Chlorhexidine side effects and drug information

Chlorhexidine gluconate is a type of germicidal mouthwash that lessens bacteria in the mouth. The oral rinse is utilized for the treatment of gingivitis and is often prescribed by dentists. But it cannot treat all kinds of gingivitis.

Molar mass505.446 g/mol
Solubility in water0.8 mg/mL (20 °C)
FormulaC22H30Cl2N10
CAS ID55-56-1
Other names1,6-bis(4-chloro-phenylbiguanido)hexane

Overview

The medication should only be used to treat such a condition if the dentist prescribes it. It is also important to note that it should not be shared with others, even if they have the same condition as you.

Important Information

Chlorhexidine gluconate may cause a severe yet rare allergic reaction that could be life-threatening. Immediately seek medical help if you are experiencing wheezing, skin rash, hives, cold sweats, difficulty breathing, swelling of the throat, tongue, lips, and face, as well as light-headedness.

The medication should never be given to a teenager or child without proper advice from the doctor as it can cause chemical burns or severe irritation.

Prior to taking the medicine

The medication should not be used by those who may have allergic reactions to chlorhexidine gluconate. For those with periodontal disease, unique treatments may be required while taking chlorhexidine gluconate.

At the same time, teenagers or children should not be given this medication without advice from the doctor. This is because it can trigger chemical burns and severe irritation in young children. The medication is not approved to be used by people who are below 18 years old.

It is still unknown if the medication can cause harm to unborn babies. Speak with your doctor if you are pregnant or have plans to be pregnant soon. There are no details yet whether the medication can pass into breast milk or if it can affect a nursing baby. Inform your doctor if you happen to be breastfeeding.

Side Effects

Along with the effects, topical chlorhexidine can cause unwanted effects. Although it is not possible for all side effects to occur, if they occur, they might require medical attention. Be sure to check with your doctor as soon as possible if the side effects below happen while taking the medication.

Rare

Signs of some allergic reactions such as shortness of breath, difficulty breathing, swelling of face, nasal congestion, itching, hives, or skin rash.

More common

Changes in taste

a surge in the tartar on the teeth

staining of mouth, teeth, tooth fillings, as well as dentures and other types of mouth appliances

Less common

Mouth irritation

enlarged glands on neck or side of the face

irritation in tongue

For Healthcare Experts

Pertains to chlorhexidine topical: mucous membrane inserts, compounding liquid, topical dressing, mucous membrane liquid, topical pad, topical liquid, topical soap, topical sponge, topical solution.

General

The known side effects include tongue coating, toothache, hypersensitivity reactions, and skin irritation.

Gastrointestinal

Very common: Toothache (up to 50.7%)

Common: Dry mouth, oral paresthesia, ulcerative stomatitis, glossodynia, dyspepsia, gum hyperplasia

Frequency (not reported): Mouth irritation, mucosa swelling, coated tongue, parotid gland swelling, increased dental calculus formation, burning sensation of the tongue, gingivitis/grossly obvious gingivitis, aphthous ulcer, tooth disorder, geographic tongue, mobile teeth, dental/gingival/mouth pain, lost bridges/crowns/fillings, discoloration of the teeth, broken/cracked/fractured teeth, discoloration of the teeth, and gums.

Post-marketing reports: Glossitis, stomatitis, glossal edema, ulcer, sialadenitis/inflammation of the salivary glands

Toothache happened usually in patients who received the periodontal chip and experienced gingival/dental/ mouth pain, aching, tenderness, soreness, throbbing, sensitivity, or discomfort.

Tooth disorder happened in patients who had the periodontal chip and also had broken/cracked/fractured teeth, lost bridges/crowns/fillings, and loose teeth.

Respiratory

Very common: Upper respiratory tract infection and sinusitis

Common: Bronchitis, pharyngitis

Frequency (not reported): Rhinitis, bronchospasm, dyspnea, coughing,

Bronchospasm happened with hypersensitivity responses.

Sinusitis and upper respiratory tract infection often occurred in patients who received the periodontal chip.

Nervous system

Common: Ageusia/dysgeusia, hypoesthesia

Frequency (not reported): Headache, transient dysgeusia, loss of consciousness

Post-marketing reports: Hypesthesia, paresthesia

Musculoskeletal

Common: Arthrosis, tendinitis

Frequency (not reported): Myalgia, back pain, arthralgia

Local

Frequency (not reported): Desquamation, ulceration, mucocele, keratinization, pain, tenderness, aching, short frenum, throbbing, soreness, sensitivity, and discomfort

Post-marketing reports: Some minor irritation

Dermatologic

Frequency (not reported): Rash, erythema/generalized erythema, dermatitis, urticaria, eczema, pruritus, skin irritation, cold sweat, blisters, irritative or some allergic skin reactions.

Erythema, rash, and urticaria happened to those with hypersensitivity reactions.

Pruritus, dermatitis, eczema, erythema, rash, skin irritation, urticaria, and blisters happened to those with allergic skin reactions.

Other

Frequency (not reported): Trauma, chemical burns in neonates, influenza-like symptoms, sensitive tissue irritation, abscess, and deafness.

Cardiovascular

Frequency (not reported): Circulatory collapse, cardiac arrest, tachycardia, hypotension, hypertension

Cardiac arrest, hypotension, circulatory collapse, and tachycardia happened as hypersensitivity responses.

Hypersensitivity

Frequency (not reported): Anaphylactoid reactions, anaphylactic shock

Post-marketing reports: Hypersensitivity and anaphylaxis

Ocular

Frequency (not reported): irritation to the conjunctiva. irreversible corneal damage

Eye exposure to chlorhexidine cleanser, especially during the preparation phase for a facial surgery has greatly resulted in eye pain, as well as edema of the epithelium, inflammation of the conjunctiva, keratitis, chronic corneal ulcers, corneal epithelial cell loss, and opacification. To correct permanent damage, corneal transplantation has been needed in some patients.

Allergic conjunctivitis is not often associated with the utilization of contact lens solutions that contain low-level concentrations of chlorhexidine as a type of preservative.

Genitourinary

Hematuria happened after bladder irrigation.

Frequency (not reported): Dysmenorrhea, hematuria

Immunologic

Frequency (not reported): Allergy

Indication and dosage

Usual Adult Dosage for Gingivitis

Usual dosage: 15 mL or about 0.5 fluid ounces is swished into the mouth unadulterated for 30-seconds and then spit out 2-times a day

Overdose and Contraindication

Allergic reaction to chlorhexidine or any element of the formulation

Clinical Pharmacology

Chlorhexidine showed some activity against gram-negative and gram-positive organisms, as well as facultative anaerobes, yeast, and aerobes. At the same time, it is considered to be both bactericidal and bacteriostatic, depending on the concentration. Some of the bactericidal effects of chlorhexidine resulted from the attachment of the cationic molecule to a negatively charged bacterial cell wall and extra-microbial complexes. When at low concentrations, such causes a modification of bacterial cell osmotic equilibrium, as well as leakage of phosphorous and potassium were resulting in bacteriostatic effects. On the other hand, at high concentrations, the cytoplasmic substances of the bacterial cell cause and lead to cell death.