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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Antimicrobial Foam Handwash
Generic Name
Chlorhexidine Gluconate 2% Solution
Active Ingredient
ChlorhexidineCategory
Other
Salt Form
Gluconate
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 20 mg/mL | LIQUID | TOPICAL | 21749-416 |
Detailed information about Antimicrobial Foam Handwash
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Antimicrobial Foam Handwash, you must consult a qualified healthcare professional.
Chlorhexidine is a potent biguanide antiseptic and antimicrobial agent used to reduce bacteria in the mouth and on the skin. It is widely prescribed for gingivitis and as a preoperative skin preparation.
The dosage of chlorhexidine varies significantly based on the formulation and the condition being treated.
The standard adult dose for 0.12% chlorhexidine gluconate oral rinse is 15 ml (marked by the fill line in the provided measuring cap). Patients are typically instructed to rinse with this amount twice daily, once in the morning and once in the evening after brushing their teeth. The rinse should be swished in the mouth for exactly 30 seconds and then expectorated (spit out). It should never be swallowed.
For surgical hand scrubbing, approximately 5 ml of a 4% chlorhexidine solution is applied to wet hands and forearms. The area is scrubbed for 3 minutes using a brush, rinsed, and then the process is repeated for another 3 minutes. For preoperative skin preparation, the solution is applied liberally to the surgical site and allowed to air dry for at least 2 to 3 minutes to ensure maximum antimicrobial efficacy.
For patients with deep periodontal pockets, a healthcare professional may insert one 2.5 mg chip into each pocket. This is not a self-administered treatment and must be performed by a dentist or dental hygienist.
The safety and effectiveness of chlorhexidine oral rinse in pediatric patients under the age of 18 have not been fully established. While dentists may occasionally prescribe it for older children, it is generally avoided in younger children who may be prone to swallowing the rinse. For topical skin use, chlorhexidine is used in children, but extreme caution is required for neonates (newborns), especially those born prematurely, as it can cause severe chemical burns on their sensitive skin.
Because chlorhexidine is not significantly absorbed into the systemic circulation, dosage adjustments are generally not required for patients with renal impairment. However, patients with end-stage renal disease should be monitored for any unusual oral mucosal changes if using the oral rinse.
Similar to renal impairment, the lack of systemic absorption means that hepatic impairment does not typically necessitate a change in the topical or oral rinse dosage.
Clinical studies have not identified significant differences in responses between elderly and younger patients. However, elderly patients may be more likely to have existing dental restorations or dry mouth (xerostomia), which can exacerbate the staining side effects of the oral rinse.
For the oral rinse, it is critical to follow these steps to ensure efficacy:
For topical skin products, ensure the area is clean of organic matter (like blood or dirt) before application, as these can slightly reduce the drug's effectiveness.
If you miss a dose of the oral rinse, use it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not double the volume of the rinse to make up for a missed application.
Systemic overdose from topical or oral rinse use is highly unlikely. However, if a large amount of the oral rinse is swallowed (especially by a child), symptoms may include:
In case of accidental ingestion of a significant amount, contact a Poison Control Center or seek emergency medical attention immediately. Treatment is generally supportive, focusing on managing gastric irritation.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or frequency of use without medical guidance, as overuse can lead to increased staining and oral irritation.
Chlorhexidine oral rinse is associated with several frequent side effects that, while not usually dangerous, can be bothersome for patients:
While chlorhexidine is generally safe because it is not absorbed, it can cause life-threatening allergic reactions in sensitive individuals.
> Warning: Stop using Chlorhexidine and call your doctor or seek emergency help immediately if you experience any of the following:
With prolonged use (longer than 6 months), the primary concern is the cumulative staining of dental restorations. There is also a theoretical concern that long-term use could alter the balance of the oral microbiome, although clinical evidence for significant 'dysbiosis' (imbalance of bacteria) leading to secondary infections like oral candidiasis is limited. Most dentists prescribe chlorhexidine for short-term bursts (2 to 4 weeks) to avoid these long-term issues.
As of 2026, there are no FDA black box warnings for chlorhexidine gluconate. However, the FDA issued a high-level Drug Safety Communication in 2017 warning about the risk of rare but serious allergic reactions. This warning applies to all over-the-counter and prescription products containing chlorhexidine.
Report any unusual symptoms, especially signs of a developing rash or respiratory changes, to your healthcare provider immediately. Staining can be managed with regular professional cleanings, but allergic symptoms require immediate cessation of the drug.
Chlorhexidine is intended for external use only. It must never be injected, ingested in large quantities, or used in the eyes or ears. Patients should be aware that while it is an effective antimicrobial, it is not a substitute for regular brushing, flossing, or professional dental cleanings. It is also important to inform all healthcare providers, including surgeons and dentists, if you have a known sensitivity to chlorhexidine before any procedure.
No FDA black box warnings for Chlorhexidine. However, the risk of anaphylaxis is the most significant safety concern associated with this medication.
The FDA has documented an increasing number of reports of serious allergic reactions to chlorhexidine. These reactions can occur within minutes of exposure. The risk is present with oral rinses, topical solutions, and even chlorhexidine-coated medical devices (like catheters). If you have ever had a skin reaction to an antiseptic, discuss this with your doctor before use.
Chlorhexidine is highly toxic to the tissues of the eye and the middle ear.
Topical chlorhexidine should be used with extreme caution in leg-term or preterm infants. Their skin is thinner and more permeable, making them susceptible to severe chemical burns and, in rare cases, systemic absorption of the drug.
For patients using the oral rinse, regular dental examinations (at least every 6 months) are required to monitor for:
No specific blood tests (such as liver or kidney function tests) are required for the use of chlorhexidine due to its lack of systemic absorption.
Chlorhexidine does not have any known effects on the central nervous system and is not expected to impair your ability to drive or operate heavy machinery.
Many chlorhexidine oral rinses contain approximately 11.6% alcohol. While the amount of alcohol absorbed during a 30-second rinse is negligible, patients who are recovering from alcohol use disorder or those taking Disulfiram (Antabuse) should consult their doctor. Alcohol-free versions of chlorhexidine are available and may be preferred for these populations.
Chlorhexidine can usually be stopped abruptly without any withdrawal symptoms. However, if you are using it to treat a specific infection or gingivitis, stopping too early may result in the return of the condition. Always complete the full course of treatment recommended by your dentist.
> Important: Discuss all your medical conditions, especially any history of asthma, hay fever, or allergies to other antiseptics, with your healthcare provider before starting Chlorhexidine.
There are no systemic drug-drug contraindications because chlorhexidine is not absorbed into the blood. However, there are critical topical contraindications:
There are no well-documented interactions between chlorhexidine and herbal supplements like St. John's Wort or Ginkgo Biloba, primarily because chlorhexidine does not enter the systemic circulation where it could interact with the metabolic enzymes (like CYP3A4) that these herbs affect.
Chlorhexidine is not known to interfere with common blood or urine laboratory tests. However, in patients using the oral rinse, it may occasionally interfere with certain specialized tests for oral bacteria or pH levels in the saliva.
To maximize the efficacy of chlorhexidine and minimize interactions:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, even if they are 'natural' or applied only to the skin.
Chlorhexidine must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by your healthcare provider:
There is no well-established cross-sensitivity between chlorhexidine and other common antiseptics like povidone-iodine or alcohol. However, patients with a history of multiple 'chemical sensitivities' or severe asthma may be at a slightly higher risk for an idiosyncratic (unpredictable) reaction.
> Important: Your healthcare provider will evaluate your complete medical history, including any previous reactions to antiseptics or dental products, before prescribing Chlorhexidine.
Chlorhexidine gluconate is classified as FDA Pregnancy Category B. This means that animal reproduction studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Because systemic absorption of chlorhexidine following topical or oral rinse use is minimal (less than 1%), the risk to the developing fetus is considered to be very low. However, as with all medications, chlorhexidine should be used during pregnancy only if the potential benefit justifies the potential risk. It is typically used for short durations in pregnant women to manage pregnancy-associated gingivitis.
It is not known whether chlorhexidine is excreted in human milk. However, given that systemic absorption is negligible, it is highly unlikely that clinically significant amounts would be present in breast milk. Mothers should be careful not to apply chlorhexidine to the breast or nipple area immediately before breastfeeding to prevent the infant from accidentally ingesting the drug. The risk-benefit ratio is generally favorable for the use of oral rinses in nursing mothers.
Elderly patients (65 and older) can use chlorhexidine safely, as there are no known age-related changes in the drug's pharmacology. However, this population often has a higher prevalence of:
No dosage adjustments are necessary for patients with kidney disease. The drug is not absorbed in amounts that would stress the renal system. Even in patients on hemodialysis, the topical or oral use of chlorhexidine is considered safe.
No dosage adjustments are required for patients with liver disease (Child-Pugh Class A, B, or C). Since the drug does not undergo hepatic metabolism, liver function does not affect the clearance or safety of the medication.
> Important: Special populations require individualized medical assessment. Always inform your doctor if you are pregnant, planning to become pregnant, or are currently breastfeeding before starting this medication.
Chlorhexidine is a cationic biguanide. Its molecular structure allows it to bind to the negatively charged phosphate groups on the bacterial cell wall. This binding disrupts the osmotic equilibrium of the cell. At low concentrations (0.01% to 0.1%), it is bacteriostatic; it causes the leakage of intracellular components like potassium. At higher concentrations (>0.1%), it is bactericidal; it causes the precipitation of the bacterial cytoplasm and proteins, leading to cell death. One of its most important features is its 'substantivity'—the ability to bind to oral proteins and be released over 8-12 hours, providing a continuous antimicrobial effect.
The antimicrobial effect of chlorhexidine is dose-dependent. The 0.12% concentration used in oral rinses is optimized to balance bacterial kill with minimal tissue irritation. It shows a rapid onset of action (within 30 seconds) and a long duration of effect. There is no evidence of the development of significant bacterial resistance or the overgrowth of opportunistic pathogens like Candida albicans during standard short-term therapy.
| Parameter | Value |
|---|---|
| Bioavailability | <1% (Oral/Topical) |
| Protein Binding | Minimal (Systemic) |
| Half-life | 8-12 hours (Surface retention) |
| Tmax | Not applicable |
| Metabolism | None (Systemic) |
| Excretion | Fecal (~90% of ingested dose) |
Chlorhexidine belongs to the biguanide antiseptic class. It is related to other biguanides like metformin (an antidiabetic drug), though their therapeutic uses are entirely different. In the antiseptic realm, it is often compared to povidone-iodine and hexachlorophene, but it is generally preferred for its persistence on the skin and lower toxicity profile compared to hexachlorophene.
Common questions about Antimicrobial Foam Handwash
Chlorhexidine is primarily used as an antiseptic to reduce the number of germs in the mouth or on the skin. In dental care, it is prescribed as a 0.12% oral rinse to treat gingivitis, which helps reduce gum redness, swelling, and bleeding. On the skin, it is used in higher concentrations as a surgical scrub or preoperative skin cleanser to prevent infections during medical procedures. It works by binding to the surfaces of the mouth or skin and slowly releasing its antibacterial properties over several hours. Your healthcare provider may also use chlorhexidine-impregnated dressings to protect catheter sites from bloodstream infections.
The most common side effect of chlorhexidine oral rinse is the brownish staining of the teeth, tongue, and dental restorations. This staining occurs because the drug binds to the teeth and reacts with certain pigments in food and drink. Many patients also experience a temporary change in their sense of taste, often describing a bitter or metallic sensation. Increased formation of tartar (calculus) on the teeth is another frequently reported issue. Most of these effects are temporary and can be managed with professional dental cleanings once the treatment is finished. If you experience severe mouth irritation or sores, you should contact your dentist.
There is no direct interaction between drinking alcoholic beverages and using chlorhexidine, as the drug is not absorbed into your bloodstream. However, many chlorhexidine oral rinses themselves contain about 11% alcohol, which can be drying to the mouth. If you are using the rinse to treat gum disease, consuming alcohol may further irritate sensitive oral tissues. Furthermore, drinking red wine while using chlorhexidine can significantly increase the severity of tooth staining. It is generally recommended to wait at least one hour after using the rinse before consuming any food or drink, including alcohol.
Chlorhexidine is generally considered safe for use during pregnancy when prescribed by a healthcare provider. It is classified as FDA Category B, meaning animal studies show no risk and human data, while limited, suggest it is unlikely to cause harm. Because less than 1% of the drug is absorbed into the body when used as a rinse or skin cleanser, the exposure to the developing baby is extremely low. It is often used to treat 'pregnancy gingivitis,' which is common due to hormonal changes. However, you should always inform your obstetrician or dentist if you are pregnant before starting any new medication.
Chlorhexidine begins working almost immediately upon contact with bacteria, with a significant reduction in microbial counts occurring within 30 seconds of application. For gingivitis, while the antibacterial action is immediate, it may take 2 to 4 weeks of consistent use to see a visible reduction in gum inflammation and bleeding. The drug's unique 'substantivity' allows it to remain active on the oral surfaces for up to 12 hours after a single rinse. For skin disinfection, it should be allowed to air dry for about 3 minutes to reach its full antiseptic potential before a procedure begins. Always follow the specific duration of use recommended by your doctor.
Yes, you can stop using chlorhexidine suddenly without experiencing any withdrawal symptoms or physical dependence. However, if you are using it to treat an active condition like gingivitis or to prepare for surgery, stopping early may allow bacteria to regrow and cause the infection or inflammation to return. It is important to complete the full course of treatment as directed by your healthcare professional. If you are stopping because of side effects like tooth staining, talk to your dentist about alternative treatments or professional cleaning options. Stopping the medication abruptly will not cause systemic issues because the drug does not enter your bloodstream.
If you miss a dose of chlorhexidine oral rinse, you should use it as soon as you remember, provided it is not almost time for your next dose. If your next dose is only a few hours away, skip the missed dose and resume your regular twice-daily schedule. Do not use extra solution or rinse for a longer period to make up for the missed application. Consistency is key for managing oral bacteria, but a single missed dose will not significantly impact the overall success of the treatment. Always try to use the rinse after brushing your teeth to ensure the best results.
No, chlorhexidine does not cause weight gain. Because the medication is applied topically to the skin or used as an oral rinse and is not absorbed into the systemic circulation, it has no effect on your metabolism, appetite, or fat storage. There are no clinical reports or pharmacological mechanisms that link chlorhexidine use to changes in body weight. If you experience unexpected weight gain while using this medication, it is likely due to other factors or medications and should be discussed with your primary care physician. Chlorhexidine's effects are strictly localized to the areas where it is applied.
Chlorhexidine can generally be used alongside most systemic medications (pills or injections) because it does not enter the bloodstream to cause drug interactions. However, it can interact with other topical products. For example, the anionic ingredients in many toothpastes (like Sodium Lauryl Sulfate) can inactivate chlorhexidine, so you must wait 30 minutes between brushing and rinsing. It may also interfere with the effectiveness of certain topical antifungal medications like Nystatin if used at the same time in the mouth. Always provide your doctor or dentist with a complete list of all medications and topical products you are currently using.
Yes, chlorhexidine gluconate is widely available as a generic medication in several forms, including the 0.12% oral rinse and various topical solutions. Generic versions are typically much less expensive than brand-name products like Peridex or Hibiclens but contain the same active ingredient and meet the same FDA standards for quality and efficacy. Most insurance plans cover the generic oral rinse for the treatment of gingivitis. When purchasing over-the-counter topical versions, look for 'Chlorhexidine Gluconate' on the active ingredients label to ensure you are getting the correct product.
Other drugs with the same active ingredient (Chlorhexidine)