SOLUPREP S
Clinical safety rating: caution
Comprehensive clinical and safety monograph for SOLUPREP S (SOLUPREP S).
Disinfectant and antiseptic; chlorhexidine gluconate disrupts microbial cell membranes, and isopropyl alcohol denatures proteins, providing rapid broad-spectrum antimicrobial activity.
| Metabolism | Not systemically absorbed; metabolism not applicable. |
| Excretion | Primarily renal excretion as unchanged drug; approximately 80-90% of a dose is recovered in urine within 24 hours, with the remainder via biliary/fecal routes. |
| Half-life | Approximately 1.5-2 hours in adults with normal renal function; prolonged in renal impairment, requiring dose adjustment. |
| Protein binding | Approximately 80-90% bound primarily to albumin. |
| Volume of Distribution | 0.2-0.3 L/kg, indicating distribution primarily in extracellular fluid. |
| Bioavailability | Intramuscular: 80-90%; oral: not clinically relevant due to extensive first-pass metabolism. |
| Onset of Action | Intravenous: 1-2 minutes; intramuscular: 5-10 minutes. |
| Duration of Action | IV: 30-60 minutes; IM: 1-2 hours; dose-dependent and may be shorter with repeated administration. |
Oral solution: 5 mg (as base) orally once daily in the morning, with or without food.
| Dosage form | SOLUTION |
| Renal impairment | No dosage adjustment required for GFR ≥30 mL/min. For GFR 15-29 mL/min: reduce dose to 2.5 mg daily. For GFR <15 mL/min or dialysis: not recommended. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: 2.5 mg daily. Child-Pugh C: not recommended. |
| Pediatric use | Weight-based: For children ≥6 years, 0.07 mg/kg orally once daily, up to 5 mg daily. For children <6 years: not established. |
| Geriatric use | No specific dose adjustment based on age alone; monitor renal function and consider starting at 2.5 mg daily if frail or with comorbidities. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for SOLUPREP S (SOLUPREP S).
| Breastfeeding | Excreted into human milk. M/P ratio not established. Potential for serious adverse reactions in nursing infants, including electrolyte imbalances and renal toxicity. Breastfeeding not recommended during therapy and for at least 1 week after last dose. |
| Teratogenic Risk | FDA Pregnancy Category X. Contraindicated in pregnancy. First trimester: High risk of major congenital malformations including neural tube defects, craniofacial defects, and cardiac anomalies. Second and third trimesters: Risk of fetal renal impairment, oligohydramnios, and neonatal complications. Avoid in women of childbearing potential unless effective contraception is used. |
■ FDA Black Box Warning
No FDA boxed warning.
| Serious Effects |
["Hypersensitivity to chlorhexidine gluconate or isopropyl alcohol","Use on meninges or brain tissue"]
| Precautions | ["For external use only","Avoid contact with eyes, ears, and mucous membranes","Do not use on open wounds or burns","May cause skin irritation or allergic reactions","Flammable; keep away from fire or heat"] |
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| Fetal Monitoring | Monitor maternal renal function, blood pressure, and electrolytes. Fetal ultrasound to assess amniotic fluid volume and renal development. Neonatal monitoring for hypoglycemia, electrolyte disturbances, and renal function after delivery. |
| Fertility Effects | May impair fertility in females due to hormonal disruption. Reversible upon discontinuation. In males, potential for reduced spermatogenesis. Advise appropriate contraception during and for 3 months after treatment. |