READYPREP CHG
Clinical safety rating: caution
Comprehensive clinical and safety monograph for READYPREP CHG (READYPREP CHG).
Chlorhexidine gluconate disrupts microbial cell membranes, causing leakage of cytoplasmic contents and cell death. Its cationic nature binds to negatively charged bacterial cell walls, providing persistent antimicrobial activity.
| Metabolism | Not significantly metabolized; absorbed chlorhexidine is primarily excreted unchanged in urine. |
| Excretion | Renal: ~100% unchanged via glomerular filtration. No biliary or fecal elimination. |
| Half-life | 60 minutes (terminal) in patients with normal renal function; prolonged in renal impairment. |
| Protein binding | <1% bound to plasma proteins. |
| Volume of Distribution | 2-3 L/kg (due to extensive tissue distribution and rapid clearance). |
| Bioavailability | Not applicable; only used topically. Absorption negligible through intact skin. |
| Onset of Action | Topical: within 1 minute for bactericidal effect. |
| Duration of Action | 6 hours after single topical application; residual antimicrobial activity persists for several hours. |
No standard systemic dosing; used as a 4% chlorhexidine gluconate topical antiseptic solution applied once daily to entire body for preoperative skin preparation or for chlorhexidine bathing in infection prevention protocols.
| Dosage form | CLOTH |
| Renal impairment | No systemic absorption; no dose adjustment required for renal impairment. |
| Liver impairment | No systemic absorption; no dose adjustment required for hepatic impairment. |
| Pediatric use | Weight-based: For children ≥2 months, apply 4% CHG solution once daily to entire body surface excluding eyes, ears, mouth, and genitalia. For neonates <2 months, use with caution due to risk of skin irritation and systemic absorption; apply sparingly and rinse thoroughly. |
| Geriatric use | No specific dose adjustment; use standard adult topical application. Caution in elderly with fragile skin due to increased risk of irritation or dermatitis. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for READYPREP CHG (READYPREP CHG).
| Breastfeeding | Chlorhexidine has low systemic absorption; trace amounts may appear in breast milk but are unlikely to cause adverse effects in infants. M/P ratio not established. Use caution in mothers nursing preterm or low-birth-weight infants due to immature skin barrier. |
| Teratogenic Risk | Topical chlorhexidine (active ingredient in READYPREP CHG) has minimal systemic absorption. No teratogenic effects reported in animal studies with topical use. Inadequate human studies; risk in first trimester cannot be ruled out. FDA category B. Avoid use in third trimester for perineal/skin disinfection prior to procedures due to potential absorption through compromised skin. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to chlorhexidine or any component","Prior allergic reaction to chlorhexidine-containing products"]
| Precautions | ["For external use only","Avoid contact with eyes, ears, and mouth","Hypersensitivity reactions including anaphylaxis","Ototoxicity if instilled in middle ear","May cause skin irritation or allergic dermatitis","Do not use on open wounds or mucous membranes unless directed"] |
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| Fetal Monitoring | Monitor for local skin reactions (e.g., irritation, allergic contact dermatitis) in pregnant patients. No specific fetal monitoring required due to minimal systemic exposure. |
| Fertility Effects | No evidence of adverse effects on fertility in animal studies. Human data lacking; topical chlorhexidine use unlikely to impact female or male fertility. |