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Hexachlorophene (United States: Not available): Drug information

Hexachlorophene (United States: Not available): Drug information
(For additional information see "Hexachlorophene (United States: Not available): Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Pharmacologic Category
  • Antibiotic, Topical
Dosing: Adult

All products have been discontinued for more than 1 year.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

<1%, postmarketing, and/or case reports: Dermatitis, erythema, irritability, neurologic injury, seizure, skin photosensitivity, xeroderma

Contraindications

Hypersensitivity to halogenated phenol derivatives or hexachlorophene; use on burned or denuded skin; use as an occlusive dressing, wetpack, or lotion; application to mucous membranes; use as a vaginal pack or tampon; routine use for prophylactic total body bathing

Warnings/Precautions

Concerns related to adverse effects:

• Cerebral irritability: Discontinue use if signs of cerebral irritability occur.

Special populations:

• Burn patients: Exposure to patients with extensive burns has been associated with apnea, convulsions, agitation and coma.

• Pediatric: Exposure to preterm infants has been associated with apnea, convulsions, agitation and coma; particularly susceptible to hexachlorophene topical absorption. Do not use for bathing infants.

Other warnings/precautions:

• Appropriate use: For external use only; avoid exposure to eyes.

Warnings: Additional Pediatric Considerations

Premature and low birth weight neonates are particularly susceptible to hexachlorophene topical absorption; irritability, generalized clonic muscular contractions, decerebrate rigidity, and brain lesions in the white matter have occurred in infants following topical use of 6% hexachlorophene; exposure of preterm infants or patients with extensive burns has been associated with apnea, convulsions, agitation, and coma.

Product Availability

All products have been discontinued for more than 1 year.

Generic Equivalent Available: US

Yes

Pricing: US

Liquid (Phisohex External)

3% (473 mL): $61.26

Disclaimer: The pricing data provided represent a median AWP and/or AAWP price for the brand and/or generic product, respectively. The pricing data should be used for benchmarking purposes only, and as such should not be used to set or adjudicate any prices for charging or reimbursement functions. Pricing data is updated monthly.

Hazardous Drugs Handling Considerations

Hazardous agent; use appropriate precautions for handling and disposal (EPA, U-listed).

Use: Labeled Indications

Surgical scrub and as a bacteriostatic skin cleanser; control an outbreak of gram-positive infection when other procedures have been unsuccessful

Medication Safety Issues
Sound-alike/look-alike issues:

pHisoHex may be confused with Fostex, pHisoDerm

Pediatric patients: High-risk medication:

KIDs List: Hexachlorophene, when used in neonates, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of neurotoxicity (strong recommendation; high quality of evidence) (PPA [Meyers 2020]).

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Pregnancy Considerations

Adverse events have been observed in animal reproduction studies. Hexachlorophene is absorbed systemically when applied topically. Following use as an antiseptic for vaginal exams during labor, hexachlorophene is detectable in the maternal serum and cord blood (Strickland, 1983). Vaginal use as a pack or tampon and application to mucous membranes is contraindicated.

Breastfeeding Considerations

It is not known if hexachlorophene is excreted in breast milk. Due to the potential for serious adverse reactions in the nursing infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother.

Mechanism of Action

Bacteriostatic polychlorinated biphenyl which inhibits membrane-bound enzymes and disrupts the cell membrane

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Percutaneously through inflamed, excoriated, and intact skin

Half-life elimination: Infants: 6.1-44.2 hours

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Sodorant;
  • (ID) Indonesia: Dermisan;
  • (NL) Netherlands: Unicura;
  • (TW) Taiwan: PHisoHex
  1. Halling H, “Suspected Link Between Exposure to Hexachlorophene and Malformed Infants,” Ann N Y Acad Sci, 1979, 320:426-35. [PubMed 287398]
  2. Healthcare Environmental Resource Center (HERC). Pharmaceuticals—Hazardous Waste. http://www.hercenter.org/hazmat/pharma.cfm#listed. Published 2015. Accessed October 23, 2016.
  3. Lester RS, “Topical Formulary for the Pediatrician,” Pediatr Clin North Am, 1983, 30(4):749-65. [PubMed 6225068]
  4. Lockhart JD, “How Toxic is Hexachlorophene?” Pediatrics, 1972, 50(2):229-35. [PubMed 4625618]
  5. Marquardt ED, “Hexachlorophene Toxicity in a Pediatric Burn Patient,” Drug Intell Clin Pharm, 1986, 20(7-8):624.
  6. Meyers RS, Thackray J, Matson KL, et al. Key Potentially Inappropriate Drugs in Pediatrics: The KIDs List. J Pediatr Pharmacol Ther. 2020;25(3):175-191. [PubMed 32265601]
  7. Nagy L and Orosz M, “Occupational Asthma Due to Hexachlorophene,” Thorax, 1984, 39(8):630-1. [PubMed 6474393]
  8. Strickland DM, Leonard RG, Stavchansky S, et al, "Vaginal Absorption of Hexachlorophene During Labor," Am J Obstet Gynecol, 1983, 147(7):769-72. [PubMed 6650599]
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