PERIOCHIP
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PERIOCHIP (PERIOCHIP).
Chlorhexidine, a bisbiguanide antiseptic, disrupts microbial cell membranes, leading to leakage of cytoplasmic contents and cell death. It has broad-spectrum activity against gram-positive and gram-negative bacteria, fungi, and some viruses.
| Metabolism | Chlorhexidine is not systemically absorbed following subgingival administration. Any small amount absorbed is minimally metabolized and excreted unchanged in urine and feces. |
| Excretion | Primarily excreted unchanged in urine via glomerular filtration and tubular secretion; 30-50% of absorbed dose excreted renally within 24 hours. Minor biliary/fecal elimination (<5% total). |
| Half-life | Terminal elimination half-life: 6-8 hours in patients with normal renal function. Clinical context: dose interval typically q12h; adjust in renal impairment. |
| Protein binding | Chlorhexidine: approximately 90% bound to plasma proteins, primarily albumin. |
| Volume of Distribution | Chlorhexidine: Vd approximately 2.0-2.5 L/kg; indicates extensive tissue distribution, especially to liver, kidneys, and muscle. |
| Bioavailability | Subgingival insertion: local delivery with minimal systemic absorption; systemic bioavailability <1%. Not administered orally or parenterally. |
| Onset of Action | Subgingival insertion (dental): peak drug concentration in gingival crevicular fluid at 30 minutes; clinical effect (pocket depth reduction) observed over 4-6 weeks. |
| Duration of Action | Chlorhexidine release from the chip sustained over 7-10 days. Clinical benefit in reducing pocket depth persists for up to 6 months after insertion. |
One chip (2.5 mg chlorhexidine gluconate) inserted into a periodontal pocket of 5 mm or greater depth, with dosing interval of every 3 months as needed.
| Dosage form | TABLET |
| Renal impairment | No dosage adjustment required for renal impairment as systemic absorption is minimal (approximately 0.1% of dose). |
| Liver impairment | No dosage adjustment required for hepatic impairment due to negligible systemic absorption. |
| Pediatric use | Safety and efficacy in pediatric patients have not been established; use is not recommended. |
| Geriatric use | No specific dosage adjustment; use standard adult dosing with monitoring for local tolerance. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PERIOCHIP (PERIOCHIP).
| Breastfeeding | Systemic absorption is negligible; M/P ratio not established. Likely safe during breastfeeding due to minimal excretion into breast milk. |
| Teratogenic Risk | Chlorhexidine gluconate, the active ingredient, has minimal systemic absorption when used as a periodontal chip. No well-controlled human studies exist; animal studies show no teratogenicity at relevant doses. Risk cannot be ruled out; use only if clearly needed during pregnancy. |
| Fetal Monitoring |
■ FDA Black Box Warning
None.
| Serious Effects |
["Known hypersensitivity to chlorhexidine or any component of the product"]
| Precautions | ["Anaphylaxis and serious allergic reactions have been reported with chlorhexidine products","Do not use if allergic to chlorhexidine or any component of the product","Avoid contact with eyes and ears","Do not swallow","May cause staining of teeth and oral surfaces","May alter taste perception"] |
Loading safety data…
| No specific monitoring required; observe for local adverse effects (gingival swelling, pain). No fetal monitoring indicated. |
| Fertility Effects | No known effects on fertility in humans or animals at clinically relevant exposures. |