Chlorhexidine

Identification

Summary

Chlorhexidine is an antiseptic used to sterilize for surgeries and in healthcare practice, to reduce pocket depth in periodontitis, and to treat gingivitis.

Brand Names

Betasept, Hibiclens, Instillagel, Nupro Chlorhexidine, Oris, Oro-Clense, Paroex, Perichlor, Peridex, Periochip, Periogard, Prevora, X-pur

Generic Name

Chlorhexidine

DrugBank Accession Number

DB00878

Background

Chlorhexidine is a broad-spectrum antimicrobial biguanide used as a topical antiseptic and in dental practice for the treatment of inflammatory dental conditions caused by microorganisms.¹¹ It is one of the most common skin and mucous membrane antiseptic agents in use today.² The molecule itself is a cationic bis-guanide consisting of two 4-chlorophenyl rings and two biguanide groups joined by a central hexamethylene chain.⁷ Topical chlorhexidine for disinfection, as well as oral rinses for dental use, carries activity against a broad range of pathogens including bacteria, yeasts, and viruses.^12,11,7

Chlorhexidine was developed in the UK by Imperial Chemical Industries in the early 1950s⁹ and was introduced to the US in the 1970s.¹⁸ The FDA withdrew its approval for the use of chlorhexidine gluconate topical tincture 0.5%, due to a significant number of reports concerning chemical and thermal burns associated with the use of this product.^19,20 Other formulations of chlorhexidine continue to be available.

Type

Small Molecule

Groups

Approved, Vet approved, Withdrawn

Structure

Similar Structures

Weight: Average: 505.447
Monoisotopic: 504.203196424
Chemical Formula: C₂₂H₃₀Cl₂N₁₀

Synonyms

1,1'-Hexamethylene bis(5-(p-chlorophenyl)biguanide)
Chlorhexidin
Chlorhexidine
Chlorhexidinum
Cloresidina
Clorhexidina
N,N'-Bis(4-chlorophenyl)-3,12-diimino-2,4,11,13-tetraazatetradecanediimidamide

Pharmacology

Indication

Chlorhexidine is available over-the-counter in various formulations (e.g. solution, sponge, cloth, swab) as a topical antiseptic to sanitize prior to surgeries and/or medical procedures.^12,13,14,15 Dental formulations, available by prescription only, include an oral rinse indicated for the treatment of gingivitis¹¹ and a slow-release "chip" which is inserted into periodontal pockets and is indicated for the reduction of pocket depth in adult patients with periodontitis as an adjunct therapy to dental scaling and root planing procedures.¹⁶

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Associated Conditions

Associated Therapies

Contraindications & Blackbox Warnings

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Pharmacodynamics

Chlorhexidine is a broad-spectrum antimicrobial with demonstrated activity against both gram-positive and gram-negative bacteria, yeasts, and viruses.² Antimicrobial activity is dose-dependent - chlorhexidine is bacteriostatic at lower concentrations (0.02%-0.06%) and bactericidal at higher concentrations (>0.12%).² Pharmacokinetic studies of oral chlorhexidine rinses indicate that approximately 30% of the active ingredient is retained in the mouth following rinsing, which is subsequently slowly released into oral fluids.¹¹ This ability to adsorb to dentine, shared with tetracycline antibiotics such as doxycycline, is known as "substantivity" and is the result of chlorhexidine's positive charge - it is likely that this substantivity plays at least some role in chlorhexidine's antimicrobial activity, as its persistence on surfaces such as dentine prevent microbial colonization.⁷

Dental chlorhexidine rinses may result in staining of oral surfaces, such as teeth. This effect is not ubiquitous and appears to be more significant with extended therapy (i.e. up to 6 months) - nevertheless, patients for whom oral staining is unacceptable should use chlorhexidine rinse with caution and for the shortest effective interval.¹¹ Allergic reactions to chlorhexidine have been associated with the development of anaphylaxis.⁸

Mechanism of action

Chlorhexidine’s broad-spectrum antimicrobial effects are due to its ability to disrupt microbial cell membranes. The positively charged chlorhexidine molecule reacts with negatively charged phosphate groups on microbial cell surfaces - this reaction both destroys the integrity of the cell, allowing leakage of intracellular material, and allows chlorhexidine to enter the cell, causing precipitation of cytoplasmic components and ultimately cell death.^16,7 The specific means of cell death is dependent on the concentration of chlorhexidine - lower concentrations are bacteriostatic and result in leakage of intracellular substances such as potassium and phosphorous, whereas higher concentrations are bactericidal and cause cytoplasmic precipitation.⁷

Target	Actions	Organism
ABacterial outer membrane	incorporation into and destabilization	Bacteria

Absorption

Topically, chlorhexidine is unlikely to undergo any degree of systemic absorption. Orally administered chlorhexidine, such as that found in oral rinses for dental purposes, is very poorly absorbed from the gastrointestinal tract - the C_max in human subjects following an oral dose of 300mg was 0.206 µg/g and occurred approximately 30 minutes after ingestion (T_max).¹¹ Following the insertion of 4 PerioChips in 18 adult patients, no detectable plasma or urine chlorhexidine levels were observed.¹⁶

Volume of distribution

Not Available

Protein binding

Chlorhexidine is known to bind albumin in both serum and saliva,⁵ though the extent of this binding is unclear.

Metabolism

As chlorhexidine is very poorly absorbed in the gastrointestinal tract, it is unlikely to undergo metabolic conversion to any significant extent.¹¹

Route of elimination

Excretion of chlorhexidine gluconate occurs almost exclusively via the feces, with less than 1% of an ingested dose excreted in the urine.¹¹

Half-life

Not Available

Clearance

Not Available

Adverse Effects

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Toxicity

The LD₅₀ of subcutaneously administered chlorhexidine in mice is >5 g/kg.¹⁷

Small children are likely to be more susceptible to chlorhexidine overdose - ingestion of 1-2 ounces by a small child may result in gastric distress, nausea, and intoxication. Treatment should consist of symptomatic and supportive measures. Seek medical attention if a child ingests >4 ounces of chlorhexidine solution or if symptoms of intoxication develop post-exposure.¹¹

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

Drug	Interaction
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Allogeneic cultured keratinocytes and dermal fibroblasts in murine collagen	The therapeutic efficacy of Allogeneic cultured keratinocytes and dermal fibroblasts in murine collagen can be decreased when used in combination with Chlorhexidine.

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Food Interactions

Take separate from meals. May affect the taste of food and beverages. Avoid eating or drinking for 30 minutes following use.

Products

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Product Ingredients

Ingredient	UNII	CAS	InChI Key
Chlorhexidine acetate	5908ZUF22Y	56-95-1	WDRFFJWBUDTUCA-UHFFFAOYSA-N
Chlorhexidine gluconate	MOR84MUD8E	18472-51-0	YZIYKJHYYHPJIB-UUPCJSQJSA-N
Chlorhexidine hydrochloride	E64XL9U38K	3697-42-5	WJLVQTJZDCGNJN-UHFFFAOYSA-N

International/Other Brands

Cida-Stat (Ecolab) / Corsodyl (GlaxoSmithKline) / DentiSept / Dyna-Hex (Xttrium) / Exidine (Xttrium) / Hexadol (Green Cross) / Hibiscrub (AstraZeneca) / Hibitane (Imperial Chemical Industries) / Microderm (Johnson & Johnson) / Periogard Oral Rinse (Colgate) / Pharmaseal Scrub Care (CareFusion) / Prevacare R (Johnson & Johnson) / Rotersept (Roter) / Sterilon (Emcure) / Tubulicid

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Antiseptic Skin Cleanser	Solution	4 g/100mL	Topical	Xttrium Laboratories, Inc.	2012-01-01	Not applicable
Antiseptic Skin Cleanser	Solution	4 g/100mL	Topical	Cardinal Health	2012-01-01	2020-10-31
Betasept	Solution	0.04 mg/1mL	Topical	Xttrium Laboratories, Inc.	1993-06-01	Not applicable
Chlorhexidine	Mouthwash	0.12 % w/v	Buccal	Euro Pharm International Canada Inc	2017-10-19	Not applicable
Chlorhexidine	Mouthwash	0.12 %	Buccal	Bajaj Medical, Llc	2000-08-29	Not applicable
Chlorhexidine Alcohol Free	Mouthwash	0.12 % w/v	Buccal	Euro Pharm International Canada Inc	2018-02-20	2021-06-03
Chlorhexidine Gluconate	Rinse	0.12 mg/1mL	Oral	Actavis Mid Atlantic LLC,	2009-02-11	Not applicable
Chlorhexidine Gluconate 0.12% Oral Rinse, USP	Liquid; Mouthwash	0.12 % w/w	Oral	Xttrium Laboratories, Inc.	Not applicable	Not applicable
Chlorhexidine Gluconate 0.12% Oral Rinse, USP	Mouthwash	0.12 % w/w	Buccal	Sage Products LLC	2016-02-03	2022-04-22
Denticare Chlorhexidine Gluconate Oral Rinse 0.12%	Mouthwash	0.12 %	Buccal	Amd Medicom Inc	1999-11-26	Not applicable

Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Acclean Chlorhexidine Gluconate 0.12% Oral Rinse	Liquid	1.2 mg/1mL	Oral	Henry Schein, Inc.	2009-10-01	Not applicable
Acclean Chlorhexidine Gluconate 0.12% Oral Rinse	Liquid	1.2 mg/1mL	Oral	Henry Schein, Inc.	2013-02-01	Not applicable
Acclean Chlorhexidine Gluconate 0.12% Oral Rinse	Liquid	1.2 mg/1mL	Oral	Xttrium Laboratories, Inc.	2013-02-01	Not applicable
Acclean Chlorhexidine Gluconate 0.12% Oral Rinse	Liquid	1.2 mg/1mL	Oral	Xttrium Laboratories, Inc.	2009-10-01	Not applicable
Chlorhexidine	Solution	1.2 mg/1mL	Oral	Nucare Pharmaceuticals,inc.	1995-12-15	Not applicable
Chlorhexidine	Solution	1.2 mg/1mL	Oral	PINNACLE PHARMA LLC	1995-12-15	Not applicable
Chlorhexidine Gluconante	Rinse	1.2 mg/1mL	Oral	Amd Medicom Inc.	2006-06-02	2023-05-31
Chlorhexidine Gluconate	Rinse	1.2 mg/1mL	Oral	Proficient Rx LP	1996-05-07	Not applicable
Chlorhexidine Gluconate	Rinse	1.2 mg/1mL	Oral	All Pharma, Llc	2010-06-01	Not applicable
Chlorhexidine Gluconate	Rinse	1.2 mg/1mL	Oral	Preferred Pharmaceuticals Inc.	2022-04-27	Not applicable

Over the Counter Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Akilgeld Hand Sanitizer	Gel	2 % w/w	Topical	Delta Pharma Inc.	Not applicable	Not applicable
Akilspray Hand Sanitizer	Spray	2 % w/w	Topical	Delta Pharma Inc.	Not applicable	Not applicable
Alsoft A Hand Disinfectant 0.2% w/v	Solution	0.2 % w/v		Goodmaid Chemicals Corp. Sdn. Bhd.	2020-09-08	Not applicable
Anti Mucedine Feminine Wash	Liquid	0.1 g/100mL	Topical	Jiangxi Renhetang pharmaceutical chain Co., Ltd.	2021-03-16	Not applicable
Anti-bac Hand	Soap	0.45 g/100mL	Topical	Fujian Jinghua Biotechnology Co.,Ltd.	2020-04-25	Not applicable
Antibacterial Protective Hand	Lotion	.0045 g/.9g	Topical	HANOVER PEN CORP dba HPC Global	2013-02-01	Not applicable
Antibacterial Protective Hand	Lotion	.07075 g/14.15g	Topical	HANOVER PEN CORP dba HPC Global	2013-02-01	Not applicable
Antimicrobial Foam Handwash	Liquid	20 mg/1mL	Topical	GOJO Industries, Inc.	2018-04-01	Not applicable
Antimicrobial Skin Cleanser	Liquid	20 mg/1mL	Topical	GOJO Industries, Inc.	2008-03-01	Not applicable
Antiseptic Body Cleanser	Cloth	2 %	Topical	Sage Products LLC	2006-02-14	Not applicable

Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End
(Fruli) Quick-Dry Disposable Hand Sanitizer	Chlorhexidine gluconate (0.5 mg/100mL) + Ethanol (70 mL/100mL)	Liquid	Topical	Shandong Zhuojian Medical Technology Co., Ltd.	2020-05-01	Not applicable
(Qiqing) Chlorhexidine Gluconate Alcohol Disinfectant	Chlorhexidine gluconate (0.45 mg/100mL) + Ethanol (75 mL/100mL)	Liquid	Topical	Qingdao precision medical technology co., LTD. Zibo branch	2020-05-01	Not applicable
3M Avagard	Chlorhexidine gluconate (8.3 mg/1mL) + Ethanol (506.3 mg/1mL)	Lotion	Topical	3M Company	2001-06-14	Not applicable
3M SoluPrep	Chlorhexidine gluconate (20 mg/1mL) + Isopropyl alcohol (0.7 mL/1mL)	Solution	Topical	3M Company	2018-10-08	2020-09-30
3M SoluPrep	Chlorhexidine gluconate (20 mg/1mL) + Isopropyl alcohol (0.7 mL/1mL)	Solution	Topical	3M Company	2018-10-08	Not applicable
3m Soluprep Sponge	Chlorhexidine gluconate (2 % w/v) + Isopropyl alcohol (70 % v/v)	Sponge	Topical	3 M Pharmaceuticals	2013-09-11	Not applicable
3เอ็ม ซีเอชจี แพด	Chlorhexidine (0.114 ML/1.142ML) + Isopropyl alcohol (0.8 ML/1.142ML)	Solution	Topical	บริษัท 3 เอ็ม ประเทศไทย จำกัด	2018-08-10	Not applicable
Alcohol Antibacterial Wipes	Chlorhexidine acetate (0.1 g/100a) + Benzalkonium chloride (0.1 g/100a) + Ethanol (15 g/100a)	Cloth	Topical	Kunming Ansheng Industry & Trade Co., Ltd.	2020-03-30	Not applicable
Alcohol Disinfectant Wipes	Chlorhexidine acetate (1 mg/1) + Benzalkonium chloride (1 mg/1) + Ethanol (750 mg/1)	Cloth	Topical	Kunming Ansheng Industry & Trade Co., Ltd.	2020-06-17	Not applicable
ANDOREX %0.15+%0.12 GARGARA, 200 ML	Chlorhexidine gluconate (18 mg/15mL) + Benzydamine hydrochloride (22.5 mg/15mL)	Rinse	Oral	PHARMACTİVE İLAÇ SAN. VE TİC. A.Ş.	2020-08-14	Not applicable

Unapproved/Other Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End
Anti Mucedine Feminine Wash	Chlorhexidine acetate (0.1 g/100mL)	Liquid	Topical	Jiangxi Renhetang pharmaceutical chain Co., Ltd.	2021-03-16	Not applicable
Anti-bac Hand	Chlorhexidine acetate (0.45 g/100mL)	Soap	Topical	Fujian Jinghua Biotechnology Co.,Ltd.	2020-04-25	Not applicable
Antibacterial Protective Hand	Chlorhexidine gluconate (.0045 g/.9g)	Lotion	Topical	HANOVER PEN CORP dba HPC Global	2013-02-01	Not applicable
Antibacterial Protective Hand	Chlorhexidine gluconate (.07075 g/14.15g)	Lotion	Topical	HANOVER PEN CORP dba HPC Global	2013-02-01	Not applicable
Antiseptic Cleansing Wipes	Chlorhexidine gluconate (0.0002 mg/1mg)	Swab	Topical	Foshan Flying Medical Products Co., Ltd.	2012-12-27	Not applicable
Antiseptic Cleansing Wipes	Chlorhexidine gluconate (0.0002 mg/1mg)	Swab	Topical	Guangdong Comfort Medical Products Co., Ltd.	2017-07-17	Not applicable
Bei Ling Tong Bao Er Zheng Yuan Antibacterial Creams	Chlorhexidine acetate (0.03 g/15g)	Cream	Topical	Jilin Mancaotang Health Management Group Co Ltd	2018-11-20	2019-10-21
Chinese Herb Essence Bacteriostatic Feminine Wash	Chlorhexidine acetate (0.1 g/100mL)	Liquid	Topical	Jiangxi Renhetang pharmaceutical chain Co., Ltd.	2021-03-16	Not applicable
DermacinRx Clorhexacin	Chlorhexidine gluconate (4 g/100mL) + Dimethicone (50 mg/1mL) + Mupirocin (20 mg/1g)	Kit	Topical	PureTek Corporation	2016-06-02	Not applicable
DermacinRx Surgical ComboPak	Chlorhexidine gluconate (4 g/100mL) + Dimethicone (50 mg/1mL)	Cream; Kit; Solution	Topical	PureTek Corporation	2015-04-28	Not applicable

Chemical Identifiers

UNII: R4KO0DY52L
CAS number: 55-56-1
InChI Key: GHXZTYHSJHQHIJ-UHFFFAOYSA-N
InChI: InChI=1S/C22H30Cl2N10/c23-15-5-9-17(10-6-15)31-21(27)33-19(25)29-13-3-1-2-4-14-30-20(26)34-22(28)32-18-11-7-16(24)8-12-18/h5-12H,1-4,13-14H2,(H5,25,27,29,31,33)(H5,26,28,30,32,34)
IUPAC Name: N-(4-chlorophenyl)-1-{N'-[6-(N-{[N'-(4-chlorophenyl)carbamimidamido]methanimidoyl}amino)hexyl]carbamimidamido}methanimidamide
SMILES: ClC1=CC=C(NC(=N)NC(=N)NCCCCCCNC(=N)NC(=N)NC2=CC=C(Cl)C=C2)C=C1

References

Synthesis Reference

Rose, F.L. and Swain, G.; US. Patent 2,684,924; July 27, 1954; assigned to Imperial Chemical Industries, Ltd.

US2684924

General References

McBain AJ, Bartolo RG, Catrenich CE, Charbonneau D, Ledder RG, Gilbert P: Effects of a chlorhexidine gluconate-containing mouthwash on the vitality and antimicrobial susceptibility of in vitro oral bacterial ecosystems. Appl Environ Microbiol. 2003 Aug;69(8):4770-6. [Article]
Karpinski TM, Szkaradkiewicz AK: Chlorhexidine--pharmaco-biological activity and application. Eur Rev Med Pharmacol Sci. 2015 Apr;19(7):1321-6. [Article]
Betcher DL, Burnham N: Chlorhexidine. J Pediatr Oncol Nurs. 1990 Apr;7(2):82-3. doi: 10.1177/104345429000700227. [Article]
Kuyyakanond T, Quesnel LB: The mechanism of action of chlorhexidine. FEMS Microbiol Lett. 1992 Dec 15;100(1-3):211-5. [Article]
Hjeljord LG, Rolla G, Bonesvoll P: Chlorhexidine-protein interactions. J Periodontal Res Suppl. 1973;12:11-6. doi: 10.1111/j.1600-0765.1973.tb02158.x. [Article]
Radford JR, Homer KA, Naylor MN, Beighton D: Inhibition of human subgingival plaque protease activity by chlorhexidine. Arch Oral Biol. 1992 Apr;37(4):245-8. doi: 10.1016/0003-9969(92)90045-a. [Article]
Mohammadi Z, Abbott PV: The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009 Apr;42(4):288-302. doi: 10.1111/j.1365-2591.2008.01540.x. Epub 2009 Feb 7. [Article]
Sharp G, Green S, Rose M: Chlorhexidine-induced anaphylaxis in surgical patients: a review of the literature. ANZ J Surg. 2016 Apr;86(4):237-43. doi: 10.1111/ans.13269. Epub 2015 Sep 11. [Article]
Lim KS, Kam PC: Chlorhexidine--pharmacology and clinical applications. Anaesth Intensive Care. 2008 Jul;36(4):502-12. doi: 10.1177/0310057X0803600404. [Article]
Health Canada Product Monograph: Peridex (chlorhexidine gluconate) oral rinse [Link]
FDA Approved Drug Products: Peridex (chlorhexidine gluconate) oral rinse [Link]
FDA Approved Drug Products: Avagard (chlorhexidine/ethyl alcohol) topical solution [Link]
FDA Approved Drug Products: Pre-Scrub (chlorhexidine gluconate) topical scrub [Link]
FDA Approved Drug Products: ChloraPrep One-Step (chlorhexidine/isopropyl alcohol) topical swab [Link]
FDA Approved Drug Products: Chlorhexidine gluconate topical cloth [Link]
FDA Approved Drug Products: PerioChip (chlorhexidine gluconate) chip for oral insertion [Link]
CaymanChem: Chlorhexidine MSDS [Link]
WHO Guidelines on Hand Hygiene in Health Care (2009) [Link]
Code of Federal Regulations 216.24: Drug products withdrawn or removed from the market for reasons of safety or effectiveness. [Link]
Federal Register: Determination that Chlorhexidine Gluconate Topical Tincture 0.5% Was Withdrawn From Sale for Reasons of Safety [Link]

External Links

Human Metabolome Database: HMDB0015016
KEGG Drug: D07668
KEGG Compound: C06902
PubChem Compound: 9552079
PubChem Substance: 46506388
ChemSpider: 2612
BindingDB: 64773
RxNav: 2358
ChEBI: 3614
ChEMBL: CHEMBL790
ZINC: ZINC000014768621
Therapeutic Targets Database: DAP001326
PharmGKB: PA164776863
RxList: RxList Drug Page
Drugs.com: Drugs.com Drug Page
Wikipedia: Chlorhexidine

FDA label

Download (56 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
4	Active Not Recruiting	Prevention	Hospitalizations / Infection	1
4	Active Not Recruiting	Prevention	Impacted Third Molar Tooth	1
4	Active Not Recruiting	Treatment	Closed Lower Extremity Fracture / Fracture of Pelvis (Disorder) / Open Appendicular Fracture / Surgical Site Infections / Unplanned Fracture-Related Reoperation	1
4	Active Not Recruiting	Treatment	Methicillin Resistant Staphylococcus Aureus Infection (MRSA) / Skin and Subcutaneous Tissue Bacterial Infections / Staphylococcus Aureus	1
4	Completed	Not Available	Antimicrobial Effectiveness	2
4	Completed	Not Available	Healthy Subjects (HS)	1
4	Completed	Not Available	Hip Arthroplasty	1
4	Completed	Not Available	This Study Evaluated the Effectiveness of Chlorhexidine Mouthrinse on Subgingival Microbiota	1
4	Completed	Health Services Research	Microbiome, Human	2
4	Completed	Other	General Skin Cleansing	1

Pharmacoeconomics

Manufacturers

Xttrium laboratories inc
Sage products inc
Actavis mid atlantic llc
Hi tech pharmacal co inc
John o butler co
Novex pharma
Teva pharmaceuticals usa inc
Wockhardt eu operations (swiss) ag
3m co
Colgate oral pharmaceuticals inc
Soapco inc
Ecolab inc
Regent medical americas llc
Johnson and johnson medical inc
Matrix medical corp
Kw griffen co
Becton dickinson and co
Kendall co
Becton dickinson surgical system
Molnlycke health care
Pharmaseal div baxter healthcare corp
Dexcel pharma technologies ltd

Packagers

3M Health Care
Adrian Pharmaceuticals LLC
Advanced Pharmaceutical Services Inc.
Aplicare Inc.
Apotex Inc.
AR Medicom Inc.
A-S Medication Solutions LLC
Atlantic Biologicals Corporation
Cao Group Inc.
Colgate Oral
Darby Dental Supply Co. Inc.
Dental Technologies Inc.
DENTSPLY International
Dexcel Ltd.
Diversified Healthcare Services Inc.
Germiphene Corp.
Henry Schein Inc.
Hi Tech Pharmacal Co. Inc.
Johnson & Johnson Healthcare
Major Pharmaceuticals
Medisca Inc.
Molnlycke Health
Murfreesboro Pharmaceutical Nursing Supply
Nord Ost Corp.
Novex Pharma
Pharmedix
Physicians Total Care Inc.
Prescript Pharmaceuticals
Raz Co. Inc.
Rebel Distributors Corp.
Sage Products Inc.
Stoma Health Products
Sunstar Pharmaceutical Inc.
Teva Pharmaceutical Industries Ltd.
Xactdose Inc.
Xttrium Laboratories
Zila Therapeutics Inc.

Dosage Forms

Form	Route	Strength
Lotion	Topical
Solution	Topical	20 mg
Solution	Topical	40 mg
Sponge	Topical
Gel	Topical	2 % w/w
Solution		0.2 % w/v
Soap	Topical	0.45 g/100mL
Lotion	Topical	.0045 g/.9g
Lotion	Topical	.07075 g/14.15g
Liquid	Topical	20 mg/1mL
Solution	Oral	1 g
Gel	Buccal; Oral	0.2 g
Cloth	Topical	2 %
Swab	Topical	0.0002 mg/1mg
Liquid	Topical	4 mg/100mL
Solution	Topical	2 % w/w
Solution	Topical	2 mg/100mL
Solution	Topical	2 g/100g
Solution	Topical	2.5 g
Solution	Topical	2 g
Dressing	Topical	.5 %
Liquid	Topical	40 mg/1mL
Sponge	Topical	40 mg/1mL
Solution	Topical	11.8 g
Solution	Topical	0.05 % w/v
Solution	Topical	20 %
Solution	Topical	0.5 %
Solution	Topical	40 g/1000mL
Cream	Topical	0.03 g/15g
Capsule	Oral
Solution	Topical	.04 mg/1mL
Solution	Topical	0.04 mg/1mL
Solution	Cutaneous; Topical
Mouthwash	Oral
Rinse	Oral
Spray	Topical
Gel	Transmucosal
Gel
Solution, concentrate	Topical
Solution		4 % w/v
Solution, concentrate		5 % w/v
Gel	Oral	1 %
Gel	Oral
Solution	Oral	0.1 %
Rinse	Oropharyngeal
Rinse	Oropharyngeal	2 mg/ml
Solution	Oral
Cloth	Topical
Mouthwash	Buccal	0.12 % w/v
Solution	Oral	1.2 mg/1mL
Solution	Topical	4 %
Gel	Topical	4 g/100mL
Liquid	Oral	0.12 mg/1mL
Rinse	Oral	0.12 mg/1mL
Rinse	Oral	1.2 mg/1mL
Liquid	Buccal	1.2 [iU]/1mL
Liquid	Buccal	1.2 mg/1mL
Liquid; mouthwash	Oral	0.12 % w/w
Mouthwash	Buccal	0.12 % w/w
Solution	Topical	0.05 %
Solution	Topical	0.75 mg/100mL
Solution	Topical	20 % w/v
Solution	Dental	1.2 mg/1mL
Liquid	Topical	.05 %
Gel	Buccal; Topical	0.2 g
Solution, concentrate
Solution	Cutaneous
Solution	Buccal; Oral	0.2 g
Solution	Oral	120 mg
Cream	Topical
Liquid	Dental	1.2 mg/1mL
Cream; kit; solution	Topical
Shampoo	Topical
Shampoo	Topical	30 g/L
Lotion	Topical	4 % w/v
Mouthwash	Oral
Solution	Oral
Liquid	Topical	0.5 g/1L
Cloth	Topical	0.2 g/100mL
Gel	Extracorporeal	0.55 g/500g
Tablet	Transmucosal
Solution	Topical	4 g/100mL
Sponge	Topical	4 %
Liquid	Topical	4.0 %
Solution	Topical	2 %
Solution	Topical	20 mg/1mL
Rinse	Oral
Liquid	Ophthalmic
Cloth	Topical	2 g/100g
Liquid	Topical	4 g/100mL
Solution	Topical	20 g
Rinse	Dental	0.5448 g/454g
Gel	Topical	2 %
Gel	Topical	4 %
Rinse	Oral	17.5 g/100g
Tablet	Transmucosal	5 MG
Mouthwash	Buccal	0.12 %
Cloth	Topical
Liquid	Topical
Swab	Topical
Ointment	Topical
Gel	Topical	4 % w/v
Aerosol	Topical
Gel
Solution	Topical	4 % w/w
Solution	Topical	213 g/1000mL
Solution	Topical	4 % w/v
Lozenge	Oral
Liquid	Cutaneous; Infiltration
Gel	Urethral
Liquid	Topical	0.02 g/10mL
Liquid	Extracorporeal
Kit	Oral
Concentrate	Irrigation	2.36 mL/236mL
Ointment	Ophthalmic
Cloth	Topical	0.127 g/100g
Cream	Topical	2 %
Cream	Topical
Injection, solution; kit; solution	Intravenous; Topical
Swab	Topical	2 % w/v
Solution	Topical	1 %
Solution	Topical	1 G/100ML
Solution	Topical	0.5 g
Gel	Topical	0.09 g/100g
Liquid	Buccal
Powder	Topical
Solution
Suppository	Vaginal
Solution	Topical
Cream; kit; ointment; solution	Topical
Lotion	Topical	1 % w/w
Solution / drops	Ophthalmic
Lotion	Oral
Lotion	Topical	0.5 % w/v
Solution	Oral	0.12 g
Rinse	Dental	1.2 mg/1mL
Ointment	Topical	1 %
Mouthwash	Oral	1.2 mg/ml
Liquid; mouthwash	Buccal	0.12 %
Spray, metered	Oral
Insert	Dental
Insert, extended release	Periodontal	2.5 mg/1
Liner, dental	Periodontal	2.5 mg
Insert	Periodontal	2.5 mg
Liquid	Oral	1.2 mg/1mL
Rinse	Buccal	1.2 mg/1mL
Solution	Buccal	0.12 % w/w
Liquid	Topical	.12 %
Solution	Ophthalmic
Liquid	Topical	0.1 g/100mL
Swab	Topical	0.2 g/100g
Solution	Topical	1 mg/25mL
Kit; solution	Dental	10 %
Liquid	Buccal	0.12 %
Lotion	Topical	.283 g/56.6g
Lotion	Topical	2.1508 g/430.16g
Lotion	Topical	2 %
Solution	Topical
Kit	Buccal; Oral
Kit	Buccal
Gel	Topical
Cloth	Topical	500 mg/1
Solution	Irrigation
Solution
Liquid	Topical	2 g/100mL
Solution	Topical	.75 mg/100mL
Solution	Topical	4 mg/100mL
Solution	Topical	2 g/100mL
Liquid	Topical	4 %
Solution	Topical	40 mg/1mL
Lotion	Topical	2.0 %
Cloth	Topical	0.35 U/100U
Soap	Topical	24 mg/3g
Soap	Topical	48 mg/3g
Cream	Topical	2 mg/g
Kit	Oral; Topical
Kit	Buccal; Topical
Kit	Topical
Lotion	Topical	2.25 %
Liquid	Topical	2 % w/w
Soap	Topical
Liquid; sponge	Topical	4 %
Aerosol	Topical	4 % w/v
Sponge	Topical	4 % w/v
Solution	Topical	2 % w/v
Sponge	Topical	2 % w/v
Cloth	Topical	2 % w/v
Sponge	Topical	0.05 % w/v
Solution; sponge	Topical
Aerosol	Topical	0.5 %
Spray	Topical	0.5 %
Liquid	Topical	.5 %
Spray	Topical	2 % w/w
Liquid	Topical	2 %
Liquid	Topical	20 %
Kit	Buccal	1.2 [iU]/1mL
Spray	Oral
Solution		0.05 %w/v
Ointment	Topical
Solution	Topical	10 g
Shampoo	Topical	2 g
Solution	Topical	0.35 g
Solution	Topical	2.3 %
Solution	Topical	4 g
Liquid	Topical	0.01 g/10mL
Spray	Oral
Liquid	Dental
Cream	Topical	1 %w/w

Prices

Unit description	Cost	Unit
Peridex 0.12% Solution 473ml Bottle	23.99USD	bottle
Periogard 0.12% Solution 473ml Bottle	15.99USD	bottle
Chlorhexidine Gluconate 0.12% Solution 473ml Bottle	14.0USD	bottle
Biopatch dressing	4.21USD	each
Hibistat towelette	0.43USD	each
Chlorhexidine gluc 20% soln	0.16USD	ml
Hibiclens 4% liquid	0.04USD	ml
Peridex 0.12% liquid	0.04USD	ml
Chlorhexidine 2% scrub	0.03USD	ml
Chlorhexidine 0.12% rinse	0.02USD	ml
Dynahex 4% liquid	0.02USD	ml
Dynahex 2% liquid	0.01USD	ml
Periogard 0.12% oral rinse	0.01USD	ml

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)
US7422388	No	2008-09-09	2027-04-25
US6536975	No	2003-03-25	2020-11-10
US6729786	No	2004-05-04	2023-03-14
US7241065	No	2007-07-10	2023-03-14
US5690958	No	1997-11-25	2016-09-30
US6991394	No	2006-01-31	2024-01-31
US7182536	No	2007-02-27	2023-12-30
US5538353	No	1996-07-23	2015-08-25
US5772346	No	1998-06-30	2017-04-22
US7081246	No	2006-07-25	2016-08-03
US5897031	No	1999-04-27	2016-06-21
USD468424	No	2003-01-07	2017-01-07
US7066916	No	2006-06-27	2024-02-17
US7595021	No	2009-09-29	2023-05-12
US7717889	No	2010-05-18	2025-02-27
US7935093	No	2011-05-03	2027-10-02
US7427574	No	2008-09-23	2026-04-25
US8623935	No	2014-01-07	2029-07-26

Properties

State

Solid

Experimental Properties

Property	Value	Source
water solubility	800 mg/L (at 20 °C)	MERCK INDEX (1996)
logP	0.08	HANSCH,C ET AL. (1995), ionized pH 5
pKa	10.8 (at 25 °C)	HANSCH,C & LEO,AJ (1985)

Predicted Properties

Property	Value	Source
Water Solubility	0.0261 mg/mL	ALOGPS
logP	2.71	ALOGPS
logP	4.51	Chemaxon
logS	-4.3	ALOGPS
pKa (Strongest Basic)	10.52	Chemaxon
Physiological Charge	4	Chemaxon
Hydrogen Acceptor Count	10	Chemaxon
Hydrogen Donor Count	10	Chemaxon
Polar Surface Area	167.58 Å²	Chemaxon
Rotatable Bond Count	9	Chemaxon
Refractivity	181.71 m³·mol^-1	Chemaxon
Polarizability	54.58 Å³	Chemaxon
Number of Rings	2	Chemaxon
Bioavailability	0	Chemaxon
Rule of Five	No	Chemaxon
Ghose Filter	No	Chemaxon
Veber's Rule	No	Chemaxon
MDDR-like Rule	No	Chemaxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	+	0.8984
Blood Brain Barrier	+	0.7872
Caco-2 permeable	+	0.5231
P-glycoprotein substrate	Substrate	0.6016
P-glycoprotein inhibitor I	Non-inhibitor	0.5733
P-glycoprotein inhibitor II	Inhibitor	0.9175
Renal organic cation transporter	Inhibitor	0.7955
CYP450 2C9 substrate	Non-substrate	0.7033
CYP450 2D6 substrate	Non-substrate	0.6218
CYP450 3A4 substrate	Non-substrate	0.6532
CYP450 1A2 substrate	Inhibitor	0.8025
CYP450 2C9 inhibitor	Non-inhibitor	0.6847
CYP450 2D6 inhibitor	Inhibitor	0.927
CYP450 2C19 inhibitor	Non-inhibitor	0.5065
CYP450 3A4 inhibitor	Non-inhibitor	0.8309
CYP450 inhibitory promiscuity	High CYP Inhibitory Promiscuity	0.59
Ames test	Non AMES toxic	0.6532
Carcinogenicity	Non-carcinogens	0.857
Biodegradation	Not ready biodegradable	0.9896
Rat acute toxicity	1.7711 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.5579
hERG inhibition (predictor II)	Non-inhibitor	0.5661

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
LC-MS/MS Spectrum - LC-ESI-qTof , Positive	LC-MS/MS	Not Available
MS/MS Spectrum - , positive	LC-MS/MS	splash10-0ufr-2900000000-77fb2c1a85c1b39d8e91
MS/MS Spectrum - , positive	LC-MS/MS	splash10-00yi-2912000000-109a5810a9e5d36f3105

Targets

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1. Bacterial outer membrane

Kind

Group

Organism

Bacteria

Pharmacological action

Yes

Actions

Incorporation into and destabilization

References

Zorko M, Jerala R: Alexidine and chlorhexidine bind to lipopolysaccharide and lipoteichoic acid and prevent cell activation by antibiotics. J Antimicrob Chemother. 2008 Oct;62(4):730-7. doi: 10.1093/jac/dkn270. Epub 2008 Jul 16. [Article]
Kuyyakanond T, Quesnel LB: The mechanism of action of chlorhexidine. FEMS Microbiol Lett. 1992 Dec 15;100(1-3):211-5. [Article]

Carriers

Details1. Serum albumin

Kind: Protein
Organism: Humans
Pharmacological action: Unknown
Actions: Substrate

General Function: Toxic substance binding
Specific Function: Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name: ALB
Uniprot ID: P02768
Uniprot Name: Serum albumin
Molecular Weight: 69365.94 Da

References

Hjeljord LG, Rolla G, Bonesvoll P: Chlorhexidine-protein interactions. J Periodontal Res Suppl. 1973;12:11-6. doi: 10.1111/j.1600-0765.1973.tb02158.x. [Article]

Drug created at June 13, 2005 13:24 / Updated at February 08, 2023 20:46

Chlorhexidine

Identification

Structure for Chlorhexidine (DB00878)

Pharmacology

Interactions

Products

Categories

Chemical Identifiers

References

Clinical Trials

Pharmacoeconomics

Properties

Spectra

Targets

References

Carriers

References