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Sodium hypochlorite solution: Drug information

Sodium hypochlorite solution: Drug information
(For additional information see "Sodium hypochlorite solution: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Anasept;
  • Anasept Antimicrobial [OTC];
  • Anasept [OTC];
  • Avenova;
  • Di-Dak-Sol [OTC];
  • Epicyn;
  • H-Chlor 12 [OTC];
  • H-Chlor 6 [OTC];
  • H-Chlor Wound;
  • Hyclodex;
  • HySept [OTC]
Pharmacologic Category
  • Disinfectant, Antibacterial, Topical
Dosing: Adult

Antiseptic: Topical:

Gel:

Indwelling catheter care: Apply sufficient amount to completely cover skin area around the indwelling catheter.

Ostomy care: Apply a thin layer.

Skin care: Apply a thin layer; repeat as needed.

Wound care: Apply thick layer (1/4 to 1/2 inch) to entire wound bed; apply a thin layer to periwound skin area.

Liquid:

Skin cleansing: Apply to site.

Wound cleansing: Apply once daily. May be repeated up to a total of twice daily.

Solution 0.062%: Apply to wound and cover with dressing; repeat if necessary.

Solution 0.0125%, 0.125%, 0.25%, 0.5%:

Lightly to moderately exudative wounds: Apply once daily.

Highly exudative or contaminated wounds: Apply twice daily.

Solution, facial cleanser (Epicyn): Apply twice daily or as directed.

Spray solution 0.01% (Avenova): Apply to eyelids twice daily or as directed.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Gel, External:

Anasept Antimicrobial: 0.057% (86 g) [latex free]

H-Chlor Wound: 0.062% (85 g)

Liquid, External:

Anasept: 0.057% (237 mL)

Anasept: 0.057% (443 mL) [latex free]

Solution, External:

Avenova: 0.01% [as hypochlorous acid] (40 mL)

Di-Dak-Sol: 0.0125% (473 mL)

Epicyn: 237 mL

H-Chlor 6: 0.062% (473 mL)

H-Chlor 12: 0.125% (473 mL)

Hyclodex: 0.012% (59 mL, 237 mL)

HySept: 0.5% (473 mL); 0.25% (473 mL)

Generic: 0.125% (473 mL); 0.25% (473 mL); 0.5% (473 mL)

Generic Equivalent Available: US

May be product dependent

Administration: Adult

Topical: For external use only; do not ingest or use in eyes.

Gel: Varies with type of wound management needed. Refer to manufacturer's product information for detailed administration directions.

Liquid:

Skin cleansing: Spray or saturate sterile gauze and apply to area. Air dry for 2 minutes or maintain as a wet dressing.

Wound cleansing: After debridement, spray onto entire wound bed, including margins (avoid pooling) or saturate sterile gauze and apply to wound site. Cover site with sterile gauze or other wound dressing. Ensure that wound bed remains moist between dressing changes.

Solution: May be poured on or applied to affected area. Protect intact skin with a moisture barrier ointment or skin sealant as needed.

Solution, facial cleanser (Epicyn): Apply using saturated cosmetic pad; avoid contact with eyes.

Spray solution 0.01% (Avenova): Prior to use, wash hands and remove any makeup or lotion around eyes. Remove original cap then insert spray pump into bottle and secure. Following application, place protective cap on the spray pump.

Option 1: With eyes closed apply 1 or 2 sprays directly to the top of each eyelid; remove excess solution with clean cotton pad to prevent solution from getting into eyes.

Option 2: Spray solution onto a clean, pure cotton pad until moistened; close one eye and gently wipe base of all the upper eyelid lashes with a horizontal motion at least 3 times; with eye open, look up and gently wipe the base of the lower eyelid lashes in a similar fashion at least 3 times. Using a new cotton pad, repeat procedure on the other eye. No rinsing is required.

Use: Labeled Indications

Antiseptic: Treatment and prevention of skin and tissue infections; treatment of cuts, abrasions, and skin ulcers; use pre- and postsurgery

Anasept, H-Chlor 6:

OTC use: Cleansing and removal of dirt, debris, and foreign material from skin abrasions, lacerations, minor irritations, cuts, exit sites, and intact skin (Anasept cleanser, H-Chlor 6), or management of conditions (Anasept gel)

Professional use: Cleansing of foreign materials (including microorganisms) from wounds (Anasept cleanser, H-Chlor 6) or management of wounds (Anasept gel, H-Chlor 6) such as stage I to IV pressure ulcers, diabetic foot and leg ulcers, postsurgical wounds, first- and second-degree burns, and grafted and donor sites

Avenova: Professional use: Cleansing and removal of foreign material and debris from eyelids

Epicyn (facial cleanser): Cleansing, irrigation, moistening, debridement, and removal of foreign material and debris from acute and chronic dermal lesions.

Medication Safety Issues
Administration issues:

A potential for confusion associated with labeling of strengths for Dakin’s solution manufactured by Century Pharmaceuticals exists. The labels list strengths as full strength at 0.5%, half strength at 0.25%, and quarter strength at 0.125%. This terminology is confusing to healthcare providers who consider half strength and quarter strength to correspond to 0.5% and 0.25%, respectively. Of note, most hospitals use a modified Dakin’s solution of 0.025% for wound care; studies have suggested that concentrations of Dakin’s solution >0.025% may potentially be harmful for wound healing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.

Dermatologic: Irritating to skin

Hematologic: Dissolves blood clots, delays clotting

Contraindications

Hypersensitivity to sodium hypochlorite, chlorine compounds, or any component of the formulation.

Warnings/Precautions

Other warnings/precautions:

• Appropriate use: For external use only; avoid eye or mucous membrane contact.

• Self-medication (OTC use): When used for self-medication, patients should be instructed to discontinue use and consult a health care provider if redness, irritation, swelling, or pain persists or increases; may bleach clothing.

Metabolism/Transport Effects

None known.

Drug Interactions

Taurolidine: May enhance the adverse/toxic effect of Sodium Hypochlorite. Specifically, concomitant use of taurolidine and sodium hypochlorite may increase the risk of metabolic acidosis. Risk X: Avoid combination

Pricing: US

Gel (Anasept Antimicrobial External)

0.057% (per gram): $0.63

Gel (H-Chlor Wound External)

0.062% (per gram): $0.29

Liquid (Anasept External)

0.057% (per mL): $0.07

Solution (Di-Dak-Sol External)

0.0125% (per mL): $0.02

Solution (H-Chlor 12 External)

0.125% (per mL): $0.03

Solution (H-Chlor 6 External)

0.062% (per mL): $0.03

Solution (Hyclodex External)

0.012% (per mL): $7.12

Solution (HySept External)

0.25% (per mL): $0.03

0.5% (per mL): $0.03

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Dakin (BE);
  • Eusol-Max (MY);
  • Milton (AU, GB, IT, ZA)


For country abbreviations used in Lexicomp (show table)

REFERENCES

  1. Anasept (sodium hypochlorite) gel [prescribing information]. San Dimas, CA: Anacapa Technologies; 2013.
  2. Anasept (sodium hypochlorite) liquid [prescribing information]. San Dimas, CA: Anacapa Technologies; June 2013.
  3. Avenova (hypochlorous acid) 0.01% spray solution [prescribing information]. Emeryville, CA: NovaBay Pharma; received November 2017.
  4. Dakin's (sodium hypochlorite) 0.5% solution [prescribing information]. Indianapolis, IN: Century Pharmaceuticals; January 2011.
  5. Dakin's (sodium hypochlorite) 0.25% solution [prescribing information]. Indianapolis, IN: Century Pharmaceuticals; January 2011.
  6. Dakin's (sodium hypochlorite) 0.125% solution [prescribing information]. Indianapolis, IN: Century Pharmaceuticals; January 2011.
  7. Dakin's (sodium hypochlorite) 0.0125% solution [prescribing information]. Indianapolis, IN: Century Pharmaceuticals; January 2011.
  8. Epicyn (sodium hypochlorite) solution [prescribing information]. Petaluma, CA: Sonoma; received October 2018.
  9. H-Chlor 6 (sodium hypochlorite) 0.062% solution [prescribing information]. Skokie, IL: Patrin Pharma; June 2016.
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