CHG SCRUB
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CHG SCRUB (CHG SCRUB).
Chlorhexidine gluconate disrupts bacterial cell membranes, leading to leakage of intracellular contents and cell death. It also binds to proteins and inhibits bacterial enzymes.
| Metabolism | Chlorhexidine is not significantly metabolized; it is primarily excreted unchanged in feces (via bile) and urine. |
| Excretion | Primarily renal (90% unchanged); <5% biliary/fecal. |
| Half-life | Approximately 2 hours (terminal); prolonged in renal impairment. |
| Protein binding | Minimal (<1%); no specific binding proteins. |
| Volume of Distribution | Not applicable (topical); negligible systemic absorption. |
| Bioavailability | Topical: negligible (<1% systemic); minimal percutaneous absorption. |
| Onset of Action | Topical: 1-3 minutes for antimicrobial effect. |
| Duration of Action | Topical: 2-6 hours (bactericidal); longer with persistent formulation. |
Apply 5 mL to wet skin, scrub for 2 minutes, rinse thoroughly. Use undiluted.
| Dosage form | SOLUTION |
| Renal impairment | No dose adjustment required; negligible systemic absorption. |
| Liver impairment | No dose adjustment required; negligible systemic absorption. |
| Pediatric use | Apply 5 mL to wet skin, scrub for 2 minutes, rinse thoroughly. Use undiluted. |
| Geriatric use | Same as adult dosing; no specific adjustment required. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CHG SCRUB (CHG SCRUB).
| Breastfeeding | Chlorhexidine gluconate is poorly absorbed systemically; no M/P ratio available; use is considered compatible with breastfeeding. |
| Teratogenic Risk | No teratogenic risk documented; chlorhexidine gluconate has no known fetal risk in any trimester based on limited systemic absorption with topical use. |
| Fetal Monitoring | No specific monitoring required; routine observation for local skin reactions. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Hypersensitivity to chlorhexidine or any component of the formulation","Use on meninges or brain tissue","Use in eyes or ophthalmic procedures"]
| Precautions | ["Avoid contact with eyes, ears, mouth, and other mucous membranes","Do not use on open wounds or broken skin","Hypersensitivity reactions including anaphylaxis","Ototoxicity if instilled into ears with perforated eardrums","May cause staining of skin, teeth, and mucous membranes","Not for use as a preoperative skin preparation in patients with known hypersensitivity to chlorhexidine"] |
| Food/Dietary | No clinically significant food interactions have been reported with topical chlorhexidine gluconate. However, avoid ingestion; if accidentally ingested, do not induce vomiting and seek medical attention immediately. |
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| Fertility Effects | No known effects on fertility. |
| Clinical Pearls | CHG SCRUB (chlorhexidine gluconate 4%) is a broad-spectrum antimicrobial skin cleanser. Avoid contact with eyes, ears, and mucous membranes. Do not use on wounds or broken skin. For preoperative bathing, instruct patients to rinse thoroughly after use to avoid irritation. Can cause ototoxicity if instilled in ears. Do not use simultaneously with soap or other detergents as they can inactivate chlorhexidine. Alcohol-based hand rubs are not a substitute for CHG SCRUB. Use with caution in patients with known hypersensitivity to chlorhexidine. |
| Patient Advice | Use only on intact skin; avoid open wounds or cuts. · Avoid contact with eyes, ears, mouth, and other mucous membranes. · Rinse thoroughly after each use to prevent skin irritation. · Do not use with regular soap; wait at least 5 minutes after washing with soap before applying CHG. · If using for preoperative preparation, follow your surgeon's instructions exactly. · Discontinue use and contact your doctor if you develop a rash or allergic reaction. |