Chlorhexidine gel

A 64-year-old man had severe anaphylaxis induced by intraurethral chlorhexidine gel 0.05% (53). Previous hypersensitivity reactions during urethral dilatation had been thought to be due to lidocaine. Chlorhexidine-specific IgE antibodies were demonstrated, and the chlorhexidine gel had been used in all the preceding urological procedures the patient had undergone. 

Immunologic Three cases of occupationally exposed workers with airway allergy to chlorhexidine were described [33 ]. A patient experienced anaphylaxis due to chlorhexidine delivered through multiple routes including a central venous catheter with chlorhexidine coating [34 ]. Three cases of anaphylaxis were caused by the insertion of central venous catheters impregnated with chlorhexidine [35 ]. Two further cases of anaphylaxis during urinary catheterisation with the aid of chlorhexidine gel lubrication were reported [36, 37 ]. 

When Hansen et al. (3) compared the effects of a 1% chlorhexidine gel, applied once daily for 4 weeks, with those of a placebo gel they detected no effect on gingivitis and only a slight effect on plaque formation even within this limited period, however, discolouration of the teeth and fillings, as assessed by standardized colour photography, seemed to be more frequent after the use of the active gel or when conventional oral... 

Chlorhexidine is available as lotions, creams, washes for disinfection and cleansing of skin and wounds, and as oral gels and mouthwashes. It also has... 

Chlorhexidine has been used as an adjuvant for plaque control and in the treatment of gingival inflammation. It is generally considered to be effective in the control of plaque and can be helpful in the treatment of gingivitis. It can be applied in the form of a solution, used as a mouth rinse or with a toothbrush, in dentifrice or as a gel. The concentrations used are 0.05-2%. 

A discoloration of the dorsum of the tongue occurs in up to one-third of subjects using chlorhexidine mouth rinses. It does not occur during the use of chlorhexidine-containing dentifrices or gels (SEDA-11, 481) (27,28). 

For skin disinfection, chlorhexidine has been formulated as a 0.5% w/v solution in 70% v/v ethanol and, in conjunction with detergents, as a 4% w/v surgical scrub. Chlorhexidine salts may also be used in topical antiseptic creams, mouthwashes, dental gels, and in urology for catheter sterilization and bladder irrigation. 

N,N-Dimethyl-N-lauric acid-amidopropyl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-myristyl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-palmityl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-stearyl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-tallow-N-(3-sulfopropyl)-ammonium betaine N,N-Distearyl-N-methyl-N-(3-sulfopropyl)-ammonium betaine bactericide, apples Sodium o-phenylphenate bactericide, aq. metal coolants Sodium pyrithione bactericide, aq. metal cutting fluids Sodium pyrithione bactericide, aq. paints 2-Bromo-4 -hydroxyacetophenone bactericide, aqueous systems Tris (hydroxymethyl) nitromethane bactericide, awning/tarpaulin fabrics 10,10-Oxybisphenoxyarsine bactericide, bath gels Chlorhexidine digluconate bactericide, beer Sodium ethylparaben bactericide, biocides Cocamidopropyl hydroxysultaine N,N-Dimethyl-N-lauric acid-amidopropyl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-myristyl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-palmityl-N-(3-sulfopropyl)-ammonium betaine N,N-Dimethyl-N-stearyl-N-(3-sulfopropyl)-ammonium betaine... 

Calcium ascorbate preservative, bacon curing Potassium nitrite preservative, bacterial infections Tea tree (Melaleuca alternifolia) oil preservative, baked goods Calcium acetate Sodium diacetate Sodium propionate preservative, balms Tea tree (Melaleuca alternifolia) oil preservative, bath gels Chlorhexidine digluconate preservative, beer... 

Methocel 2 % gel sterile Sterile products (solids) Talcum (sterile powder) Non-sterile products (liquids) Chlorhexidine tincture (or 0.02 % in glycerol) Lubricant, various indications Indication, use Pleurodesis Indication, use Irrigation... 

The type of viscosity of a (partially) neutralised carbomer hydrogel is plastic a (large) yield value and a decreasing viscosity with increasing shear stress a carbomer gel is not thixotropic (see Sect. 18.2). Carbomer hydrogel is not compatible with a number of active substances because of the pH (about 6.5) that is needed for the gel formation. For instance salicylic acid is ionised at this pH and hence not effective as a keratolytic. Weak base salts (e.g. alkaloid, chlorhexidine, aluminium and zinc salts) will precipitate at this pH. 

Skin prick tests on a patient who experienced an anaphylactic reaction to Instillagel produced results that draw attention to a potential pitfall when testing for sensitivity to this preparation. The demonstration of a positive skin test to chlorhexidine after the finding of a negative skin prick test to Instillagel was attributed to the presence of lidocaine in the gel and its effect in ablating the neurogenic wheal response required for a positive prick test. 

The fact that chlorhexidine, used as a mouthwash, discoloured the teeth, fillings and tongue, and could produce soreness of the mouth, was recorded in SED VIII. The substance has come more to the fore as a result of its promotion in the form of a gel for the removal of dental plaque as a meaits of treating chronic gingivitis. 

Hansen, F., Gjermo, P. and Eriksen, H. M. (1975) The effect of a chlorhexidine-containing gel on oral cleanliness and gingival health in young adults, y. clin. Periodont., 2, 153. 

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