In the U.S.—

In Canada—

• Antibacterial, dental

Chlorhexidine (klor-HEX-i-deen) is used to treat gingivitis. It helps to reduce the inflammation (redness) and swelling of your gums and to reduce gum bleeding.

Gingivitis is caused by the bacteria that grow in the coating (plaque) that forms on your teeth between tooth brushings. Chlorhexidine destroys the bacteria, thereby preventing the gingivitis from occurring. However, chlorhexidine does not prevent plaque and tartar from forming; proper tooth brushing and flossing are still necessary and important.

Chlorhexidine is available only with your dentist's or medical doctor's prescription, in the following dosage form:

Dental
• Oral rinse (U.S.)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your dentist or medical doctor will make. For chlorhexidine, the following should be considered:

Allergies—Tell your dentist or medical doctor if you have ever had any unusual or allergic reaction to this medicine or to skin disinfectants containing chlorhexidine. Also tell your dentist or medical health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Chlorhexidine has not been studied in pregnant women. However, chlorhexidine has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether chlorhexidine passes into the breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their dentist or medical doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of this medicine in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of this medicine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your dentist or medical doctor may want to change the dose, or other precautions may be necessary. Tell your dentist or health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine that is to be used in the mouth.

• Front-tooth fillings (especially those having rough surfaces)—Chlorhexidine may cause staining that, in some cases, may be impossible to remove and may require replacement of the filling

• Gum problems (other)—Use of chlorhexidine may make other gum problems, such as periodontitis, worse

Chlorhexidine oral rinse should be used after you have brushed and flossed your teeth. Rinse the toothpaste completely from your mouth with water before using the oral rinse. Do not eat or drink for several hours after using the oral rinse.

The cap on the original container of chlorhexidine can be used to measure the 15 mL (½ fluid ounce) dose of this medicine. Fill the cap to the ``fill line.'' If you do not receive the dental rinse in its original container, make sure you have a measuring device to measure out the correct dose. Your pharmacist can help you with this.

Swish chlorhexidine around in the mouth for 30 seconds. Then spit out. Use the medicine full strength. Do not mix with water before using. Do not swallow the medicine.

Dosing—

The dose of chlorhexidine oral rinse will be different for different patients. Follow your dentist's or medical doctor's orders or the directions on the label. The following information includes only the average doses of chlorhexidine oral rinse. If your dose is different, do not change it unless your dentist or medical doctor tells you to do so.

• For oral rinse dosage form:
  • For gingivitis:
    • Adults—Use 15 milliliters (mL) as a mouth wash for 30 seconds two times a day.
    • Children up to 18 years of age—Use and dose must be determined by your dentist or medical doctor.

Missed dose—

If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine that is no longer needed. Be sure any discarded medicine is out of the reach of children.

Chlorhexidine may have a bitter aftertaste. Do not rinse your mouth with water immediately after using chlorhexidine, since doing so will increase the bitterness. Rinsing may also decrease the effect of the medicine.

Chlorhexidine may change the way foods taste to you. Sometimes this effect may last up to 4 hours after you use the oral rinse. In most cases, this effect will become less noticeable as you continue to use the medicine. When you stop using chlorhexidine, your taste should return to normal.

Chlorhexidine may cause staining and an increase in tartar (calculus) on your teeth. Brushing with a tartar-control toothpaste and flossing your teeth daily may help reduce this tartar build-up and staining. In addition, you should visit your dentist at least every 6 months to have your teeth cleaned and your gums examined.

If you think that a child weighing 22 pounds (10 kilograms) or less has swallowed more than 4 ounces of the dental rinse, get emergency help at once. In addition, if a child of any age drinks the dental rinse and has symptoms of alcohol intoxication, such as slurred speech, sleepiness, or a staggering or stumbling walk, get emergency help at once.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Rare
  • Signs of allergic reaction (nasal congestion; shortness of breath or troubled breathing; skin rash, hives, or itching; or swelling of face 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your dentist or medical doctor if any of the following side effects continue or are bothersome:

• More common
  • Change in taste;  increase in tartar (calculus) on teeth;  staining of teeth, mouth, tooth fillings, and dentures or other mouth appliances 
  
  

• Less common or rare
  • Mouth irritation;  swollen glands on side of face or neck;  tongue tip irritation 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your dentist or medical doctor.