ACTION AND MECHANISM Antiseptic, chlorophenylbiguanidine derivative. It has a relatively broad antibacterial (bacteriostatic) spectrum, with particular activity against Gram-positive bacteria. It is sporostatic. It does not usually induce antimicrobial resistance. It also has fungistatic action (Candida). Its action is relatively slow but has considerable persistence and residual adherence. CONTRAINDICATIONS - Hypersensitivity to the medication. ADVANCED AGE No specifically geriatric problems have been described in this age group. PREGNANCY Animal safety : Animal studies have not shown fetal risk. Safety in humans : There are no adequate and well-controlled studies in humans. Use with caution. Effects on fertility : no specific studies have been conducted in humans. INDICATIONS -1% PRESENTATIONS: [DISINFECTION] of wounds, erosions, [BURNS], [BEDSORES], preoperative skin disinfection. Disinfection of the newborns umbilical cord. Barrier against bacterial infection applied to the hands of healthcare personnel (cream). -PRESENTATIONS 4%: Preoperative hand disinfection in surgery, antiseptic hand washing in hospitals and pre/postoperative skin antisepsis in patients undergoing surgery. - SPRAYER: Disinfection of minor burns, small superficial wounds, cracks and abrasions. INTERACTIONS The action of chlorhexidine is reduced by alkaline pH, the presence of organic matter, anionic detergents, and tannins. Elevated temperature, neutral pH, non-ionic detergents, alcohol, and quaternary ammonium salts promote its action. It may interfere with microbiological antibiotic assays. LACTATION Animal safety: no data available. Safety in humans: It is unknown whether this drug is excreted in breast milk. No problems have been reported in humans, although the potential risk of systemic effects should be considered. Use with caution. CHILDREN No specifically pediatric problems have been described in this age group. GUIDELINES FOR PROPER ADMINISTRATION Before using this medication, rinse the toothpaste thoroughly with water after brushing and flossing to ensure the products effectiveness. For maximum efficacy, avoid eating and drinking for several hours after using the medication. To treat denture stomatitis, rinse the dentures and then soak them in the chlorhexidine solution for 15 minutes twice a day. Alternatively, you may need to rinse your mouth for 30 seconds twice a day or brush your gums or dentures twice a day with the chlorhexidine solution. POSOLOGY - 1% PRESENTATIONS : Apply undiluted to the surface to be disinfected, recommending no more than 2 applications/day. Disinfection of healthcare personnels hands: pour approximately 5 ml onto the hands, rinse with water and repeat the process. - 4% PRESENTATIONS : Preoperative hand disinfection in surgery: Wet arms and forearms, apply 5 ml and wash for 1 minute, cleaning nails, rinse and apply another 5 ml for 2 minutes, rinse and dry. Antiseptic hand washing in hospitals: Wet hands and forearms, apply 5 ml and wash for 1 minute, rinse and dry. Preoperative skin antisepsis in patients undergoing surgery: The day before, wash with 25 ml from the face downwards, paying special attention to the areas around the nose, armpits, navel, groin and perineum. Rinse and repeat washing with another 25 ml, including the hair. Rinse and dry. Repeat the entire process the following day. Postoperative skin antisepsis in patients undergoing surgery: from the 3rd day after surgery, wash the entire body, excluding the surgical area, according to the rules set out above. - SPRAY : Apply 1-2 times after washing the wound. PRECAUTIONS - Do not apply to eyes or ears. In case of accidental application, wash immediately with plenty of water. - The solutions will be stored in bottles with glass, rubber or plastic stoppers (avoid cork stoppers). - Dilutions should be renewed weekly. Protect from light and heat. - Needles and syringes that have been in contact with chlorhexidine solutions should be rinsed in sterile water or saline solution before intrathecal use. - Treated clothes should not be washed with bleach or hypochlorites, as this can cause browning of the fabric, but with household detergents based on sodium perborate. ADVERSE REACTIONS Rarely, [SKIN IRRITATION], [DERMATITIS] or [PHOTOSENSITIVITY REACTIONS], in which case discontinue treatment. Instilled into the middle ear, it can cause [DEAFNESS], so it is recommended to take extreme precautions in case of eardrum perforation to avoid injury to the tissues of the inner ear. There are reported cases of [HEMOLYTIC ANEMIA] following accidental ingestion of chlorhexidine. OVERDOSE - Symptoms: Chlorhexidine is poorly absorbed from the gastrointestinal tract. In case of accidental ingestion, gastric disturbances, including nausea, may occur. Overdosage with chlorhexidine in children produces symptoms of alcohol intoxication (slurred speech, drowsiness, or unsteady gait). - Treatment: Gastric lavage and protection of the digestive mucosa are recommended.