Chlorhexidine topical Side Effects
For the Consumer
Applies to chlorhexidine topical: topical application cream, topical application dressing, topical application gel/jelly, topical application liquid, topical application lotion, topical application pad, topical application solution, topical application sponge
Other dosage forms:
In addition to its needed effects, some unwanted effects may be caused by chlorhexidine topical. In the event that any of these side effects do occur, they may require medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking chlorhexidine topical:Incidence not known:
- Blistering, burning, itching, peeling, skin rash, redness, swelling, or other signs of irritation on the skin
- swelling of the face, hands, or feet
- trouble breathing
For Healthcare Professionals
Applies to chlorhexidine topical: compounding liquid, mucous membrane insert, mucous membrane liquid, topical dressing, topical liquid, topical pad, topical soap, topical solution, topical sponge
In clinical trials, 56% of chlorhexidine oral rinse users had a measurable increase in staining of teeth, and 15% experienced heavy staining. Stains may generally be removed by conventional professional prophylactic techniques. Staining of rough areas may be permanent. Stains are general dark brown to blackish.
Staining will be more pronounced in the presence of heavier accumulations of unremoved plaque.
Staining due to chlorhexidine may be due to the interaction with dietary compounds such as coffee and tea.[Ref]
Gastrointestinal side effects have been reported the most frequently with chlorhexidine oral rinses. These have included staining of teeth and tongue, increased calculus formation, alteration of taste perception, bitter taste, burning, numbness, dryness, and soreness. Aphthous ulcer, grossly obvious gingivitis, trauma, ulceration, erythema, desquamation, coated tongue, keratinization, geographic tongue, mucocele, and short frenum have been reported rarely with chlorhexidine oral rinses. Gastrointestinal side effects associated with chlorhexidine oral rinses without oral hygiene measures have included increased gingival bleeding after gentle massage.
Parotid gland swelling has been reported rarely.
Gastrointestinal side effects associated with chlorhexidine cleanser have included a single case report of acute gastritis.
Gastrointestinal side effects associated with chlorhexidine cleanser enema have included a single case report of acute colitis.
Gastrointestinal side effects associated with the periodontal chip have included transient toothache (50.7% vs 41.4% placebo), including dental, gingival, or oral pain, tenderness, aching, throbbing, soreness, discomfort, and sensitivity.[Ref]
Hypersensitivity reactions to chlorhexidine have included allergic contact dermatitis, pruritus, vesicle formation, urticaria, dyspnea, and anaphylactic shock.[Ref]
Hypersensitivity reactions have been reported after the use of products containing chlorhexidine as a preservative or devices coated with chlorhexidine, including allergic contact balanitis and anaphylactic shock.
Patch testing using chlorhexidine has revealed positive reactions in more than 2% of patients tested. In eczema patients, the rate may be as high as 5%.[Ref]
Exposure of the eye to chlorhexidine cleanser, generally during preparation for facial surgery, has resulted in eye pain, edema of the epithelium, keratitis, inflammation of the conjunctiva, corneal epithelial cell loss, chronic corneal ulcers, and opacification. Corneal transplantation to correct permanent damage has been required in some patients.
Allergic conjunctivitis is rarely associated with the use of contact lens solutions which contain low concentrations of chlorhexidine as a preservative.[Ref]
Ocular side effects associated with chlorhexidine cleanser have included ocular toxicity.
Ocular side effects associated with chlorhexidine containing contact lens solutions have rarely included allergic conjunctivitis.[Ref]
Nervous system side effects have included cases of sensorineural deafness following direct instillation of chlorhexidine into the middle ear.
Nervous system side effects associated with insertion of the periodontal chip have included headache (27.1% vs 27.5% with placebo chip).[Ref]
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2. "Product Information. Peridex (chlorhexidine)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
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4. Roche S, Chinn R, Webb S "Chlorhexidine-induced gastritis." Postgrad Med J 67 (1991): 210-1
5. Rushton A "Safety of Hibitane. II. Human experience." J Clin Periodontol 4 (1977): 73-9
6. Hardin RD, Tedesco FJ "Colitis after Hibiclens enema." J Clin Gastroenterol 8 (1986): 572-5
7. Asikainen S, Sandholm L, Sandman S, Ainamo J "Gingival bleeding after chlorhexidine rinses with or without mechanical oral hygiene." J Clin Periodontol 11 (1984): 87-94
8. Skoglund LA, Holst E "Desquamative mucosal reactions due to chlorhexidine gluconate. Report of 3 cases." Int J Oral Surg 11 (1982): 380-2
9. Pittaway A, Ford S "Allergy to chlorhexidine-coated central venous catheters revisited." Br J Anaesth 88 (2002): 304-5
10. Okano M, Nomura M, Hata S, Okada N, Sato K, Kitano Y, Tashiro M, Yoshimoto Y, Hama R, Aoki T "Anaphylactic symptoms due to chlorhexidine gluconate." Arch Dermatol 125 (1989): 50-2
11. Shoji A "Contact dermatitis from chlorhexidine." Contact Dermatitis 9 (1983): 156
12. Yaacob H, Jalil R "An unusual hypersensitivity reaction to chlorhexidine." J Oral Med 41 (1986): 145-6
13. Osmundsen PE "Contact dermatitis to chlorhexidine." Contact Dermatitis 8 (1982): 81-3
14. Torricelli R, Wuthrich B "Life-threatening anaphylactic shock due to skin application of chlorhexidine." Clin Exp Allergy 26 (1996): 112
15. Stephens R, Mythen M, Kallis P, Davies DW, Egner W, Rickards A "Two episodes of life-threatening anaphylaxis in the same patient to a chlorhexidine-sulphadiazine-coated central venous catheter." Br J Anaesth 87 (2001): 306-8
16. Hoyumpa AM "Disposition and elimination of minor tranquilizers in the aged and in patients with liver disease." South Med J 71 (1978): 23-8
17. Knudsen BB, Avnstorp C "Chlorhexidine gluconate and acetate in patch testing." Contact Dermatitis 24 (1991): 45-9
18. Lasthein Andersen B, Brandrup F "Contact dermatitis from chlorhexidine." Contact Dermatitis 13 (1985): 307-9
19. Evans RJ "Acute anaphylaxis due to topical chlorhexidine acetate." BMJ 304 (1992): 686
20. Lockhart A S, Harle C C "Anaphylactic reactions due to chlorhexidine allergy." Br J Anaesth 87 (2001): 940-1
21. Cheung J, O'Leary JJ "Allergic reaction to chlorhexidine in an anaesthetised patient." Anaesth Intensive Care 13 (1985): 429-30
22. Bechgaard E, Ploug E, Hjorth N "Contact sensitivity to chlorhexidine?" Contact Dermatitis 13 (1985): 53-5
23. Roberts DL, Summerly R, Byrne JP "Contact dermatitis due to the constituents of Hibiscrub." Contact Dermatitis 7 (1981): 326-8
24. Barrazza V "Connubial allergic contact balanitis due to chlorhexidine." Contact Dermatitis 45 (2001): 42
25. Moghadam BK, Drisko CL, Gier RE "Chlorhexidine mouthwash-induced fixed drug eruption. Case report and review of the literature." Oral Surg Oral Med Oral Pathol 71 (1991): 431-4
26. Shore JW "Hibiclens keratitis." Am J Ophthalmol 104 (1987): 670-1
27. van Ketel WG, Melzer-van Riemsdijk FA "Conjunctivitis due to soft lens solutions." Contact Dermatitis 6 (1980): 321-4
28. Phinney RB, Mondino BJ, Hofbauer JD, Meisler DM, Langston RH, Forstot SL, Benes SC "Corneal edema related to accidental Hibiclens exposure." Am J Ophthalmol 106 (1988): 210-5
29. Tabor E, Bostwick DC, Evans CC "Corneal damage due to eye contact with chlorhexidine gluconate." JAMA 261 (1989): 557-8
Not all side effects for chlorhexidine topical may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
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