Usage
Benzoxonium chloride is prescribed for the short-term treatment of minor mouth and throat infections. It is classified as an antiseptic and disinfectant. Its mechanism of action involves disrupting the cell walls of microorganisms, leading to their destruction. It is effective against a broad spectrum of bacteria, some viruses, and fungi.
Alternate Names
While “benzoxonium chloride” is the commonly used name, it is sometimes referred to as “benzalkonium chloride.” There are also various brand names depending on the specific product and manufacturer. One example includes Iglü Sugar Free Pastilles, however, it’s important to note that different brands may include combinations with other active ingredients like lidocaine.
How It Works
Pharmacodynamics: Benzoxonium chloride exerts its antiseptic effect by interacting with the cell membranes of microorganisms. This interaction disrupts the membrane integrity, causing leakage of cellular contents and ultimately leading to cell death.
Pharmacokinetics: When applied topically in the mouth or throat, benzoxonium chloride is poorly absorbed into the systemic circulation. The majority of the drug remains at the site of application, where it exerts its antimicrobial effect. Elimination is primarily through excretion in feces.
Mode of Action: Benzoxonium chloride acts as a cationic surfactant, which means it has a positive charge. This positive charge allows it to interact with the negatively charged phospholipids in the microbial cell membranes, disrupting the membrane structure and causing its lysis.
Receptor Binding/Enzyme Inhibition: There is no known specific receptor binding or enzyme inhibition involved in benzoxonium chloride’s mechanism of action.
Dosage
Standard Dosage
Adults:
The standard dosage for adults is typically to dissolve one lozenge slowly in the mouth every two to three hours as needed. The maximum daily dose should not exceed eight lozenges. Depending on the formulation and brand, dosage information might be available in the package insert. Topical solutions of benzoxonium chloride at concentrations of 0.1% - 0.13% are applied to the affected area 1-3 times daily.
Children:
For children over 3 years of age, the dosage is generally the same as for adults. Use in children under 3 years of age is generally not recommended unless specifically directed by a healthcare professional. For specific pediatric formulations like sprays or gels, the dosage should be followed as per the product instructions.
Special Cases:
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Elderly Patients: Dosage adjustment is usually not necessary.
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Patients with Renal Impairment: No specific dosage adjustments are typically required.
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Patients with Hepatic Dysfunction: No specific dosage adjustments are typically required.
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Patients with Comorbid Conditions: No specific adjustments mentioned, but caution is advisable. Consultation with a healthcare provider is recommended.
Clinical Use Cases
Benzoxonium chloride is primarily intended for short-term use in minor oral and throat infections. It is not typically used in the clinical settings listed (Intubation, Surgical Procedures, Mechanical Ventilation, ICU Use, Emergency Situations).
Dosage Adjustments
No specific dose modifications mentioned for renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms.
Side Effects
Common Side Effects
- Local irritation
- Burning sensation in the mouth or throat
- Teeth staining (temporary)
Rare but Serious Side Effects
Allergic reactions, though rare, may occur and require medical attention.
Long-Term Effects
Prolonged use of benzoxonium chloride is not recommended and might increase the risk of side effects or alteration of the oral microbiota.
Adverse Drug Reactions (ADR)
Hypersensitivity reactions can occur, though rarely.
Contraindications
- Hypersensitivity to benzoxonium chloride.
Drug Interactions
Significant drug interactions are unlikely due to minimal systemic absorption. Anionic surfactants, such as soaps, may inactivate benzoxonium chloride, however, other drug interactions, including specific CYP450 interactions, are not typically clinically significant.
Pregnancy and Breastfeeding
The safety of benzoxonium chloride during pregnancy and breastfeeding has not been fully established. It is generally recommended to consult a healthcare professional before using it during these periods.
Drug Profile Summary
- Mechanism of Action: Disrupts microbial cell membranes.
- Side Effects: Local irritation, burning sensation, temporary teeth staining.
- Contraindications: Hypersensitivity.
- Drug Interactions: Inactivation by soaps and other anionic surfactants.
- Pregnancy & Breastfeeding: Consult a healthcare professional.
- Dosage: As per product instructions (e.g. lozenges every 2-3 hours as needed).
- Monitoring Parameters: Resolution of symptoms
Popular Combinations
Benzoxonium chloride is sometimes combined with lidocaine for added pain relief in oral formulations.
Precautions
- Use with caution in patients with sensitive oral mucosa.
- Avoid contact with eyes.
- Short-term use only for minor infections.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Benzoxonium Chloride?
A: The dosage depends on the formulation. For lozenges, one lozenge dissolved slowly in the mouth every 2-3 hours is common. For topical solutions, applying to the affected area 1-3 times daily is typical. Always refer to product-specific instructions.
Q2: How does Benzoxonium Chloride work?
A: It disrupts the cell walls of microorganisms, leading to their destruction.
Q3: What are the common side effects?
A: Common side effects include local irritation, burning sensation, and temporary teeth staining.
Q4: Can I use Benzoxonium Chloride during pregnancy?
A: Consult with a healthcare professional before using during pregnancy or breastfeeding.
Q5: Is Benzoxonium Chloride safe for children?
A: It is generally safe for children over 3 years of age. For children under 3, consult a healthcare professional.
Q6: How long can I use Benzoxonium Chloride?
A: It’s intended for short-term use. Prolonged use is not recommended. Consult your doctor or pharmacist for advice if your symptoms do not improve or worsen after 7 days.
Q7: Can Benzoxonium Chloride be used for all types of mouth infections?
A: No, it’s indicated for minor mouth and throat infections. For severe infections, consult a healthcare professional.
Q8: Are there any drug interactions I should be aware of?
A: It’s important to avoid using benzoxonium chloride with anionic surfactants like soap, as this can inactivate the medication. Other drug interactions are generally not clinically significant due to minimal systemic absorption.
Q9: What should I do if my symptoms don’t improve?
A: If your symptoms persist or worsen after a few days of using benzoxonium chloride, consult your doctor. A different treatment approach may be necessary.
