosensitivity, allergic reactions, dermatitis, itching and dry skin;
taste disturbance, tartar deposition, staining of tooth enamel (in the treatment of oral pathologies);
stickiness of the skin of the hands (for 3-5 minutes).

Solution for external use alcohol

photosensitivity;
stickiness of the skin of the hands (for 3-5 minutes);
dermatitis, itching, dry skin, allergic reactions (skin rash).

Vaginal suppositories

allergic reactions;
itchy skin.

Spray for external use alcohol

dermatitis;
dry and itchy skin;
allergic reactions (skin rash).

special instructions

In cases of perforation of the tympanic membrane, spinal cord injury, open traumatic brain injury, it is important not to allow the solution to enter the cavity inner ear, on the surface of the meninges and brain.

It should be borne in mind that if hypochlorite bleaching agents get on fabrics that have previously been in contact with chlorhexidine-containing products, brown spots may appear.

With an increase in temperature, the bactericidal effect of the drug increases, and at temperatures> 100 ° C, it partially decomposes. The drug is not used in combination with iodine.

In the presence of pus in the blood, the activity of Chlorhexidine remains (somewhat reduced).

The alcohol solution and spray are not used on wounds and mucous membranes. In case of accidental contact with the mucous membranes of the eyes, the eyes are quickly and thoroughly washed under running water, and then instilled with albucide (30% sodium sulfacil solution); if swallowed, they wash the stomach with plenty of water, then take an adsorbent (tablets activated carbon 10–20 pcs.), If necessary, carry out symptomatic treatment.

The solution is prescribed with caution to children, during pregnancy and lactation, since the ethanol included in its composition is partially absorbed through the skin and can lead to depression of the central nervous system.

Alcohol solution and spray are flammable. It is important not to allow them to come into contact with switched on heating devices or open flames.

The spray has a prolonged effect (up to 4 hours).

Drug interactions

it is pharmaceutically incompatible with other anionic compounds (carboxymethylcellulose, gum arabic, colloids), alkalis, soaps, with intravaginal use - with detergents containing an anionic group (sodium carboxymethylcellulose, sodium lauryl sulfate, saponins);
compatible with drugs that include a cationic group (cetrimonium bromide, benzalkonium chloride);

Very efficient and cheap antimicrobial agent is chlorhexidine bigluconate, which has found application in almost all areas of medicine due to its exceptional antibacterial properties. Today we'll talk about the treatment of which ailments this drug is useful.

How does chlorhexidine bigluconate work?

As an antiseptic with local bactericidal action, the drug is able to change the cell membrane of the microorganism, which leads to the death of the bacteria.

Sensitive to chlorhexidine bigluconate:

Trichomonas vaginalis - the causative agent of trichomoniasis;
Neisseria gonorrhoeae - the causative agent of gonorrhea;
Chlamidia spp - chlamydia, causing conjunctivitis, genital and intestinal infectious diseases, psittacosis, etc.;
Bacteroides fragilis - pathogens anaerobic infections: sinusitis, otitis media, oral infections, inflammatory diarrhea, necrotizing pneumonia, abscesses;
Treponema pallidum - the causative agent of syphilis;
Gardnerella vaginalis- causes gardnerellosis in women, men in 10% of cases are carriers of the infection.

The activity of the drug was also revealed against such microorganisms as Proteus spp, Ureaplasma spp and Pseudomonas spp, which are found in infections of the genitourinary system.

Spores of fungi and viruses (excluding) are resistant to the drug.

The use of chlorhexidine bigluconate in dentistry

The tool is widely used by dentists to disinfect the oral cavity in the treatment of gingivitis, periodontitis, (concentration 0.05% or 0.1%, rinsing three times a day).

It is appropriate to use chlorhexidine bigluconate for mouthwash if it is not possible to brush your teeth for some reason. The drug, however, leaves on the tooth enamel yellow bloom therefore it is preferable to use it diluted. Effectively rinse dentures with this product.

Dentists also use chlorhexidine digluconate when flushing the teeth canals, abscesses, fistulas and after patchwork operations on the periodontium.

The use of chlorhexidine bigluconate in gynecology

This antiseptic is irreplaceable when processing the genital tract after surgery. Chlorhexidine bigluconate is effective as a means of preventing sexually transmitted diseases: a preparation of a concentration of 0.05% is treated immediately after unsecured contact the vagina (5 - 10 ml) and the urinary canal (1 - 2 ml), as well as the external genitals, thighs.

With inflammation urinary tract shows the use of chlorhexidine bigluconate concentration 0.05% 1 - 2 times a day: the drug is injected into the urinary canal in 2 - 3 ml for 10 days.

The use of chlorhexidine bigluconate for acne

Each rash is treated pointwise, but it is not recommended to wipe large areas of skin with chlorhexidine with bigluconate, since the product can cause dryness and flaking.

Effectively spot treat pimples every day before using a basic acne remedy (cream, gel).

Other Uses for Chlorhexidine Bigluconate

ENT doctors prescribe this antiseptic for the prevention of postoperative infections (rinsing or irrigation twice a day, 0.1% or 0.05%).

Solutions of 0.05%, 0.02% or 0.5% are effective in processing open wounds, burns: irrigation and applications (1 - 3 minutes) are done three times a day.

Surgeons use chlorhexidine bigluconate (20%) with ethyl alcohol(70%) in a ratio of 1:40 for disinfection of the operating field.

Antiseptics and solutions containing these substances are widely used in medicine. They are used as preventive and treatment methods impact on both humans and environmental objects.

The chemical composition of antiseptics implies the effect of microbes on the elements of the cell, which causes their death. Such solutions are used to treat surfaces and tools in hospitals as well as the human body to protect it from bacteria.

Chlorhexidine bigluconate is one of the most popular antiseptic drugs... Chlorhexidine solution is used in many fields of medicine, including gynecology. How to use the drug?

Mechanism of action

Before disassembling the instructions for use of the drug, it is worth learning about its mechanism of action. Such a remedy as chlorhexidine bigluconate has found wide application in medicine precisely because of the peculiarities of its effect on microbes.

Chlorhexidine solution has the following mechanism of action:

The substance binds to special chemical groups on the surface of bacterial cells that contain phosphorus.
There is a change in water-salt metabolism in cells.
Through the membrane of the bacteria, liquid actively penetrates inside.
The bacterial cell is filled with fluid, which causes the death of all structural components.
The microbial wall ruptures under the increasing pressure of the fluid inside the bacterium.

This mechanism of action of chlorhexidine is especially remarkable in that it is observed in relation to a wide range of the most diverse pathogenic pathogens. Among the sensitive microbes are the following:

Treponema.
Chlamydia.
Ureaplasma.
Gonococcus.
Gardenella.
Bacteroids.
Trichomonas.
Herpes virus.

The listed pathogens very often cause diseases of the urogenital zone. That is why the medicine is very often used in gynecology.

Medical use

The antiseptic effect of the drug allows the use of chlorhexidine bigluconate not only for treatment various infections, but also for the destruction of bacteria in hospitals.

As remedy the effect of the drug is often compared to a substance such as hydrogen peroxide. A comparison of these drugs will be made below. However, the effects of these agents are really similar:

Destruction of bacteria, protozoa and viruses in the place of their reproduction.
Prevention of the spread of infection from the outbreak.
Protection of the skin from the penetration of additional microorganisms.
Keeping active in the presence of pus.
Suppression of inflammation, which means the main symptoms of the disease due to the death of pathogens.

These effects are used to treat infectious diseases.

To prevent infection even before clinical manifestations, medical workers use the drug as a sterilizing agent.

The last method of using the substance chlorhexidine bigluconate will be discussed in detail below.

Indications for use

Numerous medicines with different trade names contain chlorhexidine bigluconate. Most of them are used in gynecology, but the drug has found applications in other areas of medicine.

Instructions for use of the product contain the following indications for its use:

Acute cystitis and exacerbation chronic form infections - an antiseptic acts against most microbes, causing inflammation bladder mucosa.
Wound surface - for antiseptic treatment and preventing wound infection.
Prophylaxis sexually transmitted diseases after unprotected sex.
Bacterial colpitis, vaginosis - infectious diseases of the vagina caused by nonspecific pathogens.
Trichomoniasis, syphilis, gonorrhea, chlimidiosis - mainly as a prophylaxis or additional funds. Specific infection requires the appointment of antibiotics.
Preventive treatment birth canal in women during preparation for childbirth.
Gingivitis, stomatitis and others inflammatory diseases in dental practice.
Infectious diseases of the skin and mucous membranes, including acne.
Pharyngitis, laryngitis and tonsillitis - use in ENT practice for rinsing inflamed cavities.

Such wide range indications associated with the high activity of the funds. Unlike the drug hydrogen peroxide, the drug is used in different areas medicine.

Application for herpes

Herpetic infection and others viral diseases people are characterized limited number drugs active against the pathogen. In these conditions, it becomes relevant to choose a means that could not harm a person and achieve the desired effect.

Chlorhexidine bigluconate is used to treat such forms of herpes as:

Genital herpes in women and men.
Generalized eruptions on the skin and mucous membranes.
The recovery period after herpes infection- to prevent the addition of secondary bacterial flora.
Herpetic infection in pregnant women - the use of chlorhexidine is allowed at any period of gestation.

Chlorhexidine bigluconate should not be used to treat labial herpes on the face - a localized focus of infection is easier to cure with antiviral drugs... Chlorhexidine digluconate is a rather aggressive solution for the skin of the face, so it should not be used without sufficient need.

If there is a risk of contracting herpes from a new sexual partner, it is possible to use the drug as a prophylaxis.

How to do this and what dosage form should be used will be discussed below.

Contraindications

Despite the rather pronounced chemical effect of the drug, its use is associated with a rather small number of contraindications and side effects... They are well studied by doctors, so doctors focus on them when prescribing a remedy.

Contraindications include the following conditions:

A history of allergy reactions to chlorhexidine bigluconate or at the first attempt to use the drug.
Inflammatory diseases of the skin - dermatitis. Before identifying the cause inflammatory response skin, the medicine should not be used.
Children's age of the patient - the activity of the drug when used in children has not been studied, it should be used with caution in young patients.

If you have any of the listed contraindications, you should not use the medicine. This is also reported by the instructions for use of the drug.

Side effects

As with any treatment method, a number of side effects may occur when chlorhexidine is applied to the skin and mucous membranes.

The undesirable reactions that the drug can cause include the following:

Skin rash, itching, burning - manifestations allergic reaction on the components of the drug.
Dry skin - usually not associated with allergies, dehydration of epidermal cells is assumed with the use of chlorhexidine.
Dermatitis - inflammation of the dermis can be caused by specific skin sensitization to the antigens of the drug.

If you follow the technique of using the medicine, the risk of adverse reactions is reduced to a minimum. Before use, read the instructions, or rather consult a specialist.

The likelihood of undesirable effects of the drug also increases with the simultaneous use of other chemical compounds:

Soap.
Gum arabic.
Alkalis.
Colloids.
Carboxymethylcellulose.

Chlorhexidine bigluconate is able to enter into chemical reaction with the listed substances and cause negative effects.

Handling items

The listed aspects of the use of the drug are associated with its use on the patient's body. but pharmacological properties medicines are also used to process various instruments in medical institutions.

In order to disinfect and prevent infection, the drug is used to treat the following items:

Surgical field on the patient's body.
Surgeon's hands and gloves.
Reusable surgical instruments.
Operating table and instrument tables.
Disinfection of walls, floors in rooms.

It should be noted that in this case, a solution of the drug with a different concentration is used. If a 0.05% solution is used for the treatment and prevention of diseases, as well as a 0.5% gel, then the items are sterilized with a 1% aqueous solution of the drug.

Chlorhexidine and hydrogen peroxide

Very often, the agent in question is compared with a drug with a similar mechanism of action - hydrogen peroxide. There is a misconception that hydrogen peroxide and chlorhexidine are the same substance.

To understand the advisability of using a particular drug, you should compare them:

Hydrogen peroxide is used to treat wounds and objects to protect against gram-positive and gram-negative nonspecific bacteria.
In contrast to hydrogen peroxide, chlorhexidine is active against a wide range of pathogens, not only nonspecific, but also of a specific nature.
Hydrogen peroxide cannot be used to treat or prevent herpes, infections caused by protozoa.
Hydrogen peroxide is also active against anaerobic and putrefactive microflora, this aspect is an advantage in relation to chlorhexidine.
Hydrogen peroxide has the ability to stop bleeding, which is used in dental practice.
Unlike chlorhexidine, peroxide is short-lived, therefore it is used only at the time of possible infection.

Forms of issue

Various dosage forms of the drug are available in a wide variety pharmaceutical companies... This creates certain difficulties when choosing a drug.

Pay attention to active substance medicines, dosage and form of release. The concentration of the drug for the treatment and treatment of objects was mentioned above, you should also understand the forms of application of the agent.

The most popular ways to use chlorhexidine are:

Vaginal suppositories are widely used in gynecology for the treatment of infectious diseases. There is an option for children, but its use is limited.
Gel for topical application - it is possible to apply the product to the skin and mucous membranes. It is used in dentistry.
A solution with a low concentration of the drug - for the treatment of the conditions listed above, including dental and ENT diseases.
An aqueous solution with a high concentration - for the treatment of objects and premises, the hands of the surgeon.
Bactericidal patches - an antiseptic is added to the patch to prevent skin infection.

From the listed forms, the attending physician will help you choose the one you need. Each method has its own instructions for the use of chlorhexidine.

Instructions for use

Numerous uses of the drug have different algorithms. Instructions for use different forms can be boiled down to the following guidelines:

Water solutions in low concentrations are used for irrigation and rinsing of the skin, mucous membranes and wound surfaces. 10 ml of the drug is applied to the damaged area for 3 minutes, 3 times a day. Wash off the solution with water.
For the prevention of genital infections, the solution is inserted into the urethra (2 ml) and the vagina (10 ml) with the help of a bottle and a special nozzle for 2 minutes.
Inflammatory diseases urinary tract are treated with a similar injection into the urethra of 3 ml of solution 2 times a day for 20 days.
Vaginal suppositories are inserted in 1 pc. 3 times a day for 1-3 weeks.
Gel for topical application applied in small quantities and easily spread over the surface. Used 3 times a day.
The plaster is applied as follows: the film is removed from the surface, the plaster is applied to the skin, the edges should fix the main bandage.

The technique of using the tool for processing instrumentation is owned by medical workers in medical institutions.

Advantages and disadvantages

To do right choice drug for the treatment of infectious diseases, you should know the advantages and disadvantages of each medicine.

Chlorhexidine has the following benefits:

Active in relation to a large number microorganisms.
It is used not only for treating a person, but also for processing instrumentation.
It has a large number of dosage forms.
It has a low cost.
It can be used at any stage of pregnancy.
It has few contraindications and side effects.

The listed benefits should be compared with negative sides medicines. The disadvantages of the drug include the following aspects:

It is a fairly aggressive chemical solution.
Cannot be used in children.
The large number of use cases makes it difficult for the patient to choose.
Chemically interacts with some common substances.
Suitable for topical use only.

The peculiarities of using the drug are taken into account by the attending physician when prescribing chlorhexidine.

Chlorhexidine is a widely used antiseptic that is intended for topical external use.

The drug has an effect on gram-negative and gram-positive bacteria, eliminating the development inflammatory process in the tissues of the body. Differs in stable properties. After application remains active, and long time provides a bactericidal effect. This is one of the most common and safe means... The solution is capable of stopping the activity of many Gramplus and Gramminus pathogens.

Approved for use during pregnancy, you can treat wounds for children, used in gynecology, dentistry for rinsing the mouth and throat, venereal medicine.

Clinical and pharmacological group

Antiseptic.

Conditions of sale from pharmacies

Can buy without a doctor's prescription.

Price

How much does Chlorhexidine Bigluconate cost in pharmacies? average price is at the level of 20 rubles.

Composition and form of release

Name - Chlorhexidine (Chlorhexidine). It is produced in the form of a solution for external use of 0.05% and 20%. And also in the form of candles, gels, sprays and ointments.

A solution of 0.05% Chlorhexidine is provided in a polymer bottle with a nozzle or in glass bottles of 100 ml. The packaging for the drug is of the 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.

Pharmacological effect

Chlorhexidine bigluconate - this salt is used as an antiseptic - acts on microorganisms in different ways, and it depends on the type of microbes.

Mushrooms... The effect of the drug on pathogenic and opportunistic fungi is very similar to the effect on bacteria. Destroying the cell wall, the antiseptic penetrates into the cytoplasmic membrane of the fungus and irrevocably destroys the cell.
Bacteria... The positively charged chlorhexidine molecule binds to the negatively charged bacterial cell wall. The result is destabilization and damage to the cell wall. Interestingly, this process only takes about 20 seconds. However, the role of the antiseptic does not end there. The drug penetrates into the cell and attacks the inner cytoplasmic membrane of the bacterium, as a result of which the contents simply flow into the cytoplasm. The cell is dying. Chlorhexidine bigluconate high concentration can cause hardening or freezing of the cytoplasm.
Biofilm... It is a complex collection of microorganisms that grow on a solid organic (such as dental plaque) or inorganic surface. Biofilms are characterized by structural heterogeneity, genetic diversity and complex interactions within the conglomerate. The matrix protects the cells inside it, which causes a special resistance of biofilm microorganisms to antibacterial drugs... Most antiseptics are unable to function within the complex biofilm structure. Chlorhexidine stood out from the slender line of powerless relatives and in which it proved its exceptional abilities. The drug can prevent adhesion (adhesion) of microorganisms to a solid surface, as a result of which the growth and development of biofilms is stopped.
Other microorganisms... Unlike many antiseptic Chlorhexidine solution demonstrates high efficiency against other microbes, for example, bacterial spores and protozoa. It is also thought to act against viruses that are coated with an additional envelope: the virus herpes simplex, HIV, cytomegalovirus, influenza virus. Unenveloped viruses are resistant to Chlorhexidine. These include the causative agents of SARS rotavirus, adenovirus and enteroviruses.

Indications for use

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

Solution 0.1% (0.05 and 0.2):

appointed in preventive purposes after surgical interventions and with injuries in dentistry, laryngotorhinological organs.
when disinfecting damaged mucous membranes of the mouth and genitals.
treatment of integuments to prevent infection after manipulations in the surgical, obstetric practice and in gynecology.
as an antiseptic for wounds, scratches, abrasions, cuts and burns.
to protect against viruses entering the urethrogenital system.
for gargling.

Solution 0.5%:

for the treatment of surfaces, devices and medical instruments in a state heated to 75 0 С.

Solution 1%:

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

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

Contraindications

Chlorhexidine 0.05% should not be used:

for the treatment of patients with dermatitis;
for disinfection after operations on the central nervous system and the auditory canal;
for the treatment of ophthalmic diseases;
simultaneously with other antiseptics.

The drug is used with caution in childhood.

Appointment during pregnancy and lactation

Chlorhexidine can be used as needed 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 directly 1-2 weeks before childbirth in order to sanitize the birth canal and treat colpitis, vaginitis, and thrush.

Chlorhexidine bigluconte can be used externally and locally by nursing mothers. It is not necessary to interrupt lactation for this.

Dosage and method of administration

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

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

For the prevention of sexually transmitted diseases, the contents of the bottle are inserted through the nozzle into the vagina of women (5-10 ml) or into the urethra of men (2-3 ml), women (1-2 ml) for 2-3 minutes. It is recommended not to urinate for 2 hours after the procedure. Also, the drug should be used to treat the skin of the genitals, pubis, inner thighs.

Solution for local and external use 0.5%

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 treatment with the drug, the surgeon's hands are thoroughly washed with soap and wiped dry, after which they are washed with 20-30 ml of solution. Postoperative wounds are treated with a clean swab.

Work surfaces and a medical instrument 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.

Adverse Reactions

When using Chlorhexidine Bigluconate in the course of treatment, some patients experienced the following side effects:

dry skin;
itchy skin;
the appearance of a rash;
dermatitis;
photosensitivity.

With prolonged use of the product for rinsing and irrigating the oral cavity, taste sensations may change, tartar appears, and teeth discoloration is noted.

Overdose

If the instructions are followed, an overdose of chlorhexidine is excluded. If a person accidentally swallows the drug, the stomach should be immediately washed out using milk, a raw egg, gelatin or soap.

special instructions

Remains active in the presence of blood impurities and organic substances. Do not allow chlorhexidine to get into the eyes (with the exception of special dosage form intended for rinsing the eyes), as well as contact with meninges and the auditory nerve.

Compatibility with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

Ethyl alcohol enhances the bactericidal effect.
Does not combine with anionic compounds, in particular with soap.
Does not combine with chlorides, carbonates, phosphates, sulfates, borates, citrates.
Under the influence of the agent, the sensitivity of microorganisms to the influence of neomycin, kanamycin, chloramphenicol, cephalosporin increases.
If the pH of the medium exceeds 8, a precipitate forms. If hard water was used in the preparation of the solution, its bactericidal effect is reduced.