CHLORAPREP SINGLE SWABSTICK
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CHLORAPREP SINGLE SWABSTICK (CHLORAPREP SINGLE SWABSTICK).
Chlorhexidine gluconate, a bisbiguanide antiseptic, disrupts microbial cell membranes and precipitates cytoplasmic contents at bactericidal concentrations.
| Metabolism | Not metabolized; excreted primarily unchanged in urine and feces. |
| Excretion | Renal (minimal, <1% as unchanged drug); fecal/biliary (not significant); primarily metabolized to p-chloroaniline and subsequently excreted as conjugates in urine. |
| Half-life | Chlorhexidine: terminal half-life approximately 3-5 hours after cutaneous application; prolonged with repeated use due to dermal reservoir effect. p-Chloroaniline: terminal half-life 10-12 hours. |
| Protein binding | Chlorhexidine: approximately 90% bound to plasma proteins (albumin). p-Chloroaniline: minimal binding (<10% to albumin). |
| Volume of Distribution | Chlorhexidine: Vd 0.5-0.8 L/kg, indicating distribution into extracellular fluid and tissues; minimal CNS penetration. p-Chloroaniline: Vd approximately 2 L/kg, suggesting wider distribution. |
| Bioavailability | Topical: negligible systemic bioavailability (<0.1% of applied dose absorbed through intact skin). Oral (not relevant): not administered. |
| Onset of Action | Topical: antimicrobial effect begins within 30 seconds with 2% chlorhexidine gluconate; sustained after 2 minutes. |
| Duration of Action | Topical: residual activity persists for up to 24 hours with repeated use; single application provides bacteriostatic effect for 2-4 hours. |
Apply topically to intact skin as a single use swabstick. Allow to dry for 3 minutes. No frequency specified for single application.
| Dosage form | SWAB |
| Renal impairment | No dosage adjustment required for renal impairment as topical application results in negligible systemic absorption. |
| Liver impairment | No dosage adjustment required for hepatic impairment as topical application results in negligible systemic absorption. |
| Pediatric use | Apply topically to intact skin as a single use swabstick. Use smallest amount necessary to cover the intended surgical site. Safety and efficacy in pediatric patients have not been established. |
| Geriatric use | No specific geriatric dose adjustment required. Use with caution in patients with fragile skin to avoid irritation. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CHLORAPREP SINGLE SWABSTICK (CHLORAPREP SINGLE SWABSTICK).
| Breastfeeding | Chlorhexidine and isopropyl alcohol have minimal systemic absorption; unlikely to be excreted in milk. M/P ratio not available; considered compatible with breastfeeding. |
| Teratogenic Risk | No known teratogenic risk. Chlorhexidine and isopropyl alcohol are not associated with fetal malformations. No adverse fetal effects reported with topical use. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to chlorhexidine or any component of the preparation"]
| Precautions | ["Hypersensitivity reactions including anaphylaxis","Avoid contact with eyes, ears, and mouth","Do not use on open wounds or mucous membranes","Avoid use on patients with known hypersensitivity to chlorhexidine or any component"] |
| Food/Dietary | No known food interactions. Avoid applying near food or eating utensils until dry. |
| Clinical Pearls |
Loading safety data…
| No specific monitoring required for topical antiseptic use. Standard maternal-fetal surveillance as per pregnancy care. |
| Fertility Effects | No known effects on fertility. No reproductive toxicity data indicate impact on conception or gametogenesis. |
| Chloraprep is a combination of 2% chlorhexidine gluconate and 70% isopropyl alcohol. Apply with a scrubbing motion for at least 30 seconds (per manufacturer) or per institutional protocol (often 2 minutes for surgical sites). Allow to dry completely (typically 3 minutes) to ensure antisepsis and reduce fire risk from alcohol. Do not use on mucous membranes, open wounds, or near eyes. Avoid pooling on skin. Use dedicated swabstick for each site—do not dip back into solution. Contraindicated in patients with known hypersensitivity to chlorhexidine or alcohol. |
| Patient Advice | This solution contains alcohol and is flammable; do not use near open flames or cautery until fully dry. · Inform your healthcare provider if you have ever had an allergic reaction to chlorhexidine or alcohol. · This product is for external use only. Avoid contact with eyes, ears, mouth, or genital area. · Do not wash off after application; allow it to dry naturally. · If you experience redness, itching, or swelling at the application site, notify your healthcare provider immediately. |