Peridex 0.12% Oral Rinse,118ml
It is used to treat or prevent gingivitis.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Antiseptic
Pharmacologic Class
Biguanide Antiseptic
Pregnancy Category
Category B
FDA Approved
Sep 1986
DEA Schedule
Not Controlled
Overview
What is this medicine?
Chlorhexidine gluconate oral rinse is an antiseptic mouthwash used to treat gingivitis, which is inflammation of the gums. It works by killing bacteria in your mouth that cause gum disease. It helps reduce gum redness, swelling, and bleeding.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication effectively, follow your doctor's instructions and read all the information provided. Before rinsing, brush and floss your teeth. 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 any potential issues with the taste of 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. Keep all medications in a safe location, out of the reach of children and pets, to prevent accidental ingestion or other safety issues.
Managing Missed Doses
If you miss a dose, take it as soon as you remember. However, if it is close to the time for 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 make up for the missed one.
To use this medication effectively, follow your doctor's instructions and read all the information provided. Before rinsing, brush and floss your teeth. 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 any potential issues with the taste of 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. Keep all medications in a safe location, out of the reach of children and pets, to prevent accidental ingestion or other safety issues.
Managing Missed Doses
If you miss a dose, take it as soon as you remember. However, if it is close to the time for 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 make up for the missed one.
Lifestyle & Tips
- Do not swallow the rinse; spit it out after use.
- Rinse thoroughly with water after brushing your teeth before using chlorhexidine rinse, especially if your toothpaste contains sodium lauryl sulfate (SLS). Wait at least 30 minutes between brushing and rinsing with chlorhexidine.
- Do not eat or drink for at least 30 minutes after using the rinse.
- Staining of teeth, tongue, and dental restorations can occur, especially with prolonged use. This staining is usually temporary and can be removed by professional dental cleaning.
- Taste alteration may occur, which is usually temporary.
- Continue regular dental check-ups and cleanings as advised by your dentist.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
15 mL (0.5 fl oz) undiluted oral rinse, swished for 30 seconds, twice daily (morning and evening) after toothbrushing.
Dose Range:
15 - 15 mg
Condition-Specific Dosing:
gingivitis:
15 mL swished for 30 seconds, twice daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Safety and efficacy not established for children under 18 years of age. Use only under medical supervision if prescribed off-label.
Adolescent:
Safety and efficacy not established for children under 18 years of age. Use only under medical supervision if prescribed off-label.
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 adjustment needed (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 biguanide that binds to the negatively charged bacterial cell wall, disrupting the osmotic equilibrium of the cell and leading to leakage of intracellular components. At low concentrations, it is bacteriostatic; at higher concentrations, it is bactericidal. It has a broad spectrum of activity against Gram-positive and Gram-negative bacteria, yeasts, and some viruses. Its substantivity (ability to bind to oral tissues and be released slowly) provides prolonged antimicrobial activity.
Pharmacokinetics
Absorption:
Bioavailability:
Less than 0.002% (systemic absorption from oral rinse is negligible)
Tmax:
Not applicable (minimal systemic absorption)
FoodEffect:
Food/drink should be avoided immediately after rinsing to maximize local effect.
Distribution:
Vd:
Not applicable (minimal systemic absorption)
ProteinBinding:
Not applicable (minimal systemic absorption)
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (minimal systemic absorption)
Clearance:
Not applicable (minimal systemic absorption)
ExcretionRoute:
Not applicable (minimal systemic absorption)
Unchanged:
Not applicable (minimal systemic absorption)
Pharmacodynamics
OnsetOfAction:
Within minutes (local antimicrobial effect)
PeakEffect:
Not applicable (local action)
DurationOfAction:
Up to 12 hours (due to substantivity)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
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
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ 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 many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Mouth irritation
Staining of the mouth, teeth, or fillings
Tartar buildup on teeth
* Change in taste (in rare cases, this may be permanent)
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor for medical advice.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
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
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ 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 many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Mouth irritation
Staining of the mouth, teeth, or fillings
Tartar buildup on teeth
* Change in taste (in rare cases, this may be permanent)
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor for medical advice.
Seek Immediate Medical Attention If You Experience:
- Severe allergic reaction (anaphylaxis): swelling of face, lips, tongue, or throat; difficulty breathing; rash; itching. Seek immediate medical attention.
- Severe oral irritation, pain, or peeling of the gums/mouth lining.
- Persistent or worsening taste disturbance.
- Increased sensitivity of teeth or gums.
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, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial because this medication may interact with other drugs or exacerbate existing health problems.
* Any health issues you are experiencing, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial because this medication may interact with other drugs or exacerbate existing health problems.
* Any health issues you are experiencing, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
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 immediately. Your doctor will discuss the potential benefits and risks of this medication to both you and your baby, allowing you to make an informed decision.
Overdose Information
Overdose Symptoms:
- If swallowed, symptoms are generally mild due to poor systemic absorption but may include nausea, vomiting, stomach upset, or diarrhea.
- Large ingestions could potentially lead to alcohol intoxication due to the alcohol content in some formulations (check product label).
What to Do:
If a large amount is accidentally swallowed, drink milk or water. Contact a poison control center immediately (Call 1-800-222-1222 in the US) or seek emergency medical attention. Do not induce vomiting unless instructed by a healthcare professional.
Drug Interactions
Moderate Interactions
- Toothpaste containing anionic agents (e.g., sodium lauryl sulfate): Can inactivate chlorhexidine. Advise patients to rinse thoroughly with water after brushing and wait at least 30 minutes before using chlorhexidine rinse.
Monitoring
Routine Monitoring
Oral mucosa for irritation/ulceration
Frequency: Regularly during use
Target: Absence of irritation
Action Threshold: Discontinue if severe irritation occurs; consult dentist/physician.
Tooth and tongue staining
Frequency: Regularly during use
Target: Minimal or no staining
Action Threshold: Staining is reversible; can be removed by professional cleaning. Advise patients about potential for staining.
Taste alteration
Frequency: Regularly during use
Target: Acceptable taste perception
Action Threshold: If persistent or severe, consider discontinuation or alternative.
Symptom Monitoring
- Oral irritation
- Swelling of salivary glands
- Desquamation (peeling) of oral mucosa
- Taste disturbance (dysgeusia)
- Tooth or tongue staining
- Increased calculus formation
- Hypersensitivity reactions (rare, e.g., rash, itching, swelling, severe allergic reaction)
Special Patient Groups
Pregnancy
Chlorhexidine gluconate is Pregnancy Category B. Studies in animals have not shown harm to the fetus, and systemic absorption in humans is minimal. It is 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
Lactation Risk L2 (Safer). Systemic absorption is minimal, making transfer into breast milk unlikely to be clinically significant. It is generally considered compatible with breastfeeding.
Infant Risk:
Low risk to the infant due to negligible systemic absorption and excretion into breast milk.
Pediatric Use
Safety and effectiveness have not been established in pediatric patients under 18 years of age. Use in children should be under the direct supervision of a healthcare professional and only if clearly indicated, considering the risk of accidental ingestion.
Geriatric Use
No specific dosage adjustments are necessary for geriatric patients. The safety and efficacy profile is similar to that in younger adults, given the minimal systemic absorption.
Clinical Information
Clinical Pearls
- Chlorhexidine gluconate is the gold standard for chemical plaque control and gingivitis treatment.
- Advise patients to rinse with water after brushing and wait 30 minutes before using chlorhexidine to avoid inactivation by anionic toothpaste ingredients.
- Staining is a common side effect but is extrinsic and can be removed by professional dental cleaning.
- Taste alteration is usually temporary but can be a reason for non-compliance.
- Not intended for long-term continuous use without professional guidance; typically used for specific periods (e.g., 2-4 weeks) or as directed by a dentist.
- Patients should be reminded not to swallow the rinse.
Alternative Therapies
- Essential oil mouthwashes (e.g., Listerine)
- Cetylpyridinium chloride (CPC) mouthwashes (e.g., Crest Pro-Health)
- Povidone-iodine oral rinses (less common for daily use)
- Mechanical plaque control (brushing, flossing) remains primary
- Prescription fluoride rinses (for caries prevention, not gingivitis)
Cost & Coverage
Average Cost:
$15 - $40 per 118ml bottle (0.12%)
Generic Available:
Yes
Insurance Coverage:
Often covered by dental or medical insurance, but may require prior authorization or be subject to co-pays. Generic versions are typically Tier 1 or 2.
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.