Nasal Decolonisation / Recurrent Epistaxis Pregnancy: §4.6: Chlorhexidine and neomycin cannot be detected in the blood following application of Naseptin and its use is unlikely to have any effect on the foetus or on breast feeding.

Naseptin Nasal Cream

Brand names: Naseptin

Used in: Epistaxis (Nosebleed)

Naseptin is a nasal cream containing chlorhexidine and neomycin, used to eradicate nasal staphylococci and to treat minor nasal infections such as recurrent epistaxis-associated crusting.

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: A small amount of cream placed on the little finger and applied to the inside of each nostril

Route: nasal application only (topical)

Frequency: Prophylaxis: twice daily. Eradication of infection: four times daily for 10 days.

SPC §4.2 (Naseptin Nasal Cream): 'For prophylaxis: Naseptin is applied as above, twice daily, to prevent patients from becoming carriers and to inhibit the dispersion of Staphylococci. For eradication of infection: Naseptin is applied four times daily for 10 days to eliminate organisms from the nares.' No weight- or quantity-based dose is specified. Children and elderly patients: 'There are no special dosage recommendations for either children or elderly patients.' Naseptin is a fixed combination of neomycin and chlorhexidine (per §4.3/§4.6 wording); the fetched SPC sections do not state the concentrations of the two active substances — confirm strengths against the full SPC. §4.4: for nasal application only; keep out of the eyes and ears; irritative skin reactions can occasionally occur; prolonged use of neomycin can lead to skin sensitisation, ototoxicity and nephrotoxicity; use with caution in children, elderly patients and patients with impaired hearing; contains cetostearyl alcohol which may cause local skin reactions (e.g. contact dermatitis).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Patients who have previously shown a hypersensitivity reaction to neomycin or chlorhexidine (such reactions are extremely rare)
Hypersensitivity to the active substances or to any of the excipients listed in section 6.1

Side effects

Anaphylaxis (frequency not known)
Temporary hyposmia and temporary ageusia (frequency not known)
Ototoxicity — use with caution in children, elderly patients and patients with impaired hearing (frequency not known)
Irritative skin reactions and skin sensitisation (frequency not known)
Nephrotoxicity (frequency not known)
Application site discolouration (frequency not known)

Interactions

§4.5: None known

Clinical monograph

How it works

Chlorhexidine is an antiseptic that disrupts the bacterial cell membrane, while neomycin is an aminoglycoside antibiotic that inhibits bacterial protein synthesis, together reducing nasal bacterial carriage.

Prescribing in practice

It contains peanut (arachis) oil and is contraindicated in patients with peanut or soya allergy.
Neomycin can cause local hypersensitivity reactions with prolonged or repeated use.
It is applied to the nostrils and is not intended for use elsewhere or for systemic infection.

Monitoring

No laboratory monitoring is needed; review if nasal symptoms persist or if a local allergic reaction develops.

Counselling the patient

Do not use this cream if you are allergic to peanuts or soya.
Apply gently to the nostrils as directed and complete the course advised.
Stop and tell us if you develop a rash, itching or swelling in or around the nose.

Evidence & guidelines

Use reflects its established role in nasal decolonisation; refer to the SPC for the peanut oil contraindication and indications.

Reference: NICE Surgical Site Infection (SSI) Prevention Guidance; PHE MRSA Decolonisation Protocol; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. 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