Hexoral Tabs sugar-free lozenges, No. 20

Infectious and inflammatory diseases of the throat or oral cavity:

Х pharyngitis, tonsillitis and other inflammatory diseases of the pharynx;

Х stomatitis;

Х gingivitis

Locally.

Slowly dissolve the tablet in the mouth until it is completely dissolved.

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

General dosage recommendations

Adults and children over 12 years old

Х 1 tablet every 1-2 hours as needed, but not more than 8 tablets per day, unless otherwise indicated.

Children aged 4-12

Х Up to 4 tablets per day.

Consult a physician for use in children. Do not use in children under 4 years of age.

Due to the local anesthetic effect of benzocaine, food and drinks should be avoided immediately after the tablet has been absorbed.

Active ingredients: chlorhexidine dihydrochloride 5 mg, benzocaine 1.5 mg;

excipients: isomalt - 2243.681 mg, peppermint oil - 0.9 mg, menthol - 0.645 mg, thymol - 0.045 mg, aspartame - 2.29 mg, purified water - 45.789 mg.

Х Hypersensitivity to any of the components of the drug; Х wound and ulcerative lesions of the mouth or throat; Х low concentration of cholinesterase in the blood plasma; Х phenylketonuria; Х children under 4 years of age.

Pharmacodynamics

The double effect 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 local anesthetic benzocaine works to reduce pain symptoms.

Chlorhexidine

Chlorhexidine has a broad antibacterial spectrum of action against gram-positive and gram-negative bacteria; acts by destroying the cytoplasmic membrane of a bacterial cell. It is ineffective against yeasts, dermatophytes, mycobacteria, some species of Pseudomonas and Proteus. Chlorhexidine is most effective in a neutral or slightly alkaline environment. In an acidic environment, its activity decreases. The effectiveness is reduced in the presence of soaps, blood and purulent discharge. The use of chlorhexidine lozenges leads to a significant decrease in the bacterial content of saliva. The use of chlorhexidine for several months is accompanied by a decrease in its effectiveness by reducing the sensitivity of bacteria.

Benzocaine

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

Pharmacokinetics

Chlorhexidine

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

Benzocaine

Benzocaine is slightly soluble in water, which leads to its slow absorption. Like all ester 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 is conjugated with glycine or is excreted unchanged by the kidneys.

Carefully

In case of erosive, desquamative changes in the oral mucosa, the drug 'GeksoralЃ Tabs' can be used with caution and only under the supervision of a physician.

Pregnancy and lactation

There is no sufficient experience with the use of the drug in pregnant and lactating women. The use of the drug 'HexoralЃ 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 effect

Disorders from the gastrointestinal tract. Frequency unknown: oral hypesthesia (transient), decreased sensitivity of the oral mucosa, temporary numbness of the tongue, temporary discoloration of the teeth, discoloration of the tongue (reversible), discoloration of silicate and composite materials of dental restoration, the formation of dental plaque (tartar), stomatitis, detachment of the oral mucosa, glossodynia, enlargement of the parotid salivary glands.

Immune system disorders. Frequency unknown: hypersensitivity reactions (including severe allergic reactions, urticaria, angioedema, anaphylactic reactions, anaphylactic shock).

Nervous system disorders. Frequency unknown: taste disturbance (dysgeusia).

Disorders of the blood and lymphatic system. Frequency unknown: methemoglobinemia.

Overdose

If used correctly, 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. In case of overdose, you should immediately seek medical attention.

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, damage to the mucous membrane was noted during direct contact with chlorhexidine gluconate, as well as a systematic reversible increase in the concentration of the hepatic enzyme. 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 at first by tremors, vomiting, convulsions, and later - by depression of the central nervous system. Coma is possible due to respiratory depression. High toxic concentrations cause bradycardia, AV block and cardiac arrest. Benzocaine can cause methemoglobinemia (especially in children), accompanied by suffocation and cyanosis. Treatment: induce vomiting and gastric lavage. Perhaps the appointment of activated carbon. In case of hypoxia and anoxia, artificial respiration with oxygen support is recommended, in case of cardiac arrest - cardiac massage. For seizures, diazepam or fast-acting barbiturates are prescribed (contraindicated for anoxic seizures);in especially severe cases, after intubation and artificial respiration, suxamethonium chloride is used. Blood circulation should be supported by the administration of blood plasma or electrolyte solutions. With methemoglobinemia, up to 50 ml of 1% methylene blue solution can be used intravenously.

Interaction with other medications

Benzocaine, due to the formation of its metabolite 4-aminobenzoic acid, reduces the antibacterial activity of sulfonamides and aminosalicylates. Sucrose, polysorbate 80, insoluble magnesium, zinc and calcium salts reduce the effect of chlorhexidine.

special instructions

Benzocaine can cause methemoglobinemia. This condition is manifested by such symptoms as discoloration of the skin, lips and nail beds to a gray or blue color or their paleness; headache, light-headedness, shortness of breath, dizziness, fatigue and tachycardia. The appearance of these symptoms indicates the presence of moderate to high amounts of methemoglobin and a significant decrease in the oxygen transport function of the blood and requires discontinuation of the drug, as well as seeking medical help. Children and elderly patients may be at a higher risk of developing methemoglobinemia. The use of the drug is contraindicated in the presence of wound and ulcerative lesions of the mouth or throat. The drug contains aspartame, which is a phenylalanine derivative,which poses a danger to patients with phenylketonuria. Caution should be exercised when using the drug in young children and in persons with aspiration or swallowing disorders due to the risk of suffocation. Information for patients with diabetes mellitus: the carbohydrate content of one tablet corresponds to 0.1 bread units (BU). If a medicinal product has become unusable or has expired, do not throw it into wastewater or outdoors. Place the medicine in a bag and put it in the trash can. These measures will help protect the environment1 grain unit (BU). If a medicinal product has become unusable or has expired, do not throw it into wastewater or outdoors. Place the medicine in a bag and put it in the trash can. These measures will help protect the environment1 grain unit (BU). If a medicinal product has become unusable or has expired, do not throw it into wastewater or outdoors. Place the medicine in a bag and put it in the trash can. These measures will help protect the environment