Skin antiseptic / wound cleanser Pregnancy: Physicians should carefully consider the potential risks and benefit for each specific patient before prescribing chlorhexidine. Chlorhexidine has been used in pregnant women and no harmful effects have been reported; there are no adequate data to support use in lactating women.

Chlorhexidine with cetrimide

Brand names: Tisept, Travasept

A combined antiseptic of the biguanide chlorhexidine with the quaternary-ammonium surfactant cetrimide, used for cleansing and disinfecting wounds, burns and skin.

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: Chlorhexidine acetate 0.015% w/v with cetrimide 0.15% w/v irrigation solution: used undiluted for topical application only. No numeric dose, volume or frequency is stated — dosage and duration are individualised to the indication, the patient's age, weight, clinical condition and concomitant treatment, and to the clinical response

Route: Topical (general topical use / irrigation). NOT for intravenous or oral administration

Frequency: Not stated in the SPC — individualised to the indication and clinical response

Source product: Chlorhexidine Acetate 0.015% w/v and Cetrimide 0.15% w/v, Irrigation Solution (UK SPC §4.2). Exact source wording: 'Dosage and duration of administration are to be individualized and depend upon the indication for use, the patient's age, weight, clinical condition, and concomitant treatment, and on patient's clinical response to treatment' and 'This solution is used undiluted for topical application only. Not for intravenous or oral route of administration.' STRENGTH CAVEAT (resolves an earlier hold on this draft): 'used undiluted' is stated by the SPC for THIS ready-to-use 0.015%/0.15% irrigation presentation. Other chlorhexidine/cetrimide products are supplied as concentrates that must be diluted before use — do not carry this instruction across to a different strength or presentation. NEONATES/PAEDIATRICS: no paediatric dose is stated. Use of chlorhexidine solutions (both alcohol-based and aqueous) for skin antisepsis prior to invasive procedures has been associated with skin reactions such as chemical burns in neonates, with higher risk in preterm infants, especially those born before 32 weeks of gestation and within the first 2 weeks of life; the product should only be used in specialist units familiar with appropriate patient selection. Remove any soaked materials, drapes or gowns before proceeding with the intervention; do not use excessive quantities, do not allow the solution to pool in skin folds or under the patient, or to drip on sheets or other material in direct contact with the patient; where occlusive dressings are to be applied to areas previously exposed to chlorhexidine, ensure no excess product is present first. Take extreme care that chlorhexidine does not migrate into the eyes (particularly in anaesthetised patients); if contact occurs, wash out promptly and thoroughly with water and seek an ophthalmologist's advice. Accidental ingestion should be treated with a stomach lavage consisting of milk, egg white, gelatin or mild soap. §4.6 states the solution is recommended for swabbing in obstetrics and gynaecology.

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

Must not be used in the eye
Must not be given intravenously or orally
Must not be used in the auditory canal (especially with perforated eardrums)
Must not be used near the meninges, brain or spinal cord
Known hypersensitivity to chlorhexidine or cetrimide

Side effects

Hypersensitivity reactions including anaphylactic/anaphylactoid reactions — manifested by cardiac arrest, shock, circulatory collapse, hypotension, bronchospasm, tachycardia, rash, erythema and urticaria (fatal anaphylactic reactions have been reported with other chlorhexidine-containing products)
Rash; chemical burns in neonates
With intravesical, intravaginal or topical use on traumatised skin (very occasional): hypotension, paraesthesia, dyspnoea, tachycardia, cold sweat, generalised erythema, urticaria, loss of consciousness
Pain, haematuria and/or increased urge to urinate
Eye disorders (frequency not known): corneal erosion, corneal epithelium defect/injury, visual impairment — severe corneal erosion and permanent significant visual impairment after inadvertent ocular exposure have been reported post-marketing, with some patients requiring corneal transplant

Interactions

The action of chlorhexidine is reduced by alkaline pH and by the presence of organic matter (SPC §4.5 — text truncated at the source-fetch limit; verify the full section)

Clinical monograph

How it works

Chlorhexidine disrupts microbial cell membranes with persistent residual activity, while cetrimide acts as a cationic surfactant that emulsifies debris and has additional antimicrobial and cleansing properties.

Prescribing in practice

Avoid contact with the eyes, brain, meninges and middle ear, and do not use in body cavities, as chlorhexidine can cause serious harm to these tissues.
Solutions can become contaminated with resistant organisms, so single-use sterile presentations are preferred for open wounds.
Cetrimide can be irritant to skin, especially with repeated or prolonged use.

Monitoring

Inspect the wound for signs of irritation or sensitisation and ensure the antiseptic is not used near the eyes or within enclosed cavities.

Counselling the patient

Use for cleansing skin and wounds as directed and keep away from the eyes and ears.
Report any stinging, rash or increasing redness of the treated area.

Evidence & guidelines

Guidance on avoiding sensitive tissues and contamination risk follows the SPC and standard wound-care references.

Reference: 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