Update: October 2018

Chlorhexidine is a popular drug, a local antiseptic, which is successfully used as a universal disinfectant and antimicrobial agent, and is especially popular in the post-Soviet countries.

The chemical compound chlorhexidine was discovered in Great Britain in 1950, and already in 1954 the first skin antiseptic based on this substance appeared. Subsequently, the substance began to be added to urological lubricants, impregnated with catheters, implants, and overalls for medical personnel. It is part of a range of mouth rinses and toothpastes. They are widely used in veterinary medicine.

It is noteworthy that during the period of commercial use and numerous studies of chlorhexidine, the possibility of the formation of chlorhexidine-resistant microorganisms has not been confirmed. However, the use of Chlorhexidine is capable of causing bacterial antibiotic resistance. The drug belongs to the group of budget medicines, remains available to the general population.

Pharmaceutical group: antiseptic for topical use.

Composition, physical and chemical properties, price

The drug is present on the pharmaceutical market in several dosage forms, each of which is characterized by its own field of application. In addition to the drugs described below, registered in Russia, there are creams, gels, ointments with a similar active ingredient.

Solution 0.05% (chlorhexidine aqueous solution)	Spray	Candles (commercial name - hexicon)
Basic substance: 0.5 mg chlorhexidine bigluconate in 1 ml solution	25 mg chlorhexidine solution 20% in 1 bottle	16 mg chlorhexidine bigluconate in 1 supp.
Excipients: Purified water to the required volume	Ethyl alcohol 95% - 718.5 ml; purified water, until a solution volume of 1 l is obtained	Polyethylene oxide 400, polyethylene oxide 1500
Physiochemical properties: Liquid, clear solution	Colorless, transparent, sometimes slightly opalescent liquid with an alcoholic odor	Vaginal suppositories are white or yellowish, torpedo-shaped, slightly marbled surface.
Packaging, price: Available in various types of packaging (plastic, glass bottles), with or without dispensers. Price: 0.05% solution 100 ml: 10-15 rubles.	70 and 100 ml bottles / vials with a nozzle or a spray cap. Price 100 ml: 98 rubles.	1 or 5 supp. In a blister contour packing. 1, 2 packs in a pack. Price: No. 10 - 270-280 rubles.

pharmachologic effect

The instructions for the use of chlorhexidine indicate that the drug has a local antiseptic effect, to a greater extent bactericidal. Changes the properties and composition of the cell membranes of microorganisms. The cations formed during the dissociation of the salts of the active substance begin to react with the shell bacterial cells having a negative charge. The lipophilic groups of the antiseptic contribute to the disaggregation of the membrane of microorganisms, which has a lipoprotein structure, and lead to a violation of the osmotic balance, the loss of phosphorus and potassium from the bacterial cell. The destruction of the cytoplasmic membrane ultimately leads to the death of bacteria.

Chlorhexidine bigluconate solution is effective against a wide range of microorganisms: Trichomonas vaginalis, Bacteroides fragilis, Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamidia spp., Treponema pallidum, Ureaplasma spp. Has a moderate effect on certain strains of Pseudomonas spp. and Proteus spp. Viruses (except for the herpes virus) and fungal spores are resistant to the action of the drug.

It has a long-term antibacterial effect, can be used for antiseptic treatment of the operating field and the surgeon's hands, since after treatment the active substance remains on the skin for some time. Retains antimicrobial activity in a purulent environment, blood, but the effectiveness is somewhat reduced.

Pharmacokinetics

Local application has no systemic effect - the drug is not absorbed into the bloodstream.

Indications

Solution

Application in gynecology:

• colpitis Trichomonas;
• itching of the vulva;
• cervical erosion;
• prevention of sexually transmitted diseases: gonorrhea, trichomoniasis, syphilis, chlamydia, ureaplasmosis.

In dentistry and ENT practice:

• gingivitis;
• aphthae;
• stomatitis;
• alveolitis;
• periodontitis;
• disinfection of dentures (partially removable, removable);
• angina;
• postoperative hygiene in dental and ENT departments.

As a local antiseptic for:

• treatment of wounds, including burn surfaces;
• disinfection of the skin, including the operating field;
• treatment of hands of medical staff, surgeon;

It is also used for disinfection of work surfaces, equipment, instruments, thermometers that do not allow heat treatment.

Spray

• Hygienic treatment of the hands of a surgeon and other medical staff in institutions of various profiles;
• Treatment of the skin area of ​​the injection, surgical fields, elbow folds (skin) from donors;
• Disinfection of small surfaces of medical products (for example, ENT, dental instruments) for infections of various etiologies (bacterial, fungal, viral) in health care facilities;
• Hygienic treatment of the skin of the hands of catering workers, food industry workers, utilities.

Suppositories

• Prevention of sexually transmitted diseases: syphilis, chlamydia, trichomoniasis, ureaplasmosis, gonorrhea, genital herpes;
• Prevention of complications of an infectious and inflammatory nature in gynecology and obstetrics (before childbirth, termination of pregnancy, surgical treatment, before and after the installation of an intrauterine coil, before and after diathermocoagulation (cauterization) of the cervix, before performing an intrauterine examination;
• Treating bacterial vaginosis;
• Colpitis therapy (including mixed, Trichomonas, nonspecific).

Contraindications

• Hypersensitivity to the active or auxiliary components.
• Dermatitis, allergic reactions at the site of application.

Pregnancy, lactation

Not contraindicated in lactation and pregnancy.

special instructions

It is prescribed with caution for the treatment of children. In case of accidental ingestion of any form of chlorhexidine, immediately rinse the stomach with sufficient water, and then take the adsorbent.

The spray should not be applied to mucous membranes and wounds. The solution and spray are not allowed for contact with the auditory nerve and meninges. In case of accidental contact with these areas, rinse the drug thoroughly under running water. If the spray gets into the eyes, also rinse with water and drip with albucid.

The drug is incompatible with alkalis, soap and other anionic compounds (gum arabic, colloids, carboxymethyl cellulose, sodium lauryl sulfate, saponins). It is not used simultaneously with other antiseptics.

Do not forget that chlorhexidine is a drug, not a hygiene product, so it cannot be used for daily rinsing of the mouth and teeth, as well as for douching. There are strict indications for which such a procedure is advisable and necessary, and they should be adhered to. If chlorhexidine is used uncontrollably, it is fraught with imbalance in microflora, the development of dysbiosis and allergic reactions.

Dosage

Solution

• Prevention of sexually transmitted diseases. It is used no later than 2 hours after the break of the condom, unprotected intercourse. For men, about 2-3 ml of the drug is injected into the urethra, for women - 2-3 ml into the urethra and 5-10 ml - additionally into the vagina (chlorhexidine in the form of douching). The skin around the genitals is also necessarily processed. Urination can be carried out no earlier than 2 hours after the administration of the drug.
• In gynecology. Use as douching when indicated. It is carried out in a horizontal position, squeezing a few drops of the drug from the bottle into the vagina. After the procedure, you need to lie down for 5-10 minutes.
• For inflammatory diseases of the urinary tract in men and women. 2-3 ml of solution is injected into the urethra once or twice a day for 10 days in a row.
• For the treatment of skin lesions, wounds, burns, the solution is applied in the form of an application, which is left for 1-3 minutes.
• For gargling with sore throat, tonsillitis, pharyngitis. Recommendations for use for rinsing - rinse the mouth with warm water before the procedure. Then take 10-15 ml of the solution and rinse your throat thoroughly for about 30 seconds. Do not eat or drink for 60 minutes after the procedure. It is not necessary to dilute chlorhexidine - a 0.05% solution is suitable for the procedure.
• In dentistry. For rinsing teeth, for washing the periodontal canal, fistulas, abscess. It is also used to treat the gums after flap surgery on the periodontium.

Spray

• For hygienic treatment of the hands of the medical staff, ~ 5 ml of the spray is distributed on the hands and rubbed in for 2 minutes.
• To treat the surgeon's hands, first thoroughly wash their hands with warm running water and soap for at least 2 minutes, dry them with a sterile gauze napkin. Already on dry skin, apply a 5 ml agent at least 2 times, rub in for 3 minutes.
• To treat the elbow folds (skin areas) or the surgical field, the skin is wiped twice, sequentially, using sterile gauze tampons, abundantly moistened with the drug. After finishing processing, you should wait 2 minutes. Before the operation, the patient takes a shower, changes the linen. During the treatment of the operating field, the skin is wiped in one direction with a sterile swab, irrigated with a spray. After finishing processing, you need to wait 1 minute.
• To disinfect small surfaces (tables, armrests of chairs, equipment), they are wiped with a sterile rag soaked in the product. Consumption rate - 100 ml per 1 m 2.
• Disinfection of instruments. Before processing, dirt visible to the eye is removed from the instrument by wiping with napkins, rinsing under running water using a brush in compliance with the anti-epidemic regime. Then they are immersed in a container with a solution so that the cavities and channels are completely filled, with an exposure depending on the specifics of the treatment. The solution for disinfection under storage conditions under the lid is suitable for 3 days.

Suppositories

• For the prevention of STIs - 1 suppository once in the vagina. A prerequisite is that no more than 2 hours should pass after intercourse.
• For the treatment of vaginosis, colpitis - 1 suppository twice a day, 7-10 days in a row.

Treatment of the upper respiratory tract often requires an integrated approach. One of the simple and at the same time effective ways is to rinse. Basically, it consists in the use of various solutions that have a wide range of effects on pathogenic microflora.

In practice, the antiseptic solution chlorhexidine bigluconate has proven itself well. He is able to adversely affect almost any type of microflora. However, it must be understood that the action of an antiseptic extends to both pathogenic microbes and normal bacteria. Therefore, the drug, like many others, has its own requirements for admission, indications and contraindications.

The specificity of the drug

The drug is available in 4 pharmacological forms: solution (alcohol, water and water-alcohol), vaginal suppositories, gel and now also a spray. Rinse the throat with chlorhexidine 0.05% solution. This concentration is sufficient to effectively affect the pathological focus.

A decrease in the severity of symptoms is observed after the first session of using the product. In the process practical research not only an antiseptic effect was revealed, but it was found that chlorhexidine actively affects the fungal and viral microflora. So a positive result was observed after rinsing with herpes sore throat and candidal lesions.

The active substance of the drug does not penetrate the mucous membrane. It acts locally on the surface of the pathological focus. After rinsing, the active substance lingers on the mucous membrane for about an hour.

Indications and contraindications for use

The chlorhexidine solution has an antibacterial effect. It is capable of destroying almost all known bacteria that cause problems in the mouth and throat.

When is it ineffective?

Although gargling with chlorhexidine is suitable for everyone, however, its effect on viruses is weak. In this case, the solution can be used as an additional agent in parallel with antiviral drugs.

An immediate contraindication is an allergic reaction. If the drug is used for the first time, then it is worth conducting a test for sensitivity to its components.

Is it possible for children, pregnant women and breastfeeding?

Chlorhexidine should not be used by children under 5 years of age. During pregnancy, the use of the product is allowed, but with caution. The same goes for the breastfeeding period. The active substance does not penetrate into the blood, however, no one excludes accidental swallowing of the solution. For women in this position, it is better to use more gentle products, such as saline or soda solutions.

Side effects

because of high sensitivity to chlorhexidine or if used improperly, side effects... They occur in the case of prolonged use, a high concentration of the solution in the form of a burning sensation in the throat, immediately after rinsing. To avoid this, it is worth purchasing chlorhexidine in a ready-made concentration.

Side effects can also appear as:

• sleep disorders;
• dry mouth and throat;
• discoloration of the enamel of the teeth;
• violation of the perception of taste buds;
• burning of the tongue;
• nausea, vomiting, dizziness;
• changes in the color and structure of the oral mucosa and pharynx.

How to rinse correctly?

It must be remembered that the drug is used only for external use. The procedure is simple, it is important not to allow the solution to flow inside. The rinsing technique is as follows:

• brush your teeth thoroughly;
• prepare warm boiled water;
• rinse with water for about 30 seconds;
• measure out 10-15 ml of solution (about a tablespoon);
• carry out an intensive rinsing of the throat for 20-30 seconds;
• be sure to carefully spit the product;
• do not eat or drink liquids for an hour;
• on the first day of the disease, it is recommended to rinse every 2 hours, then 3-4 times a day.

For tonsillitis or pharyngitis, rinse at least 2-3 times a day. A purulent process reduces the effect of the remedy. To achieve the desired result, it is necessary to rinse twice. Chlorhexidine destroys purulent crusts, reduces inflammation and helps the quickest regeneration of the affected areas.

The pharmaceutical form of release of the drug provides for a 0.05% concentration. This solution in its pure form is suitable only for adults. If it is necessary to rinse the child, the solution should be diluted additionally. You can use the product for children only after consulting a pediatrician. Additionally, dilution will help protect the child from drug poisoning. The fact is that the mucous membranes of the respiratory tract are located lower in them than in adults. Therefore, it is more difficult for them to carry out the rinsing process, and they involuntarily swallow the solution.

For the safe and effective use of chlorhexidine, you must adhere to the following recommendations:

1. A 0.05% solution in pure form should be used only for adults and children over 12 years old. To reduce the irritating effect, the agent should be heated in a water bath to a temperature of 20-23 degrees.
2. Dilute a 0.05% solution with boiled warm water in a 1: 1 ratio for children aged 6 to 12 years.
3. The drug is not recommended for children under 6 years old, or it is used with caution. In this case, take 1 part of chlorhexidine and 2-3 parts of boiled water.
4. During breastfeeding or pregnancy, the drug is also used with caution. For the procedure, take a solution in a volume of no more than 1 tablespoon, 0.05% concentration without dilution;
5. The solution is prepared immediately before use each time. The active active ingredient loses its properties in the external environment, literally in 30 minutes.

The doctor decides how many days chlorhexidine can be used. On average, this is no more than 2 weeks. With prolonged use, oral dysbiosis may develop, which can lead to the development of candidiasis and different types stomatitis.

Before starting treatment, it is imperative to consult a doctor. It is advisable to conduct laboratory studies and identify the type of pathogenic microflora. Many diseases require exposure not only to chlorhexidine, but also to other drugs or even a whole complex. In this case, the treatment will be more effective and in a short period of time.

In the postpartum period, a woman's body is vulnerable to various infections, especially genital infections. Most often, after the birth of a child, thrush appears. Other typical diseases for a nursing mother are vaginitis and bacterial vaginosis. This is due to the fact that lactation requires huge energy costs, leading to a weakening of the immune system.

To prevent and eliminate infectious pathologies of the genital organs, "Geksikon" is widely used. This medication has good antiseptic properties, so doctors often prescribe it to patients after childbirth. However, many of them are interested in the question of whether it is possible to use candles "Geksikon" during lactation or not. This will be discussed in the article.

Release form of the drug

The considered medicine produced in the form of a torpedo shape. They are cream or white with a marble surface. Suppositories are packaged in plastic packages of 1, 5 and 10 pieces. They are used to treat various diseases the genital area by insertion into the vagina.

Active components of "Geksikon"

The active ingredient of these vaginal suppositories is chlorhexidine bigluconate, which is a local antiseptic. The drug is effective in the fight against gram-negative, gram-positive and protozoan microorganisms: chlamydia, Neisser's gonococcus, treponema, chemoorganoheterotrophs and gardnerella vaginalysis. But acid-fast fungi, bacteria, viruses and spores are practically insensitive to the action of such suppositories.

Even in the composition of this medication there is such an auxiliary component as polyethylene oxide.

For what pathologies is the drug prescribed?

Candles "Geksikon" during lactation can be used to treat many ailments. They are widely used to eliminate bacterial and infectious diseases female reproductive system - vulvovaginitis of a different nature or vaginitis.

These suppositories with an antiseptic effect help protect against syphilis, chlamydia, gonorrhea pathogens, and Trichomonas. Chlorhexidine is used as a prophylactic agent. It prevents infection after unprotected sex.

Also, "Geksikon" during lactation is used to protect the pelvic organs when performing the following procedures:

• thermal cauterization of erosion in the uterus;
• surgical termination of pregnancy;
• installation of a contraceptive spiral and other surgical interventions.

In addition, doctors prescribe suppositories before childbirth to prevent the development of sexually transmitted and genital infections.

Candles "Geksikon" while carrying a child

Hormonal changes during pregnancy provoke a change in the vaginal microflora and a sharp decrease in protective forces. Such changes lead to the unhindered entry of pathogens into the body, which are capable of multiplying at any time. Untimely detection of the symptoms of pathology can lead to infection of the fetus.

The drug "Geksikon" is completely safe for a child, the active ingredient (chlorhexidine) does not affect its formation, vital activity and growth. It dissolves in the vagina, without penetrating either into the bloodstream, or into the placenta, or into the digestive tract. Even when a woman uses candles in the first months of pregnancy, they do not have negative impact on the tab of the main systems of the organs of the fetus.

The antiseptic agent "Geksikon" is allowed to be used for the treatment of pathologies of the female genital area during the period of bearing a child from 1-12 weeks. Suppositories from 13 to 35 weeks act locally, without penetrating into the bloodstream, excluding the likelihood of damage to the embryo. They are aimed at creating a favorable microflora in the vagina for the normal course of pregnancy during this period.

In the last stages, candles are used to prevent the appearance of inflammatory processes and diseases of the reproductive system. In the first days after the birth of the baby, they are prescribed to avoid suppuration of the seams.

Vaginal suppositories for breastfeeding

The official instructions accompanying the drug indicate that Geksikon should be used with caution during lactation. According to doctors, with its correct use, adherence to the duration of therapy and dosages, these suppositories will not have a negative effect on breast milk. Indeed, during their use, its substances do not enter the bloodstream. Therefore, there is no danger that the composition of the nutritional fluid will change and this will affect the health of the baby.

"Geksikon" during lactation: instructions for use

The duration of treatment with this drug is 10 days. It is shown to introduce 1-2 suppositories a day, they must be inserted deep into the vagina. It is best to do this while lying down with your pelvis slightly raised. Usually this period is quite enough for a complete cure, but it is still recommended to visit a doctor after a course of therapy to undergo a second examination.

The gynecologist may decide to extend the treatment for another 10 days if there is no complete recovery. It is forbidden to interrupt therapy or independently stop using the drug "Geksikon" during lactation. Even when the unpleasant signs of the pathological process disappear, the total dosage cannot be reduced.

The use of the medication during menstruation

It is not worth starting therapy with this drug with menstruation, since the blood can prevent the suppository from completely dissolving. Moreover, the change in acidity in the vagina during this period reduces the effectiveness of "Hexicon".

However, doctors do not recommend stopping an already begun course of treatment with the onset of menstruation, since even a drug weakened by bloody discharge continues to favorably affect a woman's body. It destroys all existing disease-causing bacteria.

Treatment of pathologies with vaginal suppositories

Cystitis is a disease that causes severe discomfort to a woman. The use of suppositories "Geksikon" helps to get rid of the unpleasant symptoms of the disease and eliminate the source of the problem. Treatment of this pathology involves the use of antibiotics, anti-inflammatory drugs, as well as drugs that allow you to remove the burning sensation.

The considered vaginal suppositories for chronic or acute cystitis in the shortest possible time get rid of pathological changes... They act on the present infections, thereby eliminating the pronounced symptoms of the disease. Additionally, they also use antispasmodic drugs, which are included in the complex of medicines for cystitis, to relieve pain.

Means "Geksikon" is prescribed even with erosion of the cervix on early stages when the wound is not yet very large. Vaginal suppositories are inherently soft, therefore, they will not further damage the mucous membrane. In addition, these suppositories work quickly and do not affect the lactobacilli of the vagina.

Suppositories "Geksikon" during lactation: side effects

In some women, after using this drug, there is a bloody secretion from the genital tract. If such discharge is observed during treatment, then it is better to visit a gynecologist. Even after the introduction of suppositories, a burning sensation may occur. With such a reaction, it is also advisable to stop using them. In addition, when using this drug, there may be such negative consequences as:

In what cases is it better to refuse the use of vaginal suppositories?

The only contraindication to the use of the drug "Geksikon" during lactation is individual intolerance to the components that it contains. It will not harm the baby's health, since it acts locally without changing the composition breast milk... The body of most women tolerates this medication very well.

How to replace "Geksikon" during lactation, if there are side effects? An analogue of these suppositories is "Chlorhexidine", which has an identical spectrum of action and chemical composition... There are other products with the same active substance:

This medication should not be used simultaneously with foaming agents containing sodium lauryl and laureth sulfate, as well as saponins and additives E466, E469. Such substances are found in various cosmetics, including intimate hygiene gels.

That is why, during the use of suppositories, one should not wash off with liquid or ordinary soap in order to prevent the occurrence of side effects upon contact with an alkaline medium. In addition, it impairs the antiseptic properties of chlorhexidine, therefore, when placing the vaginal suppository, you need to rinse the genitals well with water. It is best to use a weak solution of potassium permanganate during treatment for such purposes.

"Geksikon" (suppositories) during lactation, the instructions for which will help you figure out how to enter them correctly, can cause abundant discharge. It is necessary to prepare a daily pad in advance and not worry about it.

In the course of therapy, you will have to give up sexual intercourse for some time. Additional substances of the medication can negatively affect the effectiveness of contraceptives.

Doctors advise against using the drug "Geksikon" simultaneously with iodine. If the treatment is started 1-2 days before the onset of menstruation, then you do not need to stop it, but you should consult with your gynecologist about extending the course. It is advisable to use vaginal suppositories after menstruation or in the middle of the cycle.

Most breastfeeding women leave positive reviews about the effectiveness of the drug. But he did not help everyone to cope with ailments. Some mothers complain that after using suppositories they have spotting.

The drug "Geksikon" during lactation is an effective medication and at the same time affordable. He not only fights infectious pathologies, but also helps to avoid their occurrence. The antiseptic property of suppositories in complex therapy can cure many diseases of the reproductive sphere.

Medicines with fully proven efficacy, which are not controversial in the medical community, but awe and awe, are unfortunately very rare. And this group of unconditional and recognized drugs includes the usual Chlorhexidine.

The nondescript packaging and low price hides the real leader among the antiseptics presented on the shelves of our pharmacies. If domestic brilliant green or, for example, Miramistin, remain exclusively Russian medicines, then Chlorhexidine is a generally recognized drug that is used all over the world.

Let's try to figure out together what is the secret of the popularity of this tool. And at the same time, find out all about the pitfalls that may be hidden in the instructions for Chlorhexidine - side effects and possible contraindications.

A long story that never ends

Chlorhexidine has been used for nearly 60 years in more than sixty pharmaceuticals. During this time, the drug has unconditionally proven its effectiveness and safety.

And the beginning was laid in the early 50s, when in Manchester, in the Royal Chemical Company, which was engaged in the development of antimalarial drugs, chlorhexidine digluconate was synthesized. Already in 1954, the new drug went on sale as a local antiseptic and disinfectant.

Only more than 20 years later, Chlorhexidine began to be used for gargling as a topical oral agent. It turned out that the drug can prevent the development of periodontal disease. The position of the anti-periodontal agent Chlorhexidine is firmly held today.

A little later, the antiseptic began to be included in the composition of lubricants, detergents, toothpastes, and even liners in clothes. In 2012, an antithrombogenic catheter was introduced for the first time, which contained both outside and inside Chlorhexidine.

It seems that the story does not end there - this antiseptic still has many new dosage forms and uses. After all, you still have to look for such a station wagon! How does the magic drug work? It's time to get into the details.

>> Recommended: if you are interested in effective methods of getting rid of chronic rhinitis, pharyngitis, tonsillitis, bronchitis and persistent colds, then be sure to look at this site page after reading this article. The information is based on the author's personal experience and has helped many people, we hope it will help you too. Now we return to the article.<<

Chlorhexidine mechanism of action

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

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 digluconate in high concentration can cause hardening or freezing of the cytoplasm.

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.

Biofilm

Biofilm 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 the microorganisms of the biofilm to be especially resistant 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 biofilm stops.

Other microorganisms

Unlike many antiseptic agents, Chlorhexidine solution demonstrates high efficiency against other microbes, for example, bacterial spores and protozoa. It is also believed to act against viruses coated with an additional coating: herpes simplex virus, HIV, cytomegalovirus, influenza virus. Unenveloped viruses are resistant to Chlorhexidine. These include the causative agents of ARVI rotavirus, adenovirus and enteroviruses.

Chlorhexidine when applied topically: hard work of an antiseptic

When applied topically and locally, Chlorhexidine solution forms complexes with proteins of the upper layer of the epidermis or mucous membranes.

When rinsing the mouth, the drug binds to proteins of the mucous membrane and the surface of the teeth, after which it is slowly released over a long time. Imagine that the antimicrobial activity of an antiseptic lasts for two days! As a result of the long-term antiseptic action in the oral cavity, the number of bacteria is significantly reduced, which in turn prevents plaque.

Chlorhexidine has become the gold standard in dentistry due to its ability to "stick" to soft and hard surfaces and to be released for a long time.

Pharmacokinetic properties

Studies confirm that after rinsing with Chlorhexidine solution, about 30% of the active ingredient is retained in the oral cavity.

The drug is intended exclusively for external and local use. However, if you accidentally swallow a small amount of an antiseptic, you shouldn't call an ambulance and prepare for the worst. The drug is practically not absorbed in the gastrointestinal tract. In a person who has drunk 300 mg of Chlorhexidine, which is almost 300 ml of a solution that is sold in pharmacies, the blood plasma contains only 0.206 μg / g of the active substance in half an hour.

We add that it is almost impossible to take 300 ml of antiseptic on the chest for a person in a sober mind and clear memory. If, for some reason, force majeure did occur, nothing bad will happen. Over the next 12 hours, the antiseptic will be completely eliminated from the body.

Spectrum of activity

So, let's list the microorganisms that cannot resist the drug. Sensitive microbes include:

• gram-positive microorganisms, including various strains of staphylococcus and streptococcus. The bactericidal effect against gram-positive microorganisms is achieved when exposed to a solution of Chlorhexidine at a concentration of less than 1 mg / liter;
• gram-negative microorganisms: intestinal and hemophilic bacilli, Klebsiella, Legionella, Pseudomonas, Proteus, Enterobacteriaceae, Salmonella, Moraxella and others. The drug is more active against gram-positive microorganisms than against gram-negative ones. The concentration of antiseptic, sufficient for an antibacterial effect when seeding with gram-negative bacteria, should be at least 73 μg / ml;
• mushrooms;
• enveloped viruses.
  The peculiarities of the drug's action in relation to herpes simplex viruses, HIV, cytomegalovirus are still being studied.

The drug retains antiseptic properties, although less pronounced, in direct contact with biological fluids, such as blood or pus. This ability distinguishes Chlorhexidine from most other antiseptics.

Chlorhexidine: the use of an antiseptic

The scope of Chlorhexidine is not limited to pharmaceuticals. An antiseptic is part of many disinfectants - solutions for treating the skin and hands. The cosmetic industry is also not complete without a drug. As an antibacterial agent, it is added to toothpastes, deodorants, antiperspirants. An antiseptic is also included in the composition of creams for problem skin, which once again proves the effectiveness of Chlorhexidine as a remedy for acne.

In pharmaceuticals, Chlorhexidine solutions are used at a concentration of 0.05%, less often - 0.02% as:

• preservative in eye drops;
• active ingredient in dosage forms for local and external use, as well as mouth and throat rinses, suppositories, ointments and solutions.

Chlorhexidine in dentistry: indications

Chlorhexidine digluconate is included in mouthwash solutions. The main indication of an antiseptic is the treatment and prevention of gingivitis.

As a reminder, gingivitis is an inflammatory disease of the gums that occurs due to the accumulation of microbial plaque on the teeth and is characterized by redness and swelling of the gums. A timely untreated disease threatens with a complication - periodontitis, which already leads to the destruction of the alveolar processes.

Patients who are simultaneously diagnosed with both periodontitis and gingivitis are a special category of dental patients that require complex treatment. In such cases, Chlorhexidine is only one of the drugs in the combination therapy, and not the main one.

An antiseptic is also used to treat an inflammatory disease of the oral mucosa - stomatitis, including aphthous. Chlorhexidine rinses are often prescribed to prevent infection after tooth extraction and other dental procedures.

Among the indications for rinsing, one cannot fail to note the prevention of dental plaque. Possessing a pronounced antibacterial effect, the drug effectively prevents the formation of plaque on teeth and tartar.

Rules for the use of chlorhexidine dental solution

How to properly rinse your mouth with Chlorhexidine? So, the procedure is most effective if it is carried out immediately after prophylactic tooth cleaning. The antiseptic should be applied twice a day - morning and evening - for 30 seconds. The usual dose is 15 ml of undiluted rinse solution.

Immediately after using Chlorhexidine, you should not drink water, brush your teeth or have breakfast (lunch or dinner) - you just wash off the antiseptic. Be patient for 10-15 minutes, and then feel free to start your normal life.

And the last thing. Despite the safety of the medicine, you should still not drink it. When rinsing, do your best to prevent the antiseptic from entering the gastrointestinal tract.

Mouthwash: an unaesthetic side effect

One of the most annoying side effects of Chlorhexidine Bigluconate Mouthwash is staining the surface of teeth, dentures, mouth and back of the tongue.

It is worth noting that such a manifestation of an antiseptic is not expected for all patients. In clinical trials, it has been proven that the probability of any noticeable staining is 56%. At the same time, in 15% of people, the discoloration of the teeth and tongue will be quite pronounced. Unfortunately, the color scale in which the tooth enamel and the oral cavity are painted leaves no reason for special optimism. If you fall into the 15% of sensitive patients, your teeth are likely to take on shades ranging from dark brown to black.

Against the background of such information, the possibility of removing stains left by Chlorhexidine with the help of professional methods looks very comforting. The likelihood and intensity of staining increases when interacting with dyes in tea or coffee.

Recently, manufacturers have begun to produce rinses with Chlorhexidine, which include an additional component to reduce the risk of staining the surfaces of the oral cavity. Chelated zinc has this effect.

Unlikely But Possible: Other Side Effects of Chlorhexidine Gargle

Other adverse events following the use of Chlorhexidine oral solution are rare. These include:

• change in taste, the appearance of a bitter taste;
• short-term burning sensation;
• numbness, dryness, or soreness of the mouth and tongue;
• increased bleeding of the gums after light massage;
• transient toothache, soreness of the gums or general discomfort and increased sensitivity in the treatment of periodontitis (in 50.7% of patients versus 41.4% when using a placebo drug).

Chlorhexidine in otorhinolaryngology: indications and rules of application

The activity of Chlorhexidine against most gram-positive bacteria and viruses gives reason to use an antiseptic as a solution for gargling.

Recall that most tonsillitis (inflammatory diseases of the tonsils) and pharyngitis (inflammation of the pharyngeal mucosa) are associated with streptococci and viruses, and much less often with staphylococci.

To rinse the throat, 0.02% and 0.05% Chlorhexidine solution is used. Unfortunately, it is not yet possible to find a special form of the preparation for gargling in Russian pharmacies. However, the most common Chlorhexidine for external use, which is not difficult to buy, is perfect for use in ENT practice.

For gargling, you will need about 20 ml of 0.02% or 10-15 ml of 0.05% antiseptic solution, which must be kept in your mouth for at least 45 seconds. After the procedure, you cannot drink, eat or brush your teeth for about 20-30 minutes.

The optimal frequency of rinsing with Chlorhexidine is three times a day. If desired, the number of procedures can be increased. The duration of treatment is 5-10 days or more, as long as there is a need. The positive aspects of throat treatment with Chlorhexidine include high efficacy, safety and cost effectiveness.

What is not found in the instructions: Chlorhexidine for inhalation

The use of Chlorhexidine as a solution for inhalation is also very promising, although such an indication is not mentioned in the instructions for the drug. The antiseptic can be used in nebulizers. Fine particles of Chlorhexidine, getting into the lower respiratory tract, are an excellent prevention of bronchitis and pneumonia - pneumonia. In addition, inhalations with Chlorhexidine can be used as part of the complex treatment of laryngitis (inflammation of the vocal cords), tonsillitis, tracheitis.

The frequency of procedures, as well as the duration of treatment, can be practically unlimited - the drug is so safe.

Should I drip Chlorhexidine into my nose?

Wide antiseptic possibilities and nationwide love give rise to new questions. Favorite medicine, which has helped from angina and pneumonia, thrush and stomatitis, diaper rash and burns, are trying to drip into the ears and nose in the hope of healing from new diseases. Is it possible and useful to use Chlorhexidine solution as nasal or ear drops?

With inflammation in the nasopharynx, patients experience painful sensations, which they can eliminate with certain medications. In such cases, experts recommend gargling, for which Chlorhexidine is prescribed.

Regular carrying out of such manipulations will allow achieving excellent results, since the components present in the medication are capable of destroying pathogenic microflora at the cellular level.

Structure

Today in pharmacy chains, this drug is presented in various forms, but a liquid is usually used to gargle the throat.

In its manufacture, the manufacturer uses "chlorhexidine bigluconate" as an active ingredient, as well as excipients. For rinsing the throat, patients should use a 0.05% solution.

When is the drug used?

The instructions indicate that this medicinal liquid should be used in the development of such pathological processes:

• ARVI;
• tonsillitis;
• tracheitis (in chronic or acute form);
• flu;
• pharyngitis;
• laryngitis;
• nicotine effects;
• other lesions of the tonsils.

How to use?

People should use the solution in accordance with the manufacturer's recommendations specified in the instructions, or with medical prescriptions:

1. It is necessary to measure the required amount of the medicine (0.05%).
2. Chlorhexidine is diluted with water if it has a higher concentration.
3. A small amount of liquid is collected in the mouth, after which a rinse is made and it is spat out.
   In the oral cavity, each portion of the drug should be at least thirty seconds.
4. After rinsing, do not eat or drink drinks for an hour and a half.
5. The patient should carry out no more than three procedures daily.

Is it possible to gargle with Chlorhexidine for angina?

The drug, which has antimicrobial and antiseptic properties, is often prescribed by specialists to patients with tonsillitis, since it has the following therapeutic effect:

• assists in the removal of purulent plugs;
• clears the pharynx from pathogenic microflora;
• has a softening effect on the mucous membranes of the oral cavity;
• reduces painful sensations;
• prevents the development of bacteria;
• accelerates the healing process.

During pregnancy

Expectant mothers need to be extremely careful about the use of dosage forms, since many of them can have a negative impact on the developing fetus.

That is why they should use Chlorhexidine only in extreme cases and for medical purposes.

To kid

When treating children, Chlorhexidine should be used as follows:

1. In the instructions, the manufacturer indicates that the drug can be used by children for external treatment, starting from the age of six.
2. Toddlers of the younger age group can use water for irrigation.
   At the same time, parents should be careful to ensure that their children spit out liquid.

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With pharyngitis

The solution is actively used in the treatment of pathologies such as pharyngitis.

Its experts prescribe to patients for external treatment in the following concentration:

• 0,05%;
• 0,20%;
• 0,50%.

For each patient, the doctor individually determines the dosage and daily amount of rinses.

When breastfeeding

Clinical trials of this Chlorhexidine have shown that when it is used externally by nursing mothers, there is no negative effect on the condition of the newborn.

This is due to the fact that the active substance does not penetrate into the woman's bloodstream, therefore it does not enter the milk.

But, in order to minimize the risks for mothers who keep babies breastfed, it is necessary to obtain medical advice regarding the dosage and duration of treatment before using the medication.

With tonsillitis

With tonsillitis, as well as with other ENT pathologies with an inflammatory etiology, patients are prescribed Chlorhexidine for external treatment.

How to dilute the medicine?

For rinsing the throat, experts recommend using a 0.05% solution. In such a concentration, the drug can be purchased in pharmacy chains, but if it is not on sale, the patient will have to independently dilute the drug with distilled or boiled and cooled water.

The instructions for Chlorhexidine give the following recommendations:

1. Adult patients and children over 12 years old need to use a 0.05% solution for external treatment. The medicine can be warmed up in a water bath before use.
2. For nursing mothers and pregnant women, the drug is prescribed in the same concentration.
3. For kids, whose age group varies in the range of 6-12 years old, the medication should be diluted with warm boiled water in a 1: 1 ratio.
4. Children who have not yet turned six years old should dilute 1 portion of the medicine in 2 portions of water and use water for spraying.
5. People should be aware that after preparation, the liquid retains its pharmacological properties for half an hour.
   That is why, before each procedure, it is necessary to prepare a new portion of the medicine.

Rinsing your throat

People must observe the following rules for using the solution:

1. To eliminate painful sensations in the pharynx, 15 ml of the medicine should be used.
   

   Rinse your mouth up to four times a day. In case of unbearable pain, the manipulations must be repeated every 3-4 hours.

2. Before each procedure, the patient should rinse the mouth with warm water.
3. There is no need to brush your teeth before medical manipulation, since the active ingredients can react with the paste.

How long should the treatment last?

The duration of therapy directly depends on the severity of the pathology and is determined by specialists for each person on an individual basis.

In most cases, it is necessary for patients to rinse the throat for seven days, but if necessary, treatment procedures can take two weeks.

Contraindications

The manufacturer of the drug in the instructions notes only individual intolerance to the components as a contraindication.

Indications

This drug can be used not only in the treatment of ENT diseases, but also in such pathological conditions:

• with dental problems;
• with gynecological ailments;
• for the prevention of diseases, in particular venereal;
• for the treatment of wounds and burns;
• as a disinfectant;
• for the sanitization of dentures.

Side effects

If used incorrectly, patients may experience the following side effects:

• mucous membranes dry out in the oral cavity;
• taste sensations change;
• darkening of the tooth enamel is observed;
• sleep disturbances;
• tartar is formed.

Precautions

1. If the patient has an increased sensitivity to the components of the drug, then they should use it with extreme caution and only for medical prescriptions.
2. With a tendency to dermatitis and allergic reactions, patients need to consult a specialist.
3. It is not recommended to use it in parallel with other medicines that belong to the group of antiseptics.
4. It is strictly forbidden to use the medication for people who have eye diseases.
5. Do not use liquid for disinfection of postoperative wounds that appeared during the surgical treatment of ear diseases.

If a person accidentally swallows liquid at the time of external treatment of the pharynx, then he must immediately induce vomiting, and then take an adsorbent.