Medicinal reference book geotar. Hexoral tabs classic: instructions for use Instructions for use

I don't want to get sick. Fever, cough, chills, sore throat, general malaise do not allow you to actively spend your leisure time, work and relax. So I want to get rid of them as soon as possible. The pharmaceutical industry produces many drugs to combat various diseases. True, each has its own indications and contraindications. But some drugs have become quite popular with patients for a number of reasons. Among these drugs is Hexoral (a medicine that doctors prescribe for the treatment of diseases of the nasopharynx). It is produced in two pharmacy forms, but more is still used in the form of lozenges. The article provides instructions for use.

Description of the drug, composition

Produced by German and Indian pharmacological companies.

Hexoral lozenges are available in blister packs packed in cardboard boxes. Each contains two blisters. The shape of the tablet is round, convex on both sides. Not white. May be yellowish-gray or yellowish-white, slightly rough to the touch. The drug consists of two main active ingredients that complement each other well: dihydrochloride (5 mg) and benzocaine (1.5 mg). Exactly how much substance is in one tablet. In addition, there are auxiliary ingredients, including peppermint oil, menthol, thymol, aspartame, isomalt and distilled water. They have different tastes, so they are well perceived by children. Thanks to flavors and sweeteners, they can be in the following flavors:

• orange;
• Lemon;
• Honey-lemon;
• Blackcurrant.

Hexoral is available without a prescription. There are cheaper analogues, but their effectiveness in the treatment of diseases of the oropharynx is much lower.

Pharmacological action and group

This is a drug for topical use in dentistry and otolaryngology. Included in the pharmacological group of antimicrobial and anesthetic drugs.

Hexoral lozenges for sore throats have a powerful double blow to the disease: they are antibacterial, that is, they fight pathogenic bacteria. But besides this action, they will help relieve pain, as they also have an anesthetic property. Hexolar is a drug that acts for at least eight hours. That is, the concentration in saliva is maintained precisely this period of time. Its components have the following properties:

1. Chlorhexidine dihydrochloride - significantly reduces the number of viruses in the oral cavity, showing a bactericidal effect.
2. Benzocaine - relieves pain, but it must be said that its effect is not as long as we would like.
3. Peppermint oil - has an antimicrobial effect, relieves muscle tension, reduces pain.
4. Menthol - a distracting effect helps dull pain. It has antianginal and analgesic effects.
5. Aspartame (potassium and magnesium). It is used with a lack of these elements, and in this case to relieve edematous syndrome.
6. Thymol - has an antibacterial and antiseptic effect. It also relieves itching well.
7. Isomalt is a natural sweetener. It is he who does not contribute to the growth of bacteria in the oral cavity, as it can be with the use of pure sugar.

The drug is stored for three years at a temperature not exceeding 25 degrees.

Indications and contraindications in the use of the drug for the throat

Hexoral is used for such diseases of the nasopharynx:

1. Pharyngitis -. Accompanied by sore throat. The disease can take place in two forms: acute and chronic.
2. Angina is an acute infectious disease characterized by inflammation predominantly.
3. Gingivitis is inflammation of the gum mucosa. Occurs with antihygienic maintenance of the oral cavity. And also as a result of a general disease. It is characterized by hyperemia, bleeding gums.
4. Stomatitis is an inflammation of the oral mucosa.
5. Sinusitis - inflammation of the mucosa, and in some cases, the bone walls.
6. Otitis media is an inflammation of the middle ear. Accompanied by pain and fever.
7. Auxiliary, SARS.

Hexoral lozenges are most effective at the first manifestations of the disease. It is not necessary to stop taking them until complete recovery.

In total, eight lozenges are needed per day. This is the optimal rate in the acute course of the disease. At the initial stage, you should dissolve the tablet every two hours. Just suck like candy. Do not gnaw, chew or swallow, namely dissolve. After application, try not to drink or eat for an hour. It is not recommended to use Hexoral in smaller doses, since in this case, harmful microorganisms will simply get used to the constituent components and adapt to them.

Contraindications to the use of the drug:

• Wounds and ulcers in the mouth;
• Allergy to the constituent components of the drug;
• At risk are people suffering from a violation of the swallowing process. They should not be given lozenges;
• Children under four years of age;
• Among the side effects: cough, tearing, numbness in the mouth. And also because of the dyes, the tongue or filling may be stained for a short time.

During pregnancy

How Hexoral affects the body of the mother and the unborn child has not been thoroughly studied. In some cases, if necessary, you can use this drug - no more than four tablets per day and no more than one per dose.

The components of the component and their decay products can pass through the placenta and into breast milk.

Instructions for use of Hexoral lozenges for young children

The use of the drug and its dose differ from the norms prescribed for adult patients:

• Children from four years old can dissolve lozenges one four times a day;
• This drug is not recommended for children under four years of age for the following reasons:
• The composition of the drug includes allergens. Since in young children the immunity is not yet fully formed, and in some cases the absorption of lozenges is weakened, it can lead to the development of allergies;
• Most children may be hypersensitive to the constituent components of Hexoral;
• Chlorhexidine and benzocaine are somewhat toxic when they enter the esophagus. The child can simply, without dissolving, take a sip of the lozenge;
• They can cause a deterioration in the transport of oxygen in the body in a baby.

The child should dissolve the lozenge only under the supervision of the parents.

Possible complications caused by the drug

With an overdose, there may be such complications:

1. Upon contact with the gastrointestinal mucosa (and this in most cases occurs when swallowing, and not resorption of tablets), it may be damaged.
2. Tremor, bouts of vomiting. Such a side effect with an overdose of benzocaine, which is one of the main components of Hexoral.
3. Slight numbness of the tongue, partial and temporary change in taste
4. In some cases, discoloration of silicate materials that have been used for fillings in the treatment of caries may occur.

Video

conclusions

Hexaral is a fairly effective remedy for the treatment of inflammatory diseases of the oral and pharyngeal cavities. If you apply it exactly following the instructions that come with the drug, then the course of the disease will be less acute and will end with a quick recovery. But, like every drug, this one also has its side effects and contraindications. Therefore, you should not diagnose yourself and prescribe this drug for treatment.

Also read Flemoxin Solutab in the treatment of acute tonsillitis, and Amoxicillin.

Content

To prevent diseases of the throat and gums, the antibacterial Hexoral is used - the instructions for using the medication contain important information about the appointment and dosage. The medicine belongs to antiseptic (antibiotic), is available in several forms for convenient use. Read the instructions to be aware of the rules for using the medication.

The drug Hexoral

In ENT practice and dentistry, the drug Geksoral is used, which, according to the pharmacological classification, belongs to antiseptics. It is intended for topical use, plus Hexoral Tabs tablets are available for oral administration. The active ingredient of the drug is hexetidine. The medicine is suitable for children and adults.

Composition and form of release

There are three forms of Hexoral release: spray or aerosol, solution and tablets. The latter do not contain hexetidine. The active substance of the tableted antiseptic preparation is a mixture of chlorhexidine dihydrochloride and benzocaine, additional - isomalt, menthol, water, aspartame, thymol and peppermint oil. Tablets are available in packs of 20. Detailed composition of the spray and solution:

Pharmacological properties

The drug has an antimicrobial effect due to the suppression of the oxidative process in the metabolism of bacteria. Hexetidine is the opposite active substance of thiamine, has a broad effect on bacteria and fungi. It suppresses most strains of pathogens, including the genus Candida and Proteus, does not develop their resistance to exposure, reduces the sensitivity of bacteria.

It is effective against influenza A viruses, herpes simplex type 1, during the action it slightly anesthetizes the mucous membranes of the gums. When it comes into contact with the mucous membranes of the oral cavity and pharynx, it adheres well, is practically not absorbed. After a single application, the active substance remains in the mucous membranes of the gums for 65 hours, in plaque and plaques for 10-14 hours.

Indications for use

Instructions for use indicate the following indications for the use of the drug Geksoral:

• symptomatic therapy of infectious and inflammatory diseases of the oral cavity and pharynx;
• tonsillitis, pharyngitis;
• treatment of angina, SARS;
• gingivitis, stomatitis, glossitis;
• periodontal disease, fungal infections of the mouth;
• prevention of infectious complications before and after operations;
• prevention of infection of the alveoli after tooth extraction, trauma;
• hygiene and diseases of the oral cavity (odor elimination).

Method of application and dosage

According to the instructions, Hexoral is used for gargling in the form of a solution, for irrigating the oral cavity in the form of a spray. Geksoral with angina is prescribed in the form of oral tablets. They dissolve in the mouth until completely dissolved. Adults are shown one piece every 1-2 hours, but not more than 8 per day. Children 4-12 years of age may take up to 4 tablets per day. The drug is used immediately after the appearance of the first symptoms, within a few days after their disappearance.

Geksoral Aerosol

The spray is applied topically, adheres to the oral mucosa, which is manifested in the persistence of the effect. The medicine should be taken after meals. Adults, children over six years of age process the mouth while holding the breath, once irrigating the mucous membranes for a couple of seconds twice a day. Children 3-6 years old can use a local antiseptic preparation only after consulting a pediatrician. The doctor prescribes the duration of the course depending on the type of disease.

Instructions for use of Hexoral aerosol include the following steps for spraying in the larynx or mouth:

• put a spray nozzle on the balloon;
• direct its end to the affected area of ​​the mucosa;
• hold the bottle strictly vertically during the introduction;
• spray the desired amount of spray by pressing on the head of the spray nozzle;
• do not breathe during insertion.

Hexoral solution

The second form of Hexoral release in the form of a solution is also used topically, after meals. Adults and older children fill the measuring cup to the 15 ml mark, rinse their mouth with an undiluted solution for half a minute 2-3 times / day. Children 3-6 years of age should use the drug only after consulting a doctor. The solution should not be swallowed, diluted with water or other liquids. It is allowed to treat the affected areas of the throat with swabs dipped in medicine. They are applied for 2-3 minutes. The duration of therapy is determined by the doctor.

special instructions

The instructions for use indicate special instructions during the use of the antiseptic drug. Pay attention to them:

• one dose of the solution contains 20.3 mg, which is 5.15% in terms of pure substance;
• the contents of the spray can are under pressure, do not open, puncture or burn the package even after it is completely empty;
• if the medicinal product has expired, it must not be poured into wastewater or thrown out into the street, tie it in a bag, throw it in a garbage container;
• antiseptic drug does not affect the speed of psychomotor reactions, can be used while driving cars or dangerous mechanisms;
• the drug is prescribed with caution in case of sensitivity to acetylsalicylic acid;
• the solution can be used only when the patient can spit it out after the end of the cavity rinsing procedure.

During pregnancy

According to the instructions, there is no information about undesirable effects after using the Hexoral antiseptic during pregnancy and breastfeeding, but you should consult a doctor before prescribing. If he evaluates the benefit to the mother above the risk to the baby, the drug can be used as directed. There are no data on the penetration of hexetidine through the placental barrier or into breast milk.

Geksoral for children

According to the instructions, the medication is contraindicated for use in children under three years of age. Hexoral can be prescribed to children when there is no danger of uncontrolled swallowing or resistance to a foreign object in the mouth (spray nozzle). If the child is not yet able to hold his breath on his own while injecting, it is better not to use the medicine.

drug interaction

According to the instructions for use of Hexoral, drug interactions of the aerosol and solution with other medications are not described. From this we can conclude that you can combine drugs in any order, but before any treatment of infections, a medical consultation is necessary. This will help to avoid negative effects on the health of the body.

Side effects

Instructions for the use of Hexoral indicate the following possible side effects that occur when it is taken:

• allergic reactions, hypersensitivity, urticaria, angioedema;
• ageusia, dysgeusia, poisoning;
• cough, shortness of breath;
• numbness and discoloration of the tongue, short-term loss of taste;
• dry mouth, nausea, vomiting, increased salivation;
• mucosal irritation, burning, paresthesia;
• inflammation of the mucous membranes, the formation of vesicles and ulcers;
• discoloration of the enamel.

Overdose

According to the instructions, it is unlikely that hexetidine has a toxic effect when taken at the recommended doses. If the drug is accidentally swallowed, symptoms of alcohol intoxication may appear. The treatment is gastric lavage within two hours after the child swallows the dose, symptomatic therapy. In any case of overdose, the patient should see a doctor.

An overdose of tablets is unlikely, its symptoms are suffocation, tremor of the limbs, vomiting, convulsions. Due to respiratory depression, coma and death are possible. Treatment consists of artificial induction of vomiting and gastric lavage with activated charcoal. With convulsions, barbiturates or diazepam are prescribed, with hypoxia - artificial respiration and suxamethonium chloride, circulatory support by introducing electrolyte solutions.

Contraindications

Instructions for the use of Hexoral states the following contraindications that prohibit the use of the medication:

• erosive-squamous lesions of the oral mucosa;
• age up to three years for spray and solution, up to four years for tablets;
• hypersensitivity to the components of the composition or acetylsalicylic acid;
• with caution during pregnancy and breastfeeding.

Terms of sale and storage

The drug is dispensed from pharmacies without a prescription, stored away from children and light at temperatures up to 25 degrees. The shelf life is three years, but the contents of the spray bottle must be used within six months after opening. The solution is stored for two years.

Analogues

According to the active substance and the therapeutic effect, the following Hexoral analogues are distinguished in the form of a spray and solution, produced by domestic and foreign companies:

• Stomatidin;
• Stopangin;
• Hexosept;
• Stomolik;
• Dentagel;
• Metroviol;
• Metrohex;
• Metrogil Denta;
• Metrodent;
• Dentogel;
• Candide;
• Metrozol Denta;
• Metronidazole Denta.

Geksoral's analogue is cheaper

Not all drug analogues are affordable, but the following drugs in the form of a spray or antiseptic solution can be bought at any pharmacy cheaper than Hexoral:

• spray Proposol;
• spray and ointment Tantum Verde;
• spray Ingalipt;
• antiseptic solution Miramistin;
• lozenges Lizobakt;
• medicinal aerosol Stopangin.

Hexoral price

The cost of Hexoral depends on the form of release, the manufacturer and the price category of the pharmacy. On the Internet, prices are cheaper than in the usual pharmacies, but you have to pay for delivery. Approximate drug prices.

Geksoral tablets - a combined drug with antimicrobial and anesthetic effects, are recommended to suppress ENT diseases.

Pastilles are intended for local use - resorption until completely dissolved in the mouth.

Hexoral is produced in the form of round, opaque, biconvex lozenges. The surface of non-uniformly colored lozenges with yellow-white or yellow-gray shades is rough, powdered (covered with a whitish coating).

There are air bubbles inside lollipops with slightly uneven edges.

The drug is produced with the addition of additional ingredients. Lollipops are enriched with peppermint oil. They are produced with the addition of isomalt, menthol, thymol. They contain aspartame and purified water.

Tablets are sealed in blisters. 2 blisters with 10 lozenges are placed in cardboard boxes. Hexoral lozenges are sold at an affordable price (around 200 rubles).

In pharmacies, Hexoral lozenges are dispensed without a prescription. Pastilles are usable for 3 years from the date of issue. They must be stored at a temperature not exceeding 25 0 C.

Indications, contraindications, side effects

For successful treatment with Hexoral tablets, you need to know what diseases they can be used for, what side effects they have, which patients should not use them.

Indications

Lozenges are prescribed for infections that affect the oral cavity and pharynx. They are treated:

• pharyngitis, tonsillitis and other inflammations in the nasopharynx;
• stomatitis and gingivitis.

Contraindications

Tablets should not be used if:

• the human oral cavity and nasopharynx are affected by ulcers and wounds;
• the patient has a low content of cholinesterase in the blood;
• children under 4 years of age;
• hypersensitivity to the ingredients of lozenges is noted.

Lozenges are carefully prescribed to patients with erosive and desquamative changes on the mucous membranes of the mouth and diabetes mellitus (in each lozenge the amount of carbohydrates reaches 0.1 XE). Treatment is carried out under the strict supervision of a doctor.

Side effects

With long-term use of Hexoral tablets, a short-term loss of taste sensations is noted. Sometimes temporary staining of the tongue and teeth is observed. In addition, patients may have a numb tongue.

Patients with hypersensitivity to benzocaine occasionally develop severe allergies that can result in anaphylactic shock. Children and the elderly in some cases are subject to the occurrence of methemoglobinemia.

Use in pregnancy and breastfeeding

The use of Hexoral in the treatment of pregnant and lactating women has not been fully studied. The medicine is recommended if it significantly alleviates the condition of the mother, but does not harm the development of the fetus or the health of the baby.

Hexoral - lozenges: instructions for use

The lozenges are sucked until they are completely dissolved. It is not recommended to bite and chew them due to a decrease in the therapeutic effect.

The medication is started as soon as the first symptoms appear. In order to effectively treat the pills, they do not stop taking after the signs of the disease subside.

Dosage for adults and children (12+) - 8 lozenges per day (1 lozenge is absorbed at intervals of 1-2 hours). The maximum dose for children 4-12 years old is 4 lozenges per day.

Pharmacology

The drug has a double effect on the foci of inflammation. Chlorhexidine is endowed with antibacterial properties. It destroys gram-positive and gram-negative bacteria.

To a small extent, it is able to suppress yeast fungi, dermatophytes, mycobacteria, certain varieties of Pseudomonas and Proteus.

The substance reaches its greatest activity if the pH environment in the lesions is slightly alkaline or neutral. Acidic environments, the presence of soap, pus and traces of blood reduce the effect of chlorhexidine.

Pastilles significantly reduce the number of pathogenic microorganisms in the foci of inflammation. With prolonged use of the drug, pathogens lose their sensitivity to chlorhexidine. The impact of lozenges is greatly reduced.

Benzocaine is categorized as a local pain reliever. It instantly relieves pain. The anesthetic, having penetrated through the lipophilic sectors of cell membranes, blocks the pain receptors of the epithelium and mucous membranes of the mouth.

Anesthesia is observed after 15-30 seconds. Over time, saliva dilutes the anesthetic, reducing its concentration. Anesthesia wears off after 5-10 minutes of exposure.

Pharmacokinetics

How chlorhexidine is absorbed by the mucous membranes of the mouth is still unknown. It is excreted from saliva within eight hours. Since benzocaine is practically insoluble in water, it is slowly absorbed.

Its cleavage proceeds in the blood and liver under the influence of esterase. The end products of the breakdown of benzocaine are para-aminobenzoic acid and acetylcoenzyme A. The kidneys excrete para-aminobenzoic acid unchanged.

drug interaction

As a result of the benzocaine metabolite, 4-aminobenzoic acid is synthesized - a substance that reduces the antibacterial effect of sulfonamides and aminosalicylates.

The active effect of chlorhexidine is suppressed by insoluble salts of magnesium, calcium and zinc, sucrose and polysorbate 80.

Last update of the description by the manufacturer 09/08/2011

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Pharmacological group

Nosological classification (ICD-10)

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Composition and form of release

in a blister 10 pcs.; in a pack of cardboard 2 blisters.

Description of the dosage form

Round biconvex opaque tablets with a rough surface from yellow-white to yellow-gray. Uneven staining, the presence of air bubbles and a slight unevenness of the edges are allowed. There may be a white coating (dusting).

pharmachologic effect

Pharmacodynamics

The double action of the drug is due to the presence of two active ingredients. The antibacterial activity of the drug is due to the presence of chlorhexidine. The action of a local anesthetic - benzocaine - provides a decrease in pain symptoms.

Chlorhexidine. It has a wide antibacterial spectrum of action against gram-positive and gram-negative bacteria; acts by destroying the cytoplasmic membrane of the bacterial cell. Ineffective against yeast fungi, dermatophytes, mycobacteria, some species Pseudomonas and Proteus.

Chlorhexidine is most effective in a neutral or slightly alkaline environment. In an acidic environment, its activity decreases. Efficacy is reduced in the presence of soaps, blood and purulent secretions.

The use of lozenges with chlorhexidine leads to a significant reduction in the content of bacteria in saliva. The use of chlorhexidine for several months is accompanied by a decrease in its effectiveness due to a decrease in the sensitivity of bacteria.

Benzocaine- local anesthetic, quickly and for a long time relieves pain in the oral cavity and pharynx. Benzocaine penetrates through the lipophilic regions of the cell membrane and acts on the peripheral pain receptors of the mucous membrane and skin. The anesthetic effect of benzocaine occurs in 15-30 seconds; as the substance is diluted with saliva, the anesthetic effect gradually decreases (within 5-10 minutes).

Pharmacokinetics

Chlorhexidine. There are no clinical data on the absorption of chlorhexidine through the human oral mucosa. Chlorhexidine can persist in saliva for up to 8 hours.

Benzocaine. It is sparingly soluble in water, which causes its slow absorption. Like all ether derivatives of para-aminobenzoic acid, it is cleaved by esterase in blood plasma and liver. As a result, para-aminobenzoic acid and ethyl alcohol are formed, which is metabolized to acetyl coenzyme A. Para-aminobenzoic acid undergoes conjugation with glycine or is excreted by the kidneys unchanged.

Indications for Hexoral ® tabs

Infectious and inflammatory diseases of the throat or oral cavity:

pharyngitis, tonsillitis and other inflammatory diseases of the pharynx;

stomatitis;

gingivitis.

Contraindications

hypersensitivity to any of the components of the drug;

wound and ulcerative lesions of the oral cavity or throat;

low concentration of cholinesterase in blood plasma;

children's age up to 4 years.

Carefully and only under the supervision of a physician, the drug Hexoral tabs can be used for erosive, desquamative changes in the oral mucosa.

Use during pregnancy and lactation

There is insufficient experience with the use of the drug in pregnant and lactating women.

The use of the drug Hexoral tabs during pregnancy and lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk of harmful effects to the fetus and child.

Side effects

With prolonged use, there may be a short-term violation of taste and numbness of the tongue; reversible discoloration of the teeth and tongue is also possible.

In the presence of hypersensitivity to benzocaine, in rare cases, the development of hypersensitivity reactions up to anaphylactic shock is possible.

Benzocaine may cause the development of methemoglobinemia in children.

Interaction

Benzocaine due to the formation of its metabolite - 4-aminobenzoic acid - reduces the antibacterial activity of sulfonamides and aminosalicylates.

Sucrose, polysorbate 80, insoluble salts of magnesium, zinc and calcium reduce the effect of chlorhexidine.

Dosage and administration

locally. Slowly dissolve the tablet in the mouth until completely dissolved.

The drug should be started immediately after the first symptoms of the disease appear and continue to be taken for several days after the symptoms disappear.

Adults and children over 12 years old - 1 tab. every 1-2 hours as needed, but not more than 8 tab. per day, unless otherwise stated.

Children aged 4-12 years - up to 4 tab. per day. For use in children, a doctor should be consulted.

Do not use in children under 4 years of age.

Information for diabetics: the carbohydrate content in one tablet corresponds to 0.1 bread unit (BU).

Overdose

With proper use, an overdose of the drug is impossible, since chlorhexidine is practically not absorbed into the blood, and the amount of absorbed benzocaine is extremely small.

Chlorhexidine

Symptoms: chlorhexidine hydrochloride is poorly soluble in water, all cases of overdose are described only when taking chlorhexidine gluconate, which is highly soluble in water. In these cases, mucosal damage was noted upon direct contact with chlorhexidine gluconate, as well as a systematic reversible increase in the concentration of the liver enzyme.

Treatment: there is no specific treatment.

Benzocaine

Overdose is possible only if used incorrectly.

Symptoms: possible toxic effect on the central nervous system, manifested initially by tremor, vomiting, convulsions, and later - depression of the central nervous system. Due to respiratory depression, coma is possible. High toxic concentrations cause bradycardia, AV blockade and cardiac arrest. Benzocaine can cause methemoglobinemia, especially in children, accompanied by dyspnoea and cyanosis.

Treatment: induction of vomiting and gastric lavage. Perhaps the appointment of activated charcoal. In case of hypoxia and anoxia, artificial respiration with oxygen support is recommended, in case of cardiac arrest - cardiac massage. For convulsions, diazepam or fast-acting barbiturates are prescribed (contraindicated in anoxic convulsions); in especially severe cases, after intubation and artificial respiration, suxamethonium chloride is used. Circulation must be supported by the administration of blood plasma or electrolyte solutions. With methemoglobinemia, up to 50 ml of 1% methylene blue solution IV can be used.

Storage conditions of the drug Hexoral ® tabs

Keep out of the reach of children.

Shelf life of Hexoral ® tabs

Do not use after the expiry date stated on the packaging.

Synonyms of nosological groups

Preparation: HEXORAL TABS

The active substance of the drug: benzocaine, chlorhexidine
ATX encoding: R02AA20
KFG: Drug with antimicrobial and local anesthetic action for local use in ENT practice
Registration number: LSR-002626/07
Date of registration: 14.03.08
The owner of the reg. Award: SOLDAN HOLDING+BONBONSPEZIALITATEN GmbH (Germany)

Release form Geksoral tabs, drug packaging and composition.

Lozenges are round, biconvex, opaque, with a rough surface from yellow-white to yellow-gray; uneven coloring, the presence of air bubbles and a slight unevenness of the edges are allowed; a white coating (dusting) may appear.
Lozenges
1 tab.
chlorhexidine dihydrochloride
5 mg
benzocaine
1.5 mg

Excipients: isomalt, peppermint oil, menthol, thymol, aspartame, purified water.

10 pieces. - blisters (2) - packs of cardboard.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action of Hexoral tabs

The drug with antimicrobial and local anesthetic action for local use in ENT practice.

Chlorhexidine has a broad antibacterial spectrum of activity against Gram-positive and Gram-negative bacteria. It acts by destroying the cytoplasmic membrane of the bacterial cell. It is ineffective against yeast fungi, dermatophytes, mycobacteria, some types of Pseudomonas spp. and Proteus spp.

Chlorhexidine is most effective in a neutral or slightly alkaline environment. In an acidic environment, its activity decreases. Efficiency is reduced in the presence of soaps, blood and purulent secretions.

The use of lozenges with chlorhexidine leads to a significant reduction in the content of bacteria in saliva. The use of chlorhexidine for several months is accompanied by a decrease in its effectiveness due to a decrease in the sensitivity of bacteria.

Benzocaine is a local anesthetic that relieves pain in the mouth and throat quickly and for a long time. Benzocaine penetrates through the lipophilic regions of the cell membrane and acts on the peripheral pain receptors of the mucous membrane and skin. The anesthetic effect of benzocaine occurs in 15-30 seconds; as the substance is diluted with saliva, the anesthetic effect gradually decreases (within 5-10 minutes).

Pharmacokinetics of the drug.

There are no clinical data on the absorption of chlorhexidine through the mucous membrane of the human oral cavity. Chlorhexidine can persist in saliva for up to 8 hours.

Benzocaine is slightly soluble in water, which causes its slow absorption. Like all ether derivatives of para-aminobenzoic acid, it is cleaved by esterase in blood plasma and liver. As a result, para-aminobenzoic acid and ethyl alcohol are formed, which is metabolized to acetyl coenzyme A. Para-aminobenzoic acid undergoes conjugation with glycine or is excreted unchanged by the kidneys.

Indications for use:

Infectious and inflammatory diseases of the oral cavity or pharynx:

Pharyngitis, tonsillitis and other inflammatory diseases of the pharynx;

Stomatitis;

Gingivitis.

Dosage and method of application of the drug.

Tablets should be slowly dissolved in the mouth until completely dissolved.

Adults and children over 12 years of age are prescribed 1 tab. every 1-2 hours as needed, but not more than 8 tablets / day.

Children aged 4-12 years are prescribed up to 4 tablets / day.

Side effects of Geksoral tabs:

With prolonged use, there may be a short-term violation of taste and numbness of the tongue; reversible discoloration of the teeth and tongue is also possible.

In the presence of hypersensitivity to benzocaine, in rare cases, the development of hypersensitivity reactions up to anaphylactic shock is possible.

Benzocaine may cause the development of methemoglobinemia in children.

Contraindications to the drug:

Wound and ulcerative lesions of the oral cavity or pharynx;

Low concentration of cholinesterase in blood plasma;

Children's age up to 4 years;

Hypersensitivity to any of the components of the drug.

With caution, the drug should be prescribed for erosive, desquamative changes in the oral mucosa. In these cases, it is necessary to monitor the change in the patient's state of health.

Use during pregnancy and lactation.

There is insufficient experience with the use of the drug in pregnant and lactating women.

The use of the drug Hexoral Tabs during pregnancy and lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk of harmful effects to the fetus and child.

If necessary, the use of the drug during lactation should stop breastfeeding.

Special instructions for the use of Geksoral tabs.

Patients with diabetes should be informed that the carbohydrate content in 1 tab. corresponds to 0.1 XE.

Drug overdose:

With proper use, an overdose of the drug is impossible, because. Chlorhexidine is practically not absorbed into the blood, and the amount of absorbed benzocaine is extremely small.

Chlorhexidine

Chlorhexidine hydrochloride is poorly soluble in water, all cases of overdose are described only when taking chlorhexidine gluconate, which is highly soluble in water. In these cases, mucosal damage was noted upon direct contact with chlorhexidine gluconate, as well as a systematic reversible increase in the concentration of liver enzymes. There is no specific treatment.

Benzocaine

Overdose is possible only if used incorrectly.

Symptoms: a toxic effect on the central nervous system is possible, manifested first by tremor, vomiting, convulsions, and later by depression of the central nervous system. Coma may develop due to respiratory depression. High toxic concentrations cause bradycardia, AV blockade, and cardiac arrest. Benzocaine can cause methemoglobinemia, especially in children, accompanied by dyspnoea and cyanosis.

Treatment: it is necessary to induce vomiting and wash the stomach. Perhaps the appointment of activated charcoal. In case of hypoxia and anoxia, mechanical ventilation with oxygen support is recommended, in case of cardiac arrest - heart massage. For convulsions, diazepam or fast-acting barbiturates are prescribed (contraindicated in anoxic convulsions); in especially severe cases, after intubation and artificial respiration, suxamethonium chloride is used. Circulation must be supported by the administration of blood plasma or electrolyte solutions. With methemoglobinemia, up to 50 ml of 1% methylene blue solution IV can be used.

Interaction of Hexoral tabs with other drugs.

Benzocaine, due to the formation of its metabolite 4-aminobenzoic acid, reduces the antibacterial activity of sulfonamides and aminosalicylates.

Sucrose, polysorbate 80, insoluble salts of magnesium, zinc and calcium reduce the effect of chlorhexidine.

Conditions of sale in pharmacies.

The drug is approved for use as a means of OTC.

Terms of the storage conditions of the drug Geksoral tabs.

The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. Shelf life - 3 years.