Antiseptic / disinfectant (bisbiguanide) Pregnancy: Can be used during pregnancy and breast-feeding — no effects anticipated since systemic exposure to chlorhexidine gluconate is negligible; no studies with this product in pregnant/lactating women.

Chlorhexidine

Brand names: Corsodyl (mouthwash 0.2%), Hibiscrub (skin scrub 4%), Hibitane, ChloraPrep (skin prep 2% + alcohol 70%)

Chlorhexidine is a widely used antiseptic for skin and mucous membrane disinfection, oral hygiene and as a preservative in some preparations.

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 (containing 1 mL, 1.5 mL, 3 mL, 10.5 mL or 26 mL of ChloraPrep alcoholic solution)

Route: Cutaneous (topical skin antiseptic)

Frequency: Single application before the invasive procedure

ChloraPrep skin antiseptic (chlorhexidine gluconate/isopropyl alcohol); no systemic dose. May be used in all age groups. Applicator size is chosen by the procedure and clinician preference (per SPC table): 1 mL / 1.5 mL (8x10-10x13 cm) for routine venipuncture, blood culture, peripheral/arterial cannulation, simple biopsy, dialysis fistula/graft cleansing; 3 mL (15x15 cm) for midline & CVC insertion/maintenance, peritoneal dialysis site cleansing; 10.5 mL / 26 mL (25x30-50x50 cm) for minor and major surgery, implantable/prosthetic device placement, midline/PICC/CVC insertion, cardiac catheterisation, interventional radiology. Method: squeeze applicator gently to break the ampoule; pinch wings once only to activate; once solution is visible on skin, use gentle back-and-forth strokes to prepare the site for 30 seconds; allow to air dry completely; recommended to remain on skin post-procedure. Solution is flammable — do not use ignition sources until skin is completely dry. For external use only on intact skin; keep away from eyes, mucous membranes, neural tissue and middle ear. Use with care in newborn babies, especially premature (see §4.4). Paediatric frequency, type and severity of adverse reactions expected to be the same as adults.

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 irritation skin reactions (very rare): erythema, rash, pruritus, blisters/application site vesicles
Skin burning sensation, pain and inflammation at application site
Dermatitis, eczema, urticaria; chemical burns in neonates (frequency not known)
Hypersensitivity including anaphylactic shock (frequency not known)
Eye disorders (frequency not known): eye irritation, pain, hyperaemia, corneal erosion, epithelium/corneal injury, significant permanent visual impairment following inadvertent ocular exposure

Clinical monograph

How it works

It is a cationic biguanide that binds to and disrupts negatively charged bacterial cell membranes, giving broad-spectrum bactericidal activity against many Gram-positive and Gram-negative organisms.

Prescribing in practice

Anaphylactic and other hypersensitivity reactions to chlorhexidine can occur, including with medical devices and antiseptic skin preparations, so be alert to this risk and avoid use in patients with known sensitivity.
Alcohol-based skin preparations are flammable, so allow the solution to dry fully and avoid pooling before using diathermy or other ignition sources.
Avoid contact with the eyes, brain, meninges and middle ear, and use mouthwash formulations as directed as they can cause reversible tooth and tongue staining and taste disturbance.

Monitoring

Routine laboratory monitoring is not required; observe for local irritation and for any signs of hypersensitivity.

Counselling the patient

Use externally or as a mouthwash exactly as directed and avoid getting it in the eyes.
Mouthwash may cause temporary staining of the teeth and altered taste, which generally resolves on stopping.
Stop and seek advice if rash, swelling or breathing difficulty develops.

Evidence & guidelines

Chlorhexidine is a long-established antiseptic supported by extensive clinical use and infection-control evidence.

Reference: SmPC Corsodyl / Hibiscrub / ChloraPrep; epic3 Guidelines (2014); NICE CG139 (Healthcare-associated infections); MHRA Drug Safety Update Oct 2012 (chlorhexidine anaphylaxis); 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