1634 and Preservatives

Cetalkonium Chloride (BAN, USAN, rINN) ing powder. Freely soluble in water and in alcohol. A 2.0% solu- Handling. Cetrimide powder is irritant; it has been recommend- Cetalkonii Chloridum; Cétalkonium, Chlorure de; Cloruro de ce- tion in water froths copiously when shaken. ed that the nose and mouth should be protected by a mask when BP 2008 (Strong Cetrimide Solution). It is an aqueous solution working with the powder1 and eyes should be protected by gog- talconio; NSC-32942. Benzylhexadecyldimethylammonium chlo- of cetrimide. It contains 20 to 40% w/v of cetrimide, calculated gles. ride. as C17H38BrN and up to 10% alcohol or , or 1. Jacobs JY. Work hazards from drug handling. Pharm J 1984; Цеталкония Хлорид both; alcohol may be replaced by industrial methylated spirit. It 233: 195–6. C25H46ClN = 396.1. may be perfumed and may contain colouring matter. Store at a CAS — 122-18-9. temperature above 15°. Uses and Administration Incompatibility. Cetrimide is incompatible with soaps and oth- Cetrimide is a quaternary ammonium with er anionic , bentonite, , phenylmercuric nitrate, actions and uses typical of cationic surfactants. These + and alkali hydroxides. Aqueous solutions react with metals. surfactants dissociate in aqueous solution into a rela- N (CH2)14CH3 − Cl tively large and complex cation that is responsible for H3C CH3 Adverse Effects and Treatment the surface activity and a smaller inactive anion. In ad- At the concentrations used on the skin, solutions of ce- dition to emulsifying and properties, quater- trimide and other quaternary compounds do not gener- nary ammonium compounds have bactericidal activity Profile ally cause irritation, but some patients become hyper- against Gram-positive and, at a higher concentration, Cetalkonium chloride is a quaternary ammonium antiseptic with against some Gram-negative bacteria. Some Pseu- actions and uses similar to those of other cationic surfactants (see sensitive to cetrimide after repeated applications. Cetrimide, p.1634). It is used in a variety of topical preparations Cetrimide powder is reported to be irritant. There have domonas spp. are particularly resistant as are strains of in the treatment of minor infections of the mouth and throat. It been rare reports of burns with concentrated solutions Mycobacterium tuberculosis. They are ineffective has also been used in the treatment of eye infections. Cetalko- of cetrimide. against bacterial spores, have variable antifungal activ- nium bromide has also been used. If ingested, cetrimide and other quaternary ammonium ity, and are effective against some viruses. Preparations compounds cause nausea and vomiting; strong solu- Quaternary ammonium compounds are most effective Proprietary Preparations (details are given in Part 3) tions may cause oesophageal damage and necrosis. in neutral or slightly alkaline solution and their bacteri- Multi-ingredient: Arg.: Pansoral; Austral.: Bonjela; Austria: Mundisal; Braz.: Pondicilina; Canad.: Bionet; Cz.: Mundisal; Fr.: Pansoral; Ger.: Mun- They have depolarising muscle relaxant properties and cidal activity is appreciably reduced in acid media; disal†; Gr.: Mundisal; : Bonjela; Hung.: Mundisal; Irl.: Bonjela; toxic symptoms include dyspnoea and cyanosis due to their activity is enhanced by . Israel: Baby Gum; Bonjela; : Bonjela; NZ: Bonjela; Pol.: Sachol zel Stomatologiczny; Rus.: Cholisal (Холисал); Pansoral (Пансорал); paralysis of the respiratory muscles, possibly leading to Like other quaternary ammonium compounds, notably S.Afr.: AAA†; Bonjela; : Bonjela; Switz.: Mundisal; Pansoral; asphyxia. CNS depression (sometimes preceded by ex- (p.1629), cetrimide has been Tenderdol; Thai.: Bonjela; UK: Bonjela; Bonjela Teething Gel; USA: Babee. citement and convulsions), hypotension, coma, and employed for cleansing skin, wounds (but see under death may also occur. Accidental intra-uterine or intra- Wound Disinfection, p.1624), and burns. For these Cethexonium Bromide venous administration may cause haemolysis and pul- purposes it has been used as a 0.1 to 1.0% aqueous so- monary embolism. lution, generally prepared by dilution of a more con- Cetexonio, bromuro de. Hexadecyl(2-hydroxycyclohexyl)di- methylammonium bromide. Treatment of poisoning is symptomatic; demulcents centrated solution, or as a cream or spray containing 0.5%. However, a mixture of cetrimide with chlorhex- C24H50BrNO = 448.6. and diluents may be given if necessary but emesis and CAS — 6810-42-0 (cethexonium); 1794-74-7 (cethexo- lavage should be avoided, particularly if concentrated idine (p.1635) has often been preferred to cetrimide nium bromide); 58703-78-9 (cethexonium chloride). solutions have been ingested. Activated charcoal may alone. This combination is also used in a lotion for acne be considered if the patient presents within an hour of (p.1577). H CCH ingestion. CNS stimulants and cholinesterase inhibi- Solutions containing up to 10% of cetrimide have been N CH tors are reported not to reverse paralysis due to cetrim- used as shampoos to remove the scales in seborrhoeic Br ide intoxication although sympathomimetics have dermatitis (p.1584). OH been tried. Corticosteroids may reduce oropharyngeal Cetrimide solution 0.5 or 1% has been used as a scoli- NOTE. Cethexonium Chloride is rINN. oedema. cide to irrigate hydatid cysts during surgery (see Echi- nococcosis, p.136) but systemic adverse effects have Profile Effects after cyst irrigation. Adverse effects after irrigation Cethexonium bromide is a quaternary ammonium antiseptic with cetrimide solutions in the treatment of hydatid cysts have been reported (see above). with properties similar to those of other cationic surfactants (see included chemical peritonitis,1 methaemoglobinaemia with cya- Cetrimide and benzalkonium chloride are also used as Cetrimide, p.1634). It is used in preparations for the local treat- nosis,2 and metabolic acidosis.3 ment of minor infections of the eye, nose, and throat. preservatives in cosmetics and pharmaceutical formu- 1. Gilchrist DS. Chemical peritonitis after cetrimide washout in hy- lations including eye drops and in disinfecting solu- Preparations datid-cyst surgery. Lancet 1979; ii: 1374. tions for hard contact lenses; neither compound should Proprietary Preparations (details are given in Part 3) 2. Baraka A, et al. Cetrimide-induced methaemoglobinaemia after Fr.: Biocidan. surgical excision of hydatid cyst. Lancet 1980; ii: 88–9. be used for disinfection of soft contact lenses. Multi-ingredient: Fr.: Biocidan. 3. Momblano P, et al. Metabolic acidosis induced by Cetrimide is also present in some emulsifying prepara- bromide. Lancet 1984; ii: 1045. tions such as Cetrimide Emulsifying Ointment (BP Poisoning. The fatal dose of quaternary ammonium compounds 2008). was estimated to be 1 to 3 g.1 Cetrimide (BAN, rINN) Preparations 1. Arena JM. Poisonings and other health hazards associated with Cetrimid; Cetrimida; Cetrimidas; Cétrimide; Cetrimidum; Ce- use of . JAMA 1964; 190: 56–8. BP 2008: Cetrimide Cream; Cetrimide Emulsifying Ointment; Cetrimide trymid; Setrimid; Setrimidi. Solution. Цетримид Precautions Proprietary Preparations (details are given in Part 3) Arg.: Boucren; Sorbicet; Fr.: Cetavlon; Sterilene; Gr.: Cetavlon; Irl.: Cetav- CAS — 1119-97-7 (trimethyltetradecylammonium bro- Prolonged and repeated applications of cetrimide to the lex†; Vesagex; Malaysia: Cetavlex†; Dermoplex Antiseptic; Port.: Cetav- mide); 1119-94-4 (dodecyltrimethylammonium bromide); skin are inadvisable as hypersensitivity may occur. lex; Singapore: Acnederm Wash; Spain: Cetavlon†; Turk.: Cetyl; UK: 8044-71-1 (cetrimide). Bansor†; Cetavlex; Medi-Prep; Medicaid; Richmond Antiseptic Cream; Ves- Contact with the eyes, brain, meninges, and middle ear agex. ATC — D08AJ04; D11AC01. should be avoided. Cetrimide is for external use only Multi-ingredient: Arg.: Cerosporin GS†; Jabonacid; Otidrops; Otocalmia ATC Vet — QD08AJ04; QD11AC01. and should not be used in body cavities or as an enema. Biotic; Sincerum; Austral.: Acnederm Foaming Wash; Curacleanse†; Dime- thicream; Hamilton Pine Tar with Menthol; Hamilton Skin Repair†; Medi Quaternary ammonium compounds are not reliable for Creme; Microshield Antiseptic; Pro-PS†; Savlon Antiseptic; Soov Bite; Soov - Burn; Soov Cream; Austria: Lemocin; Xylonor; Belg.: Lemocin; Braz.: Ce- Br sterilising surgical instruments and heat-labile articles. trilan; Canad.: Savlodil; Cz.: Hibicet Hospital Concentrate†; Fr.: Broncori- The antimicrobial activity of quaternary ammonium nol rhinites†; Lysocalmspray; Rectoquotane; Gr.: Hibicet; Hong Kong: Ac- CH3 nederm Wash; B-Gel; Borraginol-N; Drapolene†; Hamilton Skin Repair; N+ compounds may be reduced through absorption, or Hibicet Hospital Concentrate†; Medicreme; Soov Bite; Soov Cream; Tri- CH Gel; Zinsomine; India: Iteol-3; Scabine; Scarab; Siloderm; Indon.: Benzo- 3 through combination with organic matter, or by reduc- mid; Bioacne; Borraginol-N; Borraginol-S; Neo Resiguard; Pravlon; Irl.: CH3 CH ing pH. Ceanel†; Drapolene; Hibicet; RBC; Savlon; Siopel†; Torbetol; Israel: Cetrin; 3 Savior; Septacare†; Tisept; Travasept; Ital.: Baxidin; Cetrexidin; Cetrisan; Solutions of quaternary ammonium compounds Clotramid†; Cuprosodio; Farvicett; Hibizene; Lidocaina Spray; Panseptil; (trimethyltetradecylammonium bromide) Steridol†; Malaysia: Acnederm Foaming Wash; Burnol Plus; Drapolene; should not be used for disinfection of soft contact lens- Hibicet†; Soov Bite; Neth.: Hibicet concentraat; Hibicet verdunning; NZ: es. Acnederm Foaming Wash; Acnederm Wash†; Hairscience Conditioner†; NOTE. The name cetrimonium bromide was often formerly used Karicare Barrier Cream†; Medicreme; Savlon; Soov Bite; Soov Burn; Soov for cetrimide. Cetrimonium bromide (see below) is hexadecyl- Aqueous solutions of cetrimide or other quaternary Cream; Soov Gel; Philipp.: Drapolene; Rus.: Drapolene (Драполен); S.Afr.: Benzet†; Germolene; Hibicet†; Medituss†; Siopel; Trochain; Virobis†; trimethylammonium bromide. ammonium disinfectants may be susceptible to con- Singapore: Burnol Plus; Drapolene; Napitol†; Savlon†; Soov Bite; Soov Pharmacopoeias. In Eur. (see p.vii) and Int. tamination with micro-organisms. To reduce this risk, Cream; Switz.: Gem; Thai.: Bacard; Burnol Plus; Chlorhex-C; Dekka; Br. also includes strong cetrimide solution. Drapolene; Frebac; Hibicet†; Inhibac; Napilene; Sepdine†; Septone†; Turk.: a sterilised preparation should be used or, where neces- Drapolene; Savlex; Savonol; Savrolin; Setilin; UK: Ceanel; Cetanorm; Ph. Eur. 6.2 (Cetrimide). It consists of trimethyltetradecyl- sary, solutions must be freshly prepared at the recom- Cymex; Dermidex; Drapolene; Hibicet†; Lypsyl Cold Sore Gel; Neo Baby ammonium bromide (=tetradonium bromide (rINN)) and may Cream; Quinoderm Antibacterial Face Wash; Savlon Antiseptic Cream; contain smaller amounts of dodecyltrimethylammonium bromide mended concentration and appropriate measures Savlon Antiseptic Liquid; Siopel; Steripod Gluconate with and hexadecyltrimethylammonium bromide (=cetrimonium bro- should be taken to prevent contamination during stor- Cetrimide†; Tisept; Torbetol; Travasept; USA: Scadan. mide, p.1635). A white or almost white, voluminous, free-flow- age or dilution. Cetalkonium Chloride/Chlorhexidine 1635

Cetrimonium Bromide (BAN, rINN) Cetylpyridinium bromide is used similarly for minor mouth and Pharmacopoeias. In Chin., Eur. (see p.vii), and Int. Bromuro de cetrimonio; Cetrimonii Bromidum; Cétrimonium, throat disorders. Ph. Eur. 6.2 (Chlorhexidine Diacetate). A white or almost white, microcrystalline powder. Sparingly soluble in water; sol- Bromure de; Cetylotrimetyloamoniowy bromek; Cetyltrimethyl- Preparations uble in alcohol; slightly soluble in glycerol and in propylene gly- USP 31: Lozenges; Cetylpyridinium Chloride ammonium Bromide; CTAB. Hexadecyltrimethylammonium col. bromide. Topical Solution. (details are given in Part 3) Цетримония Бромид Proprietary Preparations Incompatibility. The incompatibilities of chlorhexidine salts Austral.: Cepacol Antibacterial; Cepacol Antiseptic Throat Lozenges; Ce- are discussed under Chlorhexidine Hydrochloride, below. C19H42BrN = 364.4. pacol Mint; Cepacol Regular; Lozenges; Austria: Dobendan; Halset; CAS — 6899-10-1 (cetrimonium); 57-09-0 (cetrimonium Braz.: Gargocetil; Laringex; Canad.: Cepacol; †; Rince Bouche Stability. The stability of chlorhexidine salts is discussed under bromide). Antiseptique; Throat Lozenges; Chile: Freesept; Cz.: Halset; Fr.: Cetylyre†; Novoptine†; Ger.: Dobendan; Halstabletten akute; Hong Kong: Cepacol; Chlorhexidine Hydrochloride, below. ATC — D08AJ02; R02AA17. Cetocomp; Hung.: Halset; Irl.: Merocets; Ital.: Bat; Borocaina Gola; ATC Vet — QD08AJ02; QR02AA17. Bronchenolo†; Cetilsan; Citromed Soap; Exil; Farin Gola; Golacetin; Gola- fair; Honeygola; Neo Cepacol Pastiglie; Neo Coricidin Gola†; Neo Form- Chlorhexidine Gluconate (BANM, USAN, rINNM) itrol; Periogard Plus; Ragaden; Stomygen; Mex.: Trociletas; Norw.: Pyrisept; NZ: Cepacol; Lemsip Throat Lozenges; Pol.: Halset; Menthosept; Port.: Chlorheksidino digliukonato tirpalas; Chlorhexidin-diglukonát; CH3 Septus; S.Afr.: Cepacol; Universal Throat Lollies; Singapore: Cepacol; Chlorhexidine Digluconate; Chlorhexidine, digluconate de; + H3C N CH3 Spain: Angifonil†; Thai.: Cepacol; Orasept; Turk.: Aseptol; Penipastil; UK: Chlorhexidine, Gluconate de; Chlorhexidini digluconas; Chlo- Listermint; Merocets; USA: Cepacol Mouthwash; Cepacol Throat; Choice DM Gentle Care; Scope; Venez.: Cepacol; Tablibut†. rhexidini Digluconatis Solutio; Chlorhexidini Gluconas; Chloro- H C 3 Multi-ingredient: Arg.: Desenfriol Caramelos†; Ernex Duo; Oral-B En- heksydyny diglukonianu roztwór; Gluconato de clorhexidina; juague Bucal†; Periodil; Solumerin; Austral.: Cepacaine; Cepacol Anaes- Klooriheksidiinidiglukonaattiliuos; Klorheksidin Glukonat; Klor- (cetrimonium) thetic; Cepacol Antibacterial; Cepacol Cough & Sore Throat; Difflam Anti- hexidindiglukonatlösning; Klórhexidin-diglükonát-oldat. 1,1′-Hex- inflammatory Lozenges with Cough Suppressant; Difflam Lozenges; Difflam Mouth Gel; Duro-Tuss Cough Lozenges; Gentlees; Seda-Gel†; Austria: amethylenebis[5-(4-chlorophenyl)] digluconate. NOTE. The name cetrimonium bromide was formerly applied to Coldistan; Dentinox; Gurfix; Paididont; Tetesept; Braz.: Cepacaina; Cepacol Хлоргексидина Глюконат cetrimide (see above). Menta; Cetildrops†; Dentalivio†; Fenotricin†; Lima C; Limao Bravo com Vi- Pharmacopoeias. In USNF. tamina C†; Limao Bravo†; Malvona†; Neopiridin; Pondicilina; Proplax†; Psiu; C22H30Cl2N10,2C6H12O7 = 897.8. Sanilin; Canad.: Cepacol Extra Strength; Cepacol with Fluoride; Green An- CAS — 18472-51-0. USNF 26 (Cetrimonium Bromide). A white to creamy white, tiseptic Mouthwash & Gargle; Kank-A; Oral Plan†; Oral-B Anti-Bacterial voluminous, free-flowing powder, with a characteristic faint with Fluoride; Throat Lozenges; Chile: Halita; Kank-Eze; Oralfresh Menta; ATC — A01AB03; B05CA02; D08AC02; D09AA12; odour. Freely soluble in water and in alcohol; practically insolu- Pancrit; Perio-Aid c Cloruro de Cetilpiridinio; Vitis Encias Colutorio; Vitis R02AA05; S01AX09; S02AA09; S03AA04. Encias Pasta; Cz.: Brand- und Wundgel†; Calgel; Neoseptolete; Panlid; ATC Vet — QA01AB03; QB05CA02; QD08AC02; ble in ether. Stas†; Tetesept Angidin†; Fin.: Bafucin; Fr.: Alodont; Broncorinol maux de gorge†; Lysopaine; Parogencyl prevention gencives; Ger.: Bioget†; Brand- QD09AA12; QR02AA05; QS01AX09; QS02AA09; QS03AA04. (BAN) und Wund-Gel Eu Rho†; Broncho-Tyrosolvetten†; Dolo-Dobendan; Em- medical†; Frubienzym; Frubizin Forte†; Nordathricin N†; Trachiform†; Ty- Cetrimonio, cloruro de. Hexadecyltrimethylammonium chlo- rosolvetten-C†; Tyrosolvetten†; Tyrosur; Wick Sulagil; Hong Kong: Denti- Pharmacopoeias. Chin., Eur. (see p.vii), and US include a so- lution which contains 19 to 21% of chlorhexidine gluconate. ride. nox Teething Gel; Difflam Anti-inflammatory Lozenges; Difflam Mouth Gel; Pharynx; Setronges†; Hung.: Mebucain; Tyrosur; Indon.: Sentril; Irl.: Ph. Eur. 6.2 (Chlorhexidine Digluconate Solution; Chlorhexidini C19H42ClN = 320.0. Anbesol; Merocaine; Israel: Cepadont; Kank-A; Ital.: Delta 80; Delta 80 Digluconatis Solutio; Chlorhexidine Gluconate Solution BP 2008). CAS — 112-02-7. Plus; Farmagola†; Ginvapast; Gola Action; Neo-Stomygen; Oral-B Colluto- rio per la Protezione di Denti e Gengive; Orosanyl†; Ridiodent; Rikospray; An aqueous solution which contains not less than 190 g/litre and Profile Stomygen; Malaysia: Cetylpyridinium B; Dentinox Teething Gel; Difflam not more than 210 g/litre of chlorhexidine gluconate. An almost Cetrimonium bromide is a quaternary ammonium antiseptic with Anti-inflammatory Lozenges (with Antibacterial); Difflam Anti-Inflammato- colourless or pale-yellowish liquid. Miscible with water, with not actions and uses similar to those of other cationic surfactants (see ry Lozenges (with cough suppressant); Difflam Mouth Gel; Orregel; Phar- more than 5 parts of alcohol, and with not more than 3 parts of ynx; Setronges†; Mex.: Cepacaina; Mentalgina; Trociletas B; Neth.: Agre- Cetrimide, p.1634). Cetrimonium chloride and cetrimonium Gola; Norw.: Aselli; NZ: Cepacaine; Cepacol Anaesthetic; Cepacol Cough acetone. A 5% v/v dilution in water has a pH of 5.5 to 7.0. Protect tosilate are also used. Discs; Difflam Cough; Difflam Mouth Gel; Duro-Tuss Lozenges; Philipp.: from light. Preparations Xylorinse; Pol.: Calgel; Lidodent; Septolete Plus; Tetesept; Undofen; Port.: USP 31 (Chlorhexidine Gluconate Solution). An aqueous solu- Anbegele†; Biofluor Ortodoncia†; Biofluor Sensitive†; Dropcina; Mebocai- tion which contains not less than 19% and not more than 21% of Proprietary Preparations (details are given in Part 3) na; Rus.: Calgel (Калгель); Septolete Plus (Септолете Плюс); S.Afr.: Braz.: Tiracaspa†; Ital.: Golaval†; Senol; Sterilene; Switz.: Aknex Cleaning; Anbesol; Andolex-C; Cepacaine; Cepacol; Cepacol Cough Discs; Cetoxol; chlorhexidine gluconate. An almost colourless or pale yellow, Tur isan. Colphen; Endcol Lozenges; Medi-Kain†; Medi-Keel A; Prodol; Vagarsol; clear liquid. Miscible with water and with glacial acetic acid; Vicks Acta Plus; Vicks Cough Syrup; Singapore: Dentinox Teething Gel; miscible with five times its volume of dehydrated alcohol and Multi-ingredient: Arg.: Bagociletas sin Anestesia†; Bagoderm; Eryteal; Difflam Anti-inflammatory Anti-Bacterial Lozenges; Difflam Mouth Gel; Klorane Bebe Eryteal; Salvicutan†; Austria: Xylestesin; Belg.: Cetavlex; Duro-Tuss Cough Lozenges; Pharynx; Soragel; Spain: Alcohocel; Alcohol with three times its volume of acetone; further addition of dehy- HAC; Hacdil-S; Braz.: Amigdalol; Drapolene; Leucocida†; Fr.: Eryteal†; Cetil†; Alcohol Cetilpi Cuve†; Babysiton; Farmalcohol; Pastillas Antisep drated alcohol or of acetone yields a white turbidity. A 5% v/v di- Nostril; Ger.: Lemocin; Xylestesin Pumpspray†; Indon.: Lemocin; Israel: Garg L; Pastillas Antisep Garg M; Silidermil†; Vicks Formula 44†; Swed.: lution in water has a pH of 5.5 to 7.0. Store in airtight containers. Lemocin; Ital.: Golamixin; Xylonor; Mex.: Dermatolona; Pol.: Cetriscabin; Bafucin; Switz.: Alodont†; Angina MCC; Anginazol; Desaquick forte†; Fla- Spain: Diformiltricina; Hongosan; Xylonor; Switz.: Desitur†; Lemocin; vangin†; Hextriletten; Hextrimint; Lidazon; Mebucaine; Nasex†; Neo-Angin Protect from light. Septivon N; Turexan Capilla; Xylestesin†; Xylonor; Venez.: Kertyol. Lido; Otothricinol; Pharmacard Family Maux de gorge†; Wulnasin; Thai.: Sentril; Sore Mouth Gel; Turk.: Calgel; Nesgarin; UAE: B-Cool; New B- Incompatibility. The incompatibilities of chlorhexidine salts Cool; UK: Adult Meltus for Chesty Coughs & Catarrh; Allens Dry Tickly are discussed under Chlorhexidine Hydrochloride, below. Cough; Anbesol; Calgel; Dentinox Teething Gel; Kilkof; Listermint with Flu- Cetylpyridinium Chloride (BAN, rINN) oride; Macleans Mouthguard; Meltus Expectorant; Meltus Junior Expecto- Stability. The stability of chlorhexidine salts is discussed under rant; Merocaine; Merocets Plus; Rinstead; Rinstead Teething Gel†; Wood- Chlorhexidine Hydrochloride, below. Cetilpiridinio chloridas; Cetilpiridinium-klorid; Cetylpyridinii chlo- wards Teething Gel; USA: Cepacol Anesthetic; Cepacol Maximum Strength ridum; Cetylpyridinii Chloridum Monohydricum; Cétylpyridin- Sore Throat; Cepacol Regular Strength; Cylex; MouthKote O/R; MouthKo- Sterilisation. Dilutions of commercial concentrated solutions te P/R†; Orajel Mouth Aid; Venez.: Borogin; Calgel†; Cepacol-BE; Isospray; may be sterilised by autoclaving. ium, chlorure de; Cetylpyridinium-chlorid monohydrát; Cetylpy- Lafarcaina; Solunovar Compuesto. ridiniumklorid; Cloruro de cetilpiridinio; Setilpiridinyum Klorür; Setyylipyridiniumkloridi. 1-Hexadecylpyridinium chloride mono- Chlorhexidine Hydrochloride (BANM, USAN, rINNM) hydrate. AY-5312; Chlorheksidino dihidrochloridas; Chlorhexidin-dihy- Цетилпиридиния Хлорид Chlorhexidine (BAN, rINN) drochlorid; Chlorhexidine, Chlorhydrate de; Chlorhexidine, C21H38ClN,H2O = 358.0. Chlorhexidinum; Clorhexidina; Klooriheksidiini; Klorheksidin; dichlorhydrate de; Chlorhexidine Dihydrochloride; Chlorhexidini CAS — 7773-52-6 (cetylpyridinium); 123-03-5 (anhy- Klorhexidin. dihydrochloridum; Chlorhexidini Hydrochloridum; Hidrocloruro drous cetylpyridinium chloride); 6004-24-6 (cetylpyridin- de clorhexidina; Klooriheksidiinidihydrokloridi; Klorheksidin Hid- ium chloride, monohydrate). Хлоргексидин roklorür; Klórhexidin-dihidroklorid; Klorhexidindihydroklorid. ATC — B05CA01; D08AJ03; D09AA07; R02AA06. CAS — 55-56-1. ATC Vet — QB05CA01; QD08AJ03; QD09AA07; ATC — A01AB03; B05CA02; D08AC02; D09AA12; 1,1′-Hexamethylenebis[5-(4-chlorophenyl)biguanide] dihydro- QR02AA06. R02AA05; S01AX09; S02AA09; S03AA04. chloride. ATC Vet — QA01AB03; QB05CA02; QD08AC02; Хлоргексидина Гидрохлорид QD09AA12; QR02AA05; QS01AX09; QS02AA09; C22H30Cl2N10,2HCl = 578.4. + QS03AA04. CAS — 3697-42-5. N (CH2)14CH3 − ATC — A01AB03; B05CA02; D08AC02; D09AA12; Cl R02AA05; S01AX09; S02AA09; S03AA04. H H H H H H N N N N N N ATC Vet — QA01AB03; QB05CA02; QD08AC02; (CH ) QD09AA12; QR02AA05; QS01AX09; QS02AA09; NH NH NH NH QS03AA04. Cl Cl Pharmacopoeias. In Eur. (see p.vii) and US. Pharmacopoeias. In Eur. (see p.vii), Int., and Jpn. Ph. Eur. 6.2 (Cetylpyridinium Chloride). A white or almost Ph. Eur. 6.2 (Chlorhexidine Dihydrochloride; Chlorhexidine Hy- white powder, slightly soapy to the touch. Soluble in water, froth- Chlorhexidine Acetate (BANM, rINNM) drochloride BP 2008). A white or almost white, crystalline pow- ing copiously when shaken; soluble in alcohol. Acetato de clorhexidina; Chlorheksidino diacetatas; Chlorhexi- der. Sparingly soluble in water and in propylene glycol; very USP 31 (Cetylpyridinium Chloride). A white powder with a slightly soluble in alcohol. slight characteristic odour. Soluble 1 in 4.5 of water and of chlo- din-diacetát; Chlorhexidine, Acétate de; Chlorhexidine Diace- roform, and 1 in 2.5 of alcohol; slightly soluble in ether and in tate; Chlorhexidine, diacétate de; Chlorhexidini Acetas; Chlo- Incompatibility. Chlorhexidine salts are incompatible with benzene. rhexidini diacetas; Chloroheksydyny octan; Klooriheksidiinidia- soaps and other anionic materials. Activity may be reduced in the setaatti; Klorhexidindiacetat; Klórhexidin-diacetát. 1,1′-Hexame- presence of suspending agents such as alginates and tragacanth, Incompatibility. Cetylpyridinium chloride is incompatible thylenebis[5-(4-chlorophenyl)biguanide] diacetate. insoluble powders such as kaolin, and insoluble compounds of with soaps and other anionic surfactants. Хлоргексидина Ацетат calcium, magnesium, and zinc. Chlorhexidine acetate is incom- Profile patible with potassium iodide. At a concentration of 0.05%, chlo- C22H30Cl2N10,2C2H4O2 = 625.6. Cetylpyridinium chloride is a quaternary pyridinium antiseptic CAS — 56-95-1. rhexidine salts are incompatible with borates, bicarbonates, car- with actions and uses similar to those of other cationic sur- ATC — A01AB03; B05CA02; D08AC02; D09AA12; bonates, chlorides, citrates, nitrates, phosphates, and sulfates, factants (see Cetrimide, p.1634). It is used chiefly as lozenges or R02AA05; S01AX09; S02AA09; S03AA04. forming salts of low solubility which may precipitate out of so- solutions for the treatment of minor infections of the mouth and ATC Vet — QA01AB03; QB05CA02; QD08AC02; lution. At dilutions of 0.01% or more, these salts are generally throat. It is also used topically for the treatment of skin and eye QD09AA12; QR02AA05; QS01AX09; QS02AA09; soluble. Insoluble salts may form in hard water. Chlorhexidine infections. QS03AA04. salts are inactivated by cork. The symbol † denotes a preparation no longer actively marketed The symbol ⊗ denotes a substance whose use may be restricted in certain sports (see p.vii)