Chlorhexidine Gluconate (Oral)

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Mouth/Throat:

Peridex: 0.12% (118 mL, 1893 mL) [contains alcohol, usp, brilliant blue fcf (fd&c blue #1), saccharin sodium; mint flavor]

Periogard: 0.12% (473 mL) [mint flavor]

Generic: 0.12% (15 mL [DSC], 118 mL [DSC], 473 mL)

Serum concentrations: Detectable levels are not present in the plasma 12 hours after administration

Medication-related osteonecrosis of the jaw (MRONJ), adjunctive therapy: Oral rinse:

Based on a position paper by the American Association of Maxillofacial Surgeons (AAOMS), chlorhexidine gluconate oral rinse is an effective and recommended adjunctive treatment strategy in the management of medication-related osteonecrosis of the jaw (MRONJ) (stage 1 and above [eg, patients with exposed and necrotic bone or fistulae that probes to bone]).

Oropharyngeal decontamination to reduce the risk of ventilator-associated or hospital-acquired pneumonia, Cardiac surgical patients: Oral rinse:

Data from a prospective, randomized, double-blind, placebo-control trial and a prospective, randomized, case-controlled trial in patients undergoing coronary artery bypass grafting, valve, or other open heart surgical procedures who received chlorhexidine gluconate 0.12% oral rinse during the perioperative period showed a decreased rate in hospital-acquired pneumonia [DeRiso 1996], [Houston 2002]. Of note, one trial showed statistical significance only in patients intubated >24 hours who had the highest degree of bacterial colonization [Houston 2002]. Additional trials may be necessary to further define the role of chlorhexidine gluconate oral rinse in this condition.

Oropharyngeal decontamination to reduce the risk of ventilator-associated or hospital-acquired pneumonia, Mechanically-ventilated patients: Oral rinse:

Data from meta-analyses have suggested benefit of chlorhexidine gluconate when used for oropharyngeal decontamination in mechanically-ventilated adults for the prevention of ventilator-associated pneumonia [Chan 2007], [Labeau 2011]. However, the trials used in both meta-analyses were heterogeneous and included patients in a variety of settings (eg, cardiothoracic, general ICU, mixed medical-surgical ICU, trauma ICU). The trials also displayed significant variability with chlorhexidine treatment regimens. Chlorhexidine concentration varied from 0.12%, 0.2%, or 2% across studies. Frequency of administration, chlorhexidine dosage form (oral rinse, gel, paste, foam), and technique of application also varied across studies. In the US, chlorhexidine gluconate for use in the oral cavity is commercially available only as 0.12% solution. Additional trials may be necessary to further define the role of chlorhexidine gluconate oral rinse in this condition.

Hypersensitivity to chlorhexidine or any component of the formulation

Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).

There are no known significant interactions.