Skin antiseptic Pregnancy: No studies in pregnant or lactating women, but no effects are anticipated since systemic exposure to chlorhexidine gluconate is negligible — can be used during pregnancy and during breast-feeding. Effects on human fertility have not been studied.

Chlorhexidine gluconate with isopropyl alcohol

Brand names: ChloraPrep

An alcohol-based antiseptic skin solution combining chlorhexidine gluconate with isopropyl alcohol, used for rapid skin disinfection before surgery, venepuncture and invasive procedures.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One applicator per application, containing 1 mL, 1.5 mL, 3 mL, 10.5 mL or 26 mL of the alcoholic solution; the choice of applicator depends on the invasive procedure being undertaken and the clinician's preference

Route: Cutaneous (topical skin antisepsis); for external use only on intact skin

Frequency: Applied before the procedure — once the solution is visible on the skin, use gentle back and forth strokes to prepare the site for 30 seconds, then allow the area to air dry completely

Source product: ChloraPrep Clear (UK SPC §4.2). Applicator selection by coverage area and procedure as stated in the SPC: 1 mL covers 8 x 10 cm — routine venipuncture, blood culture collection, peripheral (arterial line) cannulation, simple biopsy; 1.5 mL (including 1.5 mL Frepp) covers 10 x 13 cm — the same plus dialysis fistula/graft site cleansing; 3 mL covers 15 x 15 cm — midline and central venous catheter (CVC) insertion and maintenance, peritoneal dialysis site cleansing; 10.5 mL covers 25 x 30 cm and 26 mL covers 50 x 50 cm — minor and major surgical procedures, implantable or prosthetic device placement/removal, midline, PICC and CVC insertion and maintenance, cardiac catheterisation and cardiac cath lab procedures, interventional radiology procedures. Technique: remove the applicator from the wrapper, hold with the sponge facing downward, squeeze gently to break the ampoule (for the 26 mL applicator press the lever); pinch the wings once only to activate — do not repeatedly pinch or pump the wings to accelerate saturation of the foam. The 26 mL applicator includes two swabs. It is recommended that the product remain on the skin post-procedure to provide continued antimicrobial activity; if removal is necessary, remove with soap and water or alcohol. AGE: the SPC states it may be used in all age groups and patient populations, but should be used with care in newborn babies, especially those born prematurely — no numeric paediatric dose is given. SAFETY: the solution is flammable — do not use electrocautery or other ignition sources until the skin is completely dry; do not use excessive quantities or allow pooling in skin folds, under the patient, or dripping onto material in contact with the patient; do not use on open, broken or damaged skin; avoid mucous membranes, the eyes, neural tissue and the middle ear.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances or to any of the excipients, especially in those with a history of possible chlorhexidine-related allergic reactions

Side effects

Allergic or irritant skin reactions — very rare (<1/10,000): erythema, rash (erythematous, papular or maculopapular), pruritus, blisters/application site vesicles
Skin burning sensation, application site pain and inflammation
Dermatitis, eczema, urticaria, and chemical burns in neonates — frequency not known
Hypersensitivity including anaphylactic shock — frequency not known; anaphylactic reactions have been reported during anaesthesia
Eye disorders (frequency not known): eye irritation, pain, hyperaemia, corneal erosion, corneal epithelium defect/injury, significant permanent visual impairment following inadvertent ocular exposure (some patients required corneal transplant)

Clinical monograph

How it works

Chlorhexidine disrupts microbial cell membranes and gives persistent residual activity, while isopropyl alcohol denatures proteins for rapid, broad-spectrum kill, the combination acting faster and more durably than either alone.

Prescribing in practice

The solution is flammable, so it must be allowed to dry fully and pooling avoided before diathermy or other ignition sources are used, to prevent surgical fires.
Avoid contact with the eyes, middle ear and meninges, and use with care on broken skin and in neonates where chemical burns have been reported.
Chlorhexidine can rarely cause anaphylaxis, so check for known hypersensitivity.

Monitoring

Confirm the prepared skin is fully dry before draping or using electrosurgery and observe for any local irritation or hypersensitivity reaction.

Counselling the patient

For external skin preparation only — keep away from the eyes and ears.
Allow the skin to dry completely before any procedure involving heat or electrical instruments.

Evidence & guidelines

MHRA and patient-safety guidance highlight fire risk from incomplete drying and pooling of alcohol-based skin antiseptics; use follows the SPC.

Reference: NICE NG125; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways