Drug reference

Chlorhexidine gluconate

Topical/oral antiseptic (cationic bisbiguanide) · Topical disinfection

Also known as HIBITANE PLUS, HIBISCRUB, HIBITANE OBSTETRIC, HIBI LIQUID HAND RUB+, Cepton, ChloraPrep

START

Pre-op skin: 2% in alcohol, allow to dry; mouth: 0.12% 15 mL BID rinse

TYPICAL MAX

Topical to application area as protocol

STOP IF

Hypersensitivity / anaphylaxis or contact dermatitis

WATCH

Avoid eye/middle ear/meninges; let alcohol dry before drapes

CDSCO approvedOTCATC D08AC02

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 18s · seconds
PEAK: 6min · local
t½: 36s · not absorbed
DURATION: 6h · reservoir

EXCRETION

Mainly faecal; minimal systemic

route + CYP

INTERACTIONS

—

none in our sources

PREGNANCY

Topical use considered safe.

FDA category + note

Mechanism

Cationic bisbiguanide that binds negatively charged bacterial cell walls and disrupts membrane permeability; broad-spectrum bactericidal (Gram-positive > Gram-negative), some fungi/enveloped viruses; persistent skin substantivity (6 h reservoir).

Indications

Surgical hand/skin antisepsis (4% scrub)Pre-operative skin preparation (2% in alcohol)Oral antiseptic (0.12–0.2% mouthwash) for gingivitis/peri-implantVaginal cleansingWound irrigation (low concentration)Bathing (2% wipes — ICU CLABSI prevention)

Dosing

Adult: Skin: 4% scrub for surgical hand prep; 2% alcohol for surgical site. Mouth: 15 mL of 0.12% twice daily ×30 s rinse. Bathing: 2% wipes daily in ICU.
Pediatric: Avoid ≥2% products on premature/term neonates (chemical burn risk); use diluted formulations.
Renal adjustment: No adjustment (topical).
Hepatic adjustment: No adjustment.
Geriatric: Standard topical use.
Max dose: Topical to application area; routine dosing

Pharmacokinetics

Onset

Bactericidal within seconds; reservoir effect 6 h

Peak effect

Local — immediate

Duration

Sustained reservoir effect ~6 h

Half-life

Not applicable (negligible systemic absorption)

Bioavailability

Negligible systemic

Protein binding

Not applicable

Metabolism

Not metabolised systemically

Excretion

Mainly faecal (any swallowed); minimal renal

Contraindications

Use on / in / near the middle ear or meninges (ototoxicity/neurotoxicity)
Use on eyes (corneal damage)
Severe hypersensitivity (anaphylaxis reported)
Use in spinal/epidural anaesthesia field with alcohol still wet

Side effects

Common

Local skin irritationTooth/restoration staining (mouthwash)Taste alterationTongue discoloration

Serious

Severe hypersensitivity / anaphylaxis (rare)
Chemical burns (high concentration on neonatal skin)
Ototoxicity if used in middle ear
Corneal injury

Pregnancy & lactation

Pregnancy

Topical use considered safe.

Lactation

Compatible (topical/local; rinse nipple before feeding if used).

Drug interactions

Anionic Surfactants

Moderate

Database

Anionic-cationic neutralisation

Rinse soap before chlorhexidine