Chlorhexidine (Oral Route) Precautions - Mayo Clinic (2024)

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Paroex
  2. Peridex
  3. Periogard

Descriptions

Chlorhexidine is used to treat gingivitis. It helps to reduce the inflammation (redness) and swelling of your gums and to reduce gum bleeding.

Gingivitis is caused by the bacteria that grow in the coating (plaque) that forms on your teeth between tooth brushings. Chlorhexidine destroys the bacteria, thereby preventing the gingivitis from occurring. However, chlorhexidine does not prevent plaque and tartar from forming; proper tooth brushing and flossing are still necessary and important.

Chlorhexidine is available only with your dentist's or medical doctor's prescription.

This product is available in the following dosage forms:

  • Liquid
  • Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of this medicine in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of this medicine in the elderly with use in other age groups.

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Front-tooth fillings (especially those having rough surfaces)—Chlorhexidine may cause staining that, in some cases, may be impossible to remove and may require replacement of the filling
  • Gum problems (other)—Use of chlorhexidine may make other gum problems, such as periodontitis, worse

Proper Use

Chlorhexidine oral rinse should be used after you have brushed and flossed your teeth. Rinse the toothpaste completely from your mouth with water before using the oral rinse. Do not eat or drink for several hours after using the oral rinse.

The cap on the original container of chlorhexidine can be used to measure the 15 mL (½ fluid ounce) dose of this medicine. Fill the cap to the ``fill line.'' If you do not receive the dental rinse in its original container, make sure you have a measuring device to measure out the correct dose. Your pharmacist can help you with this.

Swish chlorhexidine around in the mouth for 30 seconds. Then spit out. Use the medicine full strength. Do not mix with water before using. Do not swallow the medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral rinse dosage form:
    • For gingivitis:
      • Adults—Use 15 milliliters (mL) as a mouth wash for 30 seconds two times a day.
      • Children up to 18 years of age—Use and dose must be determined by your dentist or medical doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions

Chlorhexidine may have a bitter aftertaste. Do not rinse your mouth with water immediately after using chlorhexidine, since doing so will increase the bitterness. Rinsing may also decrease the effect of the medicine.

Chlorhexidine may change the way foods taste to you. Sometimes this effect may last up to 4 hours after you use the oral rinse. In most cases, this effect will become less noticeable as you continue to use the medicine. When you stop using chlorhexidine, your taste should return to normal.

Chlorhexidine may cause staining and an increase in tartar (calculus) on your teeth. Brushing with a tartar-control toothpaste and flossing your teeth daily may help reduce this tartar build-up and staining. In addition, you should visit your dentist at least every 6 months to have your teeth cleaned and your gums examined.

If you think that a child weighing 22 pounds (10 kilograms) or less has swallowed more than 4 ounces of the dental rinse, get emergency help at once. In addition, if a child of any age drinks the dental rinse and has symptoms of alcohol intoxication, such as slurred speech, sleepiness, or a staggering or stumbling walk, get emergency help at once.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

  1. Signs of allergic reaction (nasal congestion; shortness of breath or troubled breathing; skin rash, hives, or itching; or swelling of face

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Change in taste
  2. increase in tartar (calculus) on teeth
  3. staining of teeth, mouth, tooth fillings, and dentures or other mouth appliances

Less common or rare

  1. Mouth irritation
  2. swollen glands on side of face or neck
  3. tongue tip irritation

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: Feb. 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/chlorhexidine-oral-route/precautions/drg-20068551

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Chlorhexidine (Oral Route) Precautions - Mayo Clinic (2024)

FAQs

Chlorhexidine (Oral Route) Precautions - Mayo Clinic? ›

Do not rinse your mouth with water immediately after using chlorhexidine, since doing so will increase the bitterness. Rinsing may also decrease the effect of the medicine. Chlorhexidine may change the way foods taste to you. Sometimes this effect may last up to 4 hours after you use the oral rinse.

What precautions should be taken when using chlorhexidine? ›

Chlorhexidine should only be used on the skin. Do not swallow it or get it in the eyes, ears, mouth, or nose. Do not use it on the genital area (sex organs) or anal area. If it does get on these areas, rinse it off right away.

Is chlorhexidine safe for oral care? ›

Based on 16 randomized controlled trials, Klompas and colleagues found a trend toward increased mortality. In a selection of general intensive care units (excluding specialty units), Price and colleagues found chlorhexidine oral care to be significantly associated with an increased risk of death.

What is the oral route of chlorhexidine? ›

For oral rinse dosage form: For gingivitis: Adults—Use 15 milliliters (mL) as a mouth wash for 30 seconds two times a day. Children up to 18 years of age—Use and dose must be determined by your dentist or medical doctor.

What are the instructions for chlorhexidine mouthwash? ›

Rinse with 10 ml of chlorhexidine mouthwash for 30 – 40 seconds twice a day after flossing and brushing. Do not swallow the mouthwash. Spit, but DO NOT rinse with water, and refrain from drinking or eating for 30 minutes after use. Use this chlorhexidine mouthwash for 2-4 weeks only or as instructed.

What precautions should be taken when using Hibiclens? ›

Pharmacist tips for Hibiclens (chlorhexidine)

Be careful not to get Hibiclens (chlorhexidine) in your eyes, ears, mouth or genital area. If this happens, rinse the area with cold water right away to prevent skin or tissue injury.

What precautions should be taken when using Peridex? ›

Peridex can cause a rare but serious allergic reaction that may be life-threatening. Get emergency medical help if you have: hives, severe skin rash; wheezing, difficult breathing; cold sweats, feeling light-headed; swelling of your face, lips, tongue, or throat.

Why is chlorhexidine no longer recommended? ›

The main reason many clinicians dislike chlorhexidine is because of its side effects. We all know chlorhexidine stains teeth, and another common side effect is calculus buildup. Neither side effect is something you'd logically want for patients after their scalings, prophies, or surgeries.

What is the main disadvantage of chlorhexidine? ›

Chlorhexidine may cause staining and an increase in tartar (calculus) on your teeth. Brushing with a tartar-control toothpaste and flossing your teeth daily may help reduce this tartar build-up and staining.

Why can't I drink water after chlorhexidine? ›

It's recommended that you wait to eat food or drink liquid after using chlorhexidine (Peridex). If you don't wait, you might accidentally swallow some of the medication, which can cause stomach irritation or nausea.

How soon can you eat after chlorhexidine? ›

After using chlorhexidine, wait at least 30 minutes before rinsing your mouth with water or mouthwash, brushing your teeth, eating, or drinking.

Why would a dentist prescribe chlorhexidine? ›

Chlorhexidine is a medication that comes as an oral rinse. It treats gingivitis. This is a bacterial gum disease. The oral rinse kills or prevents the growth of bacteria in your mouth and reduces inflammation in your gums.

What to do if chlorhexidine is swallowed? ›

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222, especially if a child has swallowed 4 or more ounces of chlorhexidine gluconate. An overdose of chlorhexidine would occur only if the medicine were swallowed.

Is it safe to use chlorhexidine mouthwash every day? ›

While daily use of chlorhexidine mouthwash can offer benefits, it also comes with potential side effects. These may include staining of the teeth, alteration of taste, and possible mouth irritation. It's also worth noting that prolonged use may lead to an imbalance in the mouth's microbiome.

Do you perform oral care with chlorhexidine? ›

Chlorhexidine gluconate is an antiseptic agent with a broad spectrum (gram-positive bacteria, gram-negative bacteria, and yeast) that has been widely included in different hospitals' protocols for oral hygiene care in intubated patients to reduce the incidence of VAP.

Do I brush my teeth before chlorhexidine? ›

Chlorhexidine oral rinse should be used after you have brushed and flossed your teeth. Rinse the toothpaste completely from your mouth with water before using the oral rinse. Do not eat or drink for several hours after using the oral rinse.

What are the PPE requirements for chlorhexidine? ›

Skin Protection: Wash thoroughly after handling. Clothing Protection: Wear gloves. No extra needed under normal conditions of use. Respiratory Protection: S38: In case of insufficient ventilation wear suitable respiratory equipment.

What are the hazards of chlorhexidine? ›

Trade name: Chlorhexidine (hydrochloride)

Acute Toxicity - Oral 4 H302 Harmful if swallowed. Skin Irritation 2 H315 Causes skin irritation. Eye Irritation 2A H319 Causes serious eye irritation. Specific Target Organ Toxicity - Single Exposure 3 H335 May cause respiratory irritation.

What are the special considerations for chlorhexidine gluconate? ›

Before using this medication, tell your doctor or pharmacist your medical history, especially of: dental crowns, veneers, or fillings (especially if on the front teeth and if made of porcelain). Tell your doctor if you are pregnant before using this medication. It is unknown if this drug passes into breast milk.

What should I assess before giving chlorhexidine? ›

They need to know if you have any of the following conditions:
  • Front tooth fillings, dentures or other mouth appliances, especially those having rough surfaces.
  • Other gum or dental problems.
  • An unusual or allergic reaction to chlorhexidine, other medications, foods, dyes, or preservatives.

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