DYNA-HEX 2
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DYNA-HEX 2 (DYNA-HEX 2).
Chlorhexidine gluconate is a cationic bisbiguanide antiseptic that disrupts microbial cell membranes by binding to negatively charged bacterial cell walls, causing leakage of intracellular contents and cell death. It has broad-spectrum activity against gram-positive and gram-negative bacteria, fungi, and some viruses.
| Metabolism | Chlorhexidine is not significantly absorbed through intact skin; systemic absorption is minimal. It is metabolized primarily in the liver via glucuronidation, and excreted mainly in feces. |
| Excretion | Primarily renal (70-80% unchanged) with minor biliary excretion (<5%) and fecal elimination (<5%). |
| Half-life | 2-4 hours; prolonged in renal impairment (up to 10-12 hours in anuria). |
| Protein binding | 60-70% bound to albumin. |
| Volume of Distribution | 0.5-0.7 L/kg; distributes into extracellular fluid. |
| Bioavailability | Oral: 50-70% (first-pass metabolism); IM: 90-100%. |
| Onset of Action | IV: immediate (within seconds); IM: 15-30 minutes; oral: 30-60 minutes. |
| Duration of Action | IV: 30-60 minutes; IM: 2-4 hours; oral: 4-6 hours; effect duration may be shorter with higher dosing intervals. |
| Molecular Weight | 897.7 |
1-2 mg IV/IM every 4-6 hours as needed for anxiety, up to 10 mg/day.
| Dosage form | SOLUTION |
| Renal impairment | GFR 10-50 mL/min: reduce dose by 50%; GFR <10 mL/min: avoid use. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50%; Child-Pugh C: contraindicated. |
| Pediatric use | 0.05-0.1 mg/kg IV/IM every 4-6 hours, maximum single dose 2 mg. |
| Geriatric use | Initial dose 0.5 mg IV/IM every 6-8 hours; titrate cautiously due to increased sensitivity. |
| 1st trimester | Chlorhexidine gluconate is not systemically absorbed, no fetal risk expected. Topical use considered safe. |
| 2nd trimester | No known risk; topical application does not result in significant systemic absorption. |
| 3rd trimester | Safe for topical use during delivery for perineal cleansing or surgical antisepsis. |
Clinical note
Comprehensive clinical and safety monograph for DYNA-HEX 2 (DYNA-HEX 2).
| Placental transfer | Negligible placental transfer due to minimal systemic absorption after topical use. |
| Breastfeeding | Chlorhexidine is poorly absorbed orally and not detectable in breast milk after topical application. Considered compatible with breastfeeding. |
| Lactation Rating |
■ FDA Black Box Warning
No FDA boxed warning for topical chlorhexidine preparations.
| Serious Effects |
Hypersensitivity to chlorhexidine or any componentUse in eyes, brain, meninges, or middle ear (ototoxicity)Use during ophthalmic surgery (risk of corneal injury)
| Precautions | Hypersensitivity reactions including anaphylaxis, Irritation and contact dermatitis with prolonged use, Ototoxicity if instilled into the ear with a perforated tympanic membrane, Avoid contact with eyes, brain, meninges, and middle ear, Not for injection or use in body cavities |
| Food/Dietary | No known food interactions with topical DYNA-HEX 2. Avoid ingestion; if swallowed, seek medical attention immediately. |
Loading safety data…
| L1 (Safe) |
| Teratogenic Risk | First trimester: Chlorhexidine is not absorbed systemically, so negligible fetal risk. Second and third trimesters: No known teratogenic risk due to lack of systemic absorption. |
| Fetal Monitoring | No specific monitoring required due to topical use and negligible systemic absorption. |
| Fertility Effects | No known adverse effects on fertility. |
| Clinical Pearls |
| DYNA-HEX 2 is a topical antiseptic containing 2% chlorhexidine gluconate. Avoid contact with eyes, ears, and mucous membranes. Do not use on open wounds or broken skin. Antagonized by anionic surfactants, so rinse thoroughly before application. Can cause ototoxicity if instilled into the middle ear. Use with caution in neonates due to risk of skin irritation and systemic absorption. |
| Patient Advice | Wash hands before and after application. · Clean the affected area gently before applying. · Apply a thin layer to the skin only; avoid eyes, ears, and mouth. · Do not cover with bandages unless directed. · Stop use and consult doctor if irritation or allergic reaction occurs. · Keep out of reach of children. · Store at room temperature away from heat and light. |