Drugs List

Therapeutic Indications

Uses

Skin disinfection
Wound cleanser

Contraindications

None known

Precautions and Warnings

Premature infants

Some products may contain soya or soya derivative
Avoid contact with mucous membranes
Do not allow to come into contact with eyes, middle ear, brain or meninges
If accidental contact with the eyes occurs, rinse thoroughly with water
Not for use in body cavities
Premature infants: Use minimum amount and remove excess from the skin
Premature infants: Risk of severe chemical injury
Discontinue if irritation or sensitisation occur

Pregnancy and Lactation

Pregnancy

Chlorhexidine is considered safe for use in pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Chlorhexidine is considered safe for use in breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic shock
Blistering
Dermatitis
Eczema
Erythema
Hypersensitivity reactions
Pruritus
Rash
Skin irritation
Urticaria

Presentation

Topical formulations of chlorhexidine

Drugs List

Therapeutic Indications

Uses

Skin disinfection
Wound cleanser

Contraindications

None known

Precautions and Warnings

Premature infants

Some products may contain soya or soya derivative
Avoid contact with mucous membranes
Do not allow to come into contact with eyes, middle ear, brain or meninges
If accidental contact with the eyes occurs, rinse thoroughly with water
Not for use in body cavities
Premature infants: Use minimum amount and remove excess from the skin
Premature infants: Risk of severe chemical injury
Discontinue if irritation or sensitisation occur

Pregnancy and Lactation

Pregnancy

Chlorhexidine is considered safe for use in pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Chlorhexidine is considered safe for use in breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic shock
Blistering
Dermatitis
Eczema
Erythema
Hypersensitivity reactions
Pruritus
Rash
Skin irritation
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: February 2016

Reference Sources

Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press Accessed on 4 February 2016.

Paediatric Formulary Committee. BNF for Children (online) London: BMJ Group, Pharmaceutical Press, and RCPCH Publications Accessed on 4 February 2016.

Summary of Product Characteristics: Chlorhexidine acetate BP 0.02% w/v for irrigation. Baxter Healthcare Ltd. Revised January 2013.
Summary of Product Characteristics: Chlorhexidine acetate BP 0.05% w/v for irrigation. Baxter Healthcare Ltd. Revised January 2013.

Summary of Product Characteristics: Sterets Unisept. Medlock Medical Ltd. Revised August 2015.