Peridex 0.12% Oral Rinse
It is used to treat or prevent gingivitis.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Anti-infective, dental
Pharmacologic Class
Antiseptic, bisbiguanide
Pregnancy Category
Category B
FDA Approved
Sep 1986
DEA Schedule
Not Controlled
Overview
What is this medicine?
Peridex is an antiseptic mouthwash used to treat gum disease (gingivitis). It works by killing bacteria in your mouth that cause inflammation and bleeding of the gums. It helps reduce redness, swelling, and bleeding of your gums.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication effectively, follow your doctor's instructions and read all accompanying information carefully. Before rinsing, brush and floss your teeth thoroughly. Then, rinse with 1 tablespoon (15 mL) of the medication for 30 seconds. It is essential not to swallow the medication; instead, spit it out. Repeat this process twice a day, once in the morning and once in the evening. To minimize potential taste disturbances with food, use the medication after meals. After using the medication, avoid eating, brushing your teeth, or rinsing with water or other mouthwashes for a while.
Storing and Disposing of Your Medication
Store the medication at room temperature, protected from heat sources. Keep all medications in a secure location, out of the reach of children and pets, to ensure safety.
Managing Missed Doses
If you miss a dose, take it as soon as you remember. However, if the missed dose is close to the time of your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to compensate for the missed one.
To use this medication effectively, follow your doctor's instructions and read all accompanying information carefully. Before rinsing, brush and floss your teeth thoroughly. Then, rinse with 1 tablespoon (15 mL) of the medication for 30 seconds. It is essential not to swallow the medication; instead, spit it out. Repeat this process twice a day, once in the morning and once in the evening. To minimize potential taste disturbances with food, use the medication after meals. After using the medication, avoid eating, brushing your teeth, or rinsing with water or other mouthwashes for a while.
Storing and Disposing of Your Medication
Store the medication at room temperature, protected from heat sources. Keep all medications in a secure location, out of the reach of children and pets, to ensure safety.
Managing Missed Doses
If you miss a dose, take it as soon as you remember. However, if the missed dose is close to the time of your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to compensate for the missed one.
Lifestyle & Tips
- Use exactly as prescribed by your dentist or doctor.
- Do not dilute the rinse.
- Rinse for 30 seconds and then spit it out; do not swallow.
- Do not eat or drink for at least 30 minutes to an hour after using the rinse to allow it to work effectively.
- If you use toothpaste, rinse your mouth thoroughly with water after brushing and before using Peridex, as some toothpastes can reduce its effectiveness.
- Maintain good oral hygiene practices, including regular brushing and flossing, as directed by your dental professional.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Rinse with 15 mL of undiluted Peridex oral rinse twice daily for 30 seconds, morning and evening, after toothbrushing. Expectorate after rinsing.
Dose Range:
15 - 15 mg
Condition-Specific Dosing:
gingivitis:
15 mL twice daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established (safety and efficacy not established for children under 18 years of age)
Adolescent:
Not established (safety and efficacy not established for children under 18 years of age)
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No specific considerations (minimal systemic absorption)
Hepatic Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Pharmacology
Mechanism of Action
Chlorhexidine gluconate is a cationic bisbiguanide with broad-spectrum antimicrobial activity. It binds to the negatively charged bacterial cell wall, disrupting its integrity and increasing its permeability, leading to leakage of intracellular components and ultimately cell death. It also binds to the pellicle and oral mucosa, providing sustained release (substantivity) and prolonged antimicrobial action.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (less than 0.005% to 0.02% of the dose)
Tmax:
Not applicable for systemic absorption; local binding is rapid.
FoodEffect:
Not relevant for systemic absorption; however, food/drink should be avoided for a few hours after use to maximize local effect.
Distribution:
Vd:
Not applicable for systemic distribution due to minimal absorption
ProteinBinding:
Not applicable for systemic protein binding; locally binds to oral tissues (mucosa, pellicle, salivary proteins).
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable for systemic elimination due to minimal absorption; local substantivity provides prolonged action (up to 12 hours).
Clearance:
Not applicable for systemic clearance.
ExcretionRoute:
Primarily expectorated; if swallowed, excreted via feces.
Unchanged:
Not applicable for systemic unchanged excretion.
Pharmacodynamics
OnsetOfAction:
Immediate antibacterial action upon contact with oral tissues.
PeakEffect:
Sustained antimicrobial activity due to binding to oral tissues, releasing for several hours.
DurationOfAction:
Up to 12 hours due to substantivity.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
If you experience any of the following severe side effects, contact your doctor or seek medical help right away, as they can be life-threatening:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
- Severe gum pain or swelling.
- Numbness or tingling in the mouth.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you encounter any of the following side effects, or if they persist or bother you, contact your doctor for advice:
- Mouth irritation.
- Staining of the mouth, teeth, or dental fillings.
- Tartar buildup on teeth.
- Change in taste, which in rare cases may be permanent.
Important Note
This list does not include all possible side effects. If you have concerns about side effects or experience any symptoms not mentioned here, consult your doctor for medical advice.
If you experience any of the following severe side effects, contact your doctor or seek medical help right away, as they can be life-threatening:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
- Severe gum pain or swelling.
- Numbness or tingling in the mouth.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you encounter any of the following side effects, or if they persist or bother you, contact your doctor for advice:
- Mouth irritation.
- Staining of the mouth, teeth, or dental fillings.
- Tartar buildup on teeth.
- Change in taste, which in rare cases may be permanent.
Important Note
This list does not include all possible side effects. If you have concerns about side effects or experience any symptoms not mentioned here, consult your doctor for medical advice.
Seek Immediate Medical Attention If You Experience:
- Severe allergic reaction (anaphylaxis): rash, itching, swelling of face/tongue/throat, severe dizziness, trouble breathing. Seek immediate medical attention.
- Mouth sores or irritation that worsens or does not go away.
- Swelling of the salivary glands (rare).
- Significant or persistent changes in taste perception.
- Excessive or bothersome tooth/tongue staining.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. This drug may interact with other prescription or over-the-counter (OTC) medications, natural products, or vitamins, which could affect its safety and efficacy.
A complete list of all your current medications, including prescription and OTC drugs, natural products, and vitamins. This will help your doctor and pharmacist assess potential interactions and ensure safe use.
Any existing health problems, as they may impact the safety and effectiveness of this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is crucial to verify that it is safe to take this medication with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
Potential interactions with other medications or health conditions. This drug may interact with other prescription or over-the-counter (OTC) medications, natural products, or vitamins, which could affect its safety and efficacy.
A complete list of all your current medications, including prescription and OTC drugs, natural products, and vitamins. This will help your doctor and pharmacist assess potential interactions and ensure safe use.
Any existing health problems, as they may impact the safety and effectiveness of this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is crucial to verify that it is safe to take this medication with all your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. To maintain good oral health, practice proper dental care and schedule regular dental check-ups. If you are pregnant, planning to become pregnant, or are breast-feeding, notify your doctor promptly. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- If swallowed, may cause stomach upset, nausea, or vomiting. Large amounts may cause alcohol intoxication due to the alcohol content in the rinse.
What to Do:
If a large amount is accidentally swallowed, contact a poison control center immediately (e.g., 1-800-222-1222 in the US) or seek emergency medical attention. Treatment is generally supportive.
Drug Interactions
Moderate Interactions
- Anionic compounds (e.g., sodium lauryl sulfate found in many toothpastes): Can inactivate chlorhexidine. Advise patients to rinse thoroughly with water after brushing and before using chlorhexidine oral rinse.
Monitoring
Baseline Monitoring
Oral examination (gingival index, plaque index)
Rationale: To assess baseline severity of gingivitis and establish a reference for treatment efficacy.
Timing: Prior to initiation of therapy
Routine Monitoring
Oral examination (gingival health, plaque accumulation)
Frequency: Periodically, as determined by dental professional (e.g., every 3-6 months)
Target: Reduction in gingival inflammation and bleeding, reduction in plaque
Action Threshold: Lack of improvement or worsening of gingivitis may indicate need for re-evaluation of treatment plan or underlying causes.
Patient report of side effects (e.g., tooth staining, taste alteration, oral irritation)
Frequency: At follow-up visits
Target: Absence or minimal side effects
Action Threshold: Significant or bothersome side effects may require discontinuation or management strategies (e.g., professional cleaning for staining).
Symptom Monitoring
- Increased gingival inflammation or bleeding
- Tooth or tongue staining (brownish discoloration)
- Altered taste perception (dysgeusia), especially bitter taste
- Oral irritation or burning sensation
- Swelling of salivary glands (rare)
- Peeling of oral mucosa (rare)
- Signs of allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
Special Patient Groups
Pregnancy
Chlorhexidine gluconate oral rinse is classified as Pregnancy Category B. Studies in animals have not shown harm to the fetus, and systemic absorption in humans is minimal. Generally considered safe for use during pregnancy when indicated.
Trimester-Specific Risks:
First Trimester:
Low risk due to minimal systemic absorption.
Second Trimester:
Low risk due to minimal systemic absorption.
Third Trimester:
Low risk due to minimal systemic absorption.
Lactation
Chlorhexidine gluconate oral rinse is considered L3 (moderately safe) for lactation. Systemic absorption is minimal, making it unlikely to be excreted in breast milk in clinically significant amounts. Use is generally considered compatible with breastfeeding.
Infant Risk:
Low risk to the infant due to minimal maternal systemic absorption and negligible transfer into breast milk.
Pediatric Use
Safety and efficacy have not been established for children under 18 years of age. Use in pediatric patients should be under the guidance of a dental professional, considering potential for staining and taste alteration, and the child's ability to rinse and expectorate properly.
Geriatric Use
No specific dose adjustments are necessary for geriatric patients. The safety and efficacy profile is similar to that in younger adults. However, monitor for potential oral irritation or taste changes.
Clinical Information
Clinical Pearls
- Chlorhexidine gluconate oral rinse is highly effective for treating gingivitis but does not treat periodontitis (bone loss).
- Advise patients that temporary staining of teeth, restorations, and the tongue is a common side effect. This staining is usually extrinsic and can be removed by professional dental cleaning.
- Taste alteration, particularly a bitter taste, is also a common and usually reversible side effect.
- Emphasize the importance of rinsing thoroughly with water after using toothpaste and before using chlorhexidine to prevent inactivation by anionic surfactants (e.g., sodium lauryl sulfate) found in many toothpastes.
- Chlorhexidine is not a substitute for regular brushing, flossing, and professional dental cleanings.
- Patients should not swallow the rinse.
Alternative Therapies
- Improved mechanical oral hygiene (e.g., proper brushing and flossing techniques)
- Professional dental cleanings (scaling and root planing)
- Other antimicrobial agents (e.g., systemic antibiotics for severe infections, though not for routine gingivitis)
- Surgical interventions for advanced periodontal disease
Cost & Coverage
Average Cost:
Varies widely (e.g., $15-$50) per 480 mL bottle
Generic Available:
Yes
Insurance Coverage:
Often covered by dental insurance plans or medical plans for specific indications (e.g., post-surgical). May be out-of-pocket for some.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.