How and why should I take the drug "Hexoral Tabs"? The instructions for this medication, its indications and contraindications will be described in this article. From it you will learn about what other forms this drug has, whether it can be used during pregnancy, whether the drug has side effects, etc.
The composition of the medication
In what form is the drug "Hexoral Tabs" produced? It goes on sale in the form of lozenges, which have a biconvex and round shape, as well as a rough yellowish surface.
The active substance of the drug are chlorhexidine dihydrochloride and benzocaine. As for the auxiliary components, they include isomalt, peppermint oil, menthol, aspartame, thymol and purified water.
Pharmacological characteristics of the drug
What are the properties of Hexoral Tabs tablets? A good therapeutic effect from their administration is due to the composition of the medication.
The combined preparation "Hexoral Tabs" for topical use has antibacterial activity. It is due to the presence of a substance such as chlorhexidine. As for benzocaine, it is a local anesthetic that provides relief from pain symptoms.
Details on the properties of the drug
Chlorhexidine, which is part of the Hexoral Tabs preparation, has a good antibacterial effect against gram-negative and gram-positive bacteria. After ingestion, the active substance destroys the cytoplasmic membrane of the bacterial cell. However, it is ineffective against dermatophytes, yeast, mycobacteria and some species of Proteus and Pseudomonas.
Chlorhexidine dihydrochloride is more effective in a slightly alkaline or neutral environment. In acidic, its activity is significantly reduced. In addition, the effectiveness of the drug decreases in the presence of blood, soaps, as well as pus.
The use of Hexoral Tabs tablets leads to a noticeable decrease in the content of harmful microorganisms in saliva. Moreover, the use of the drug for several weeks (or months) is accompanied by a decrease in its effectiveness. This occurs due to a decrease in the sensitivity of bacteria.
In addition to chlorhexidine dihydrochloride, the medication we are considering contains an active element such as benzocaine. It is a local anesthetic that very quickly eliminates pain in the pharynx and oral cavity. The analgesic effect lasts for a long time.
Benzocaine is able to penetrate the lipophilic portion of the cell membrane, and then act on the pain receptors (peripheral) of the skin and mucous membranes.
The anesthetic effect of benzocaine usually occurs within 20-28 seconds after application. But as the active substance is diluted with saliva, the effect begins to gradually decrease.
Pharmacokinetics of the drug
The active element of the drug “Hexoral Tabs” (chlorhexidine) is able to persist in saliva for up to eight hours. However, there are no clinical indicators about its absorption through the mucous membrane of a person’s mouth.
As for benzocaine, due to its low solubility in water, it is absorbed quite slowly. Like all derivatives of essential para-aminobenzoic acids, this substance is broken down in the liver and blood plasma by esterase. As a result, ethanol is formed, which is metabolized to acetyl coenzyme. As for paraaminobenzoic acid, it undergoes conjugation with glycine or leaves the body through the kidneys unchanged.
Indications for use of the drug
When is Hexoral Tabs Medication prescribed? The instruction for this drug contains the following list of indications:
- tonsillitis, pharyngitis and other inflammatory diseases of the pharynx;
- gingivitis;
- stomatitis.
Contraindications to the use of the drug
In what cases is it forbidden to use the drug “Hexoral” (aerosol, absorbable tablets)? According to the attached instructions, the use of this medication is prohibited in the following cases:
- with phenylketonuria;
- with ulcerative and wound lesions of the pharynx or oral cavity;
- with a low concentration of cholinesterase in the blood;
- if the child is not yet 4 years old;
- with increased sensitivity to the elements of the drug.
Medication "Hexoral Tabs": instructions for use
The mentioned medication is used only locally. The tablet must be slowly absorbed in the mouth (until it is completely dissolved).
The drug should begin to be used immediately after the first signs of the disease appear. Moreover, treatment must be continued for several days after the complete disappearance of all symptoms.
For adults and children over 12 years of age, the drug is usually prescribed in 1 tablet every 1 or 2 hours (if necessary). However, the daily dosage of the medication should not be more than 8 tablets per day.
For children aged 4 to 12 years, the drug is prescribed in an amount of not more than four tablets per day, use is possible only as directed by the pediatrician.
The drug should not be given to children under 4 years of age.
Overdose cases
Can there be an overdose of the drug "Hexoral Tabs" (classic, etc.)? With the correct use of the medication, an overdose is impossible. After all, the active element - chlorhexidine - is not absorbed into the blood, and the amount of absorbed benzocaine is small.
As mentioned above, chlorhexidine hydrochloride is very poorly soluble in water. Therefore, all cases of overdose are described only when taking well-soluble chlorhexidine gluconate. Symptoms of this condition are damage to the mucous membranes as a result of direct contact with the active substance, as well as a systematic, but reversible, increase in the concentration of the liver enzyme. There is no specific therapy in this case.
As for benzocaine, an overdose of this substance can occur only with improper use of the drug. In this case, a toxic effect on the nervous system occurs, which is manifested first by tremor, convulsions and vomiting, and then depression of the central nervous system. Ultimately, the patient may fall into a coma.
Among other things, high toxic concentrations of this substance cause blockade of AV conduction, bradycardia and cardiac arrest. Benzocaine also causes methemoglobinemia (usually in young children), which is accompanied by cyanosis and suffocation.
How to treat? If an overdose of benzocaine occurs, then the patient must induce vomiting and immediately rinse the stomach. Sometimes doctors prescribe activated charcoal.
If the patient has hypoxia and anoxia, then artificial respiration is necessary. Cardiac arrest requires massage.
When convulsions occur, the patient is prescribed fast-acting barbiturates (but not with anoxic convulsions) and Diazepam. In especially severe cases, after artificial respiration and intubation, suxamethonium chloride is used.
The patient's blood circulation is maintained by the introduction of electrolyte solutions or blood plasma. With methemoglobinemia, up to 50 ml of methylene blue solution (1%) is used. Enter it intravenously.
Side effects
Are there any side effects of the drug “Hexoral” (aerosol, tablets)? According to the instructions, this medication has a fairly large number of negative consequences. They have been identified through epidemiological or clinical studies.
- Digestive system: decreased sensitivity of the oral mucosa, taste disturbance (or so-called dysgeusia), temporary numbness of the tongue, stomatitis, reversible discoloration of the teeth and tongue, discoloration of composite and silicate materials for tooth restoration, detachment of the oral mucosa, formation of tartar or plaque glossodynia, as well as an increase in the salivary glands (parotid).
- Human immunity: hypersensitivity reactions, including angioedema, urticaria, anaphylactic shock and other anaphylactic reactions.
- Lymphatic and circulatory system: methemoglobinemia.
If these side effects are exacerbated or other negative effects are noted that were not prescribed in the instructions, then the patient must inform the doctor about this.
Interaction with other means
Does the use of this drug affect the use of other drugs? What does the instruction say about this? “Hexoral Tabs” (classic, etc.) can reduce the antibacterial activity of aminosalicylates and sulfonamides. This happens due to the formation of an aminobenzoic acid metabolite.
As for the action of chlorhexidine, it decreases markedly with the simultaneous use of sucrose, polysorbate 80, insoluble salts of zinc, magnesium and calcium.
The drug "Hexoral Tabs" during pregnancy
Currently, there is no experience with the use of the drug “Hexoral” (in the form of chewable tablets and aerosol) in nursing and pregnant women. That is why its use is possible only in cases where the expected benefit to the mother significantly exceeds the potential risk to the fetus or child.
Special instructions for using the medication
What you need to know for the safe use of the drug "Hexoral Tabs" (classic)? Reviews of specialists about this tool are ambiguous: if used improperly, benzocaine can cause methemoglobinemia. A similar condition is accompanied by signs such as discoloration of the lips, skin, and nail beds. They become pale or acquire a blue, grayish tint. Also, the patient may experience a faint, headache, fatigue, shortness of breath and tachycardia. The appearance of these symptoms indicates the presence of methemoglobin in high or moderate amounts, as well as a significant decrease in the oxygen transport function of the blood.
The highest risk of methemoglobinemia is in elderly and small patients. Children can take this drug only under the supervision of adults.
The medication contains such an auxiliary element as aspartame. It is a derivative of phenylalanine, which poses a clear danger to patients with phenylketonuria.
The use of the drug is strictly prohibited in the presence of ulcerative and wound lesions of the throat and oral cavity. Special care should be taken when prescribing the drug to small children (from 4 years old) and people with swallowing or aspiration disorders, as this can cause choking.
If the “Hexoral Tabs” medicine has expired , then it should not be thrown into wastewater or into the street. The drug is recommended to be placed in a bag and sent to a garbage container. These measures will help protect and preserve the environment.
The medication we are considering does not have any effect on the ability to operate the machine, as well as engage in other activities.
Other forms of release
In addition to tablets, the drug "Hexoral" is available in other forms. Let's consider them in more detail.
- 0.1% solution for topical application. This medication contains hexetidine, as well as such auxiliary elements as anise and eucalyptus oil, ethanol, citric acid monohydrate, clove oil, levomenthol, polysorbate 60, methyl salicylate, peppermint oil, purified water, sodium saccharin and azorubine. The presented tool is used only for rinsing the pharynx and mouth.
- Aerosol "Hexoral" (spray). The use of this drug is indicated in the same cases as tablets. The spray must be sprayed onto the affected areas for no more than 2 seconds. As a rule, it is prescribed twice a day (after breakfast and dinner). In severe diseases, aerosol is used more often.
Drug Reviews
According to patient reviews, the drug "Hexoral" copes well with the task. Thanks to him, tonsillitis and pharyngitis, as well as other inflammatory diseases of the pharynx, are much easier to tolerate and pass quite quickly. As for negative reviews, most often they are left by those who used the medication incorrectly.