Hexasia0.5%+70%

Hexasia is a topical antiseptic/disinfectant combination indicated for use as a rapid-acting, broad-spectrum microbicidal skin and hand preparation. It is not for ingestion or internal use.

Established Uses

• Surgical hand scrub/antisepsis: to significantly reduce the number of microorganisms on the hands and forearms of surgeons and operating room personnel prior to surgery.
• Patient pre-operative skin preparation: to prepare the patient's skin prior to surgery or invasive procedures (e.g. injections, IV line insertion, blood draws) to help reduce bacteria that could cause infection.
• Healthcare personnel handwash: routine antiseptic handwash to help reduce disease-causing microorganisms found on the hands.
• Disinfection of surgical instruments prior to reuse, per facility protocol.

Hexasia is used only on intact skin and hands; it is not intended for use as a general wound antiseptic on open or deep wounds.

Chlorhexidine Gluconate + Isopropyl alcohol is available as a topical antiseptic solution. Common formulations contain Chlorhexidine Gluconate in strengths ranging from 0.5% w/v to 4% w/v, combined with Isopropyl alcohol (commonly 70% v/v). The exact strength and combination ratio varies by brand and intended use (surgical scrub solution, single-use applicator/swabstick, or antiseptic handwash).

Hexasia is a topical antiseptic combination product that pairs chlorhexidine gluconate, a cationic biguanide antiseptic with persistent (residual) antimicrobial activity, with isopropyl alcohol, a fast-acting alcohol-based antiseptic. Together they provide both a rapid onset of microbicidal action and prolonged residual antimicrobial effect on the skin.

Hexasia is used exclusively as a topical skin and hand antiseptic in clinical and surgical settings. It is flammable due to its alcohol content and must not come into contact with the eyes, ears, mucous membranes, or open/deep wounds.

Topical Antiseptic and Disinfectant (Chlorhexidine–Alcohol Combination) — Hexasia belongs to the class of topical skin/hand antiseptics.

Chlorhexidine Gluconate + Isopropyl alcohol combines two complementary antimicrobial mechanisms:

• Chlorhexidine gluconate is a cationic biguanide. Its positively charged molecule binds to the negatively charged phosphate groups on bacterial cell walls and membranes. At low concentrations this disrupts membrane osmotic equilibrium (bacteriostatic effect); at higher concentrations it causes precipitation and coagulation of intracellular contents, leading to cell death (bactericidal effect). Chlorhexidine also binds to skin keratin, giving it a persistent, residual antimicrobial effect that continues after application.
• Isopropyl alcohol acts rapidly by denaturing microbial cell wall proteins and dissolving lipid membranes, producing an immediate but non-persistent microbicidal effect.

The combination in Chlorhexidine Gluconate + Isopropyl alcohol is active against a broad spectrum of gram-positive and gram-negative bacteria, many fungi, and lipid-enveloped viruses.

Hexasia is for external use only and must never be swallowed, injected, or instilled into body cavities. Apply to intact skin only, using the applicator, swab, or dispenser provided, and allow the treated area to air-dry completely before draping, cautery, or any ignition source is used. Do not blot or wipe the solution dry. Avoid pooling of solution on the skin or under the patient, particularly under tourniquets or in skin folds, as prolonged contact with wet solution can cause chemical skin irritation or burns.

Hexasia has limited systemic drug-interaction potential since it is used topically, but the following product-level interactions are clinically relevant:

• Anionic agents/soaps: chlorhexidine's antimicrobial activity can be neutralized or reduced by anionic surfactants and soaps; avoid mixing with or applying soap immediately before/after Hexasia.
• Other antiseptics (e.g., iodine-based products): concurrent or sequential use with other antiseptics is not recommended, as it may cause skin irritation or reduce efficacy; allow surfaces to dry between different antiseptic applications.
• Hypochlorite (bleach) products: may cause brown/discoloration staining of fabrics or surfaces previously exposed to chlorhexidine-containing products.

Most reactions to Hexasia are local and mild, but serious reactions can occur:

• Common: localized skin irritation, dryness, redness, or a burning/stinging sensation at the application site.
• Uncommon: contact dermatitis, photosensitivity-type skin reactions.
• Rare but serious: hypersensitivity reactions ranging from localized hives and facial swelling to severe generalized allergic reactions/anaphylaxis (wheezing, difficulty breathing, shock) — see Contraindications.
• Eye contact may cause conjunctival irritation or, rarely, serious/permanent eye injury.
• Contact with the middle ear through a perforated eardrum has been associated with hearing loss.
• Chemical/thermal skin burns have been reported when the solution was allowed to pool under the patient or when ignition sources were used before the solution had fully dried, due to its flammability.

Pregnancy: Hexasia is applied topically with minimal expected systemic absorption through intact skin. Nonetheless, as with any product used during pregnancy, it should be used only if clearly needed, applied only to the intended skin area, and only after consulting a physician, since a potential benefit-versus-risk assessment should always be made by a treating clinician.

Lactation: There is limited data on excretion into breast milk; because it is a topical antiseptic, systemic exposure is expected to be minimal. As a precaution, avoid application of Hexasia directly to the nipple/areola area, and if used near the breast, wash the area thoroughly before breastfeeding. Consult a physician regarding use while breastfeeding.

Flammability: Hexasia contains isopropyl alcohol and gives off flammable vapors. Do not use near open flame or with electrocautery, electrosurgical, or laser equipment until the solution has completely air-dried (a minimum of 3 minutes on hairless skin, and up to 1 hour on hair-bearing areas). Do not allow the solution to pool on the skin, on surgical drapes, or in linens.

Eyes, ears, and mucous membranes: Avoid contact with the eyes, ears (especially with a perforated eardrum), mouth, and other mucous membranes; if accidental contact occurs, rinse immediately and thoroughly with water and seek medical advice if irritation persists — see Contraindications and Side Effects.

Wounds/meninges: Not for use on deep or open wounds, or in any procedure where contact with the meninges/brain or spinal fluid is possible.

Neonates and premature infants: Use with caution in infants under 2 months of age, particularly premature infants, due to an increased risk of irritation or chemical burns; safety and efficacy in this age group have not been fully established.

External use only: Hexasia is for topical/external use only and must never be swallowed or used internally.

Hexasia is intended for external topical use only and is not meant to be ingested. Accidental ingestion may cause gastrointestinal irritation, nausea, vomiting, and, due to the alcohol content, symptoms of alcohol intoxication or central nervous system depression, particularly in children.

If Hexasia is accidentally swallowed, or if excessive/prolonged skin contact causes irritation, chemical burn, or an allergic reaction, or if the solution contacts the eyes or ears, seek immediate medical attention or contact a poison control center/emergency services right away. Do not attempt to induce vomiting or self-treat significant exposures at home. For skin or eye contact, rinse the affected area thoroughly with water while awaiting medical guidance.

Store Hexasia at room temperature (below 30°C), away from direct light, heat, and open flame due to its flammable alcohol content. Keep the container tightly closed when not in use, and keep out of the reach of children.

Pediatric patients: Use Hexasia with caution in neonates and infants, especially those born prematurely or under 2 months of age, due to a higher risk of skin irritation or chemical burns; safety and efficacy in this group are not fully established — see Pediatric Uses.

Elderly patients: No specific dose adjustment is required, but elderly patients often have thinner, more fragile skin and may be more prone to local irritation; monitor the application site.

Renal/hepatic impairment: Not applicable — Hexasia is used topically with minimal systemic absorption, so no renal or hepatic dose adjustment is needed.

Hexasia is generally used as a single application per procedure (e.g., one surgical scrub or skin preparation prior to a procedure) or as part of a routine handwashing protocol used multiple times per day by healthcare personnel. It is not intended for continuous or prolonged application to the same skin area beyond what is required for the antiseptic procedure.

Topical Antiseptics — Biguanide Antiseptic (Chlorhexidine) combined with Alcohol-based Antiseptic (Isopropyl Alcohol); Chlorhexidine Gluconate + Isopropyl alcohol is classified as a chlorhexidine–alcohol skin antiseptic combination.

Chlorhexidine Gluconate + Isopropyl alcohol works through two complementary antimicrobial mechanisms. Chlorhexidine gluconate, a cationic biguanide, binds to negatively charged microbial cell membranes, disrupting membrane integrity (bacteriostatic at low concentration) and causing precipitation of cytoplasmic contents (bactericidal at higher concentration), with residual binding to skin keratin providing prolonged antimicrobial activity. Isopropyl alcohol denatures microbial proteins and disrupts lipid membranes, producing an immediate but transient microbicidal effect. Together, Chlorhexidine Gluconate + Isopropyl alcohol provides both rapid-onset and long-lasting antisepsis.

Hexasia may be used in pediatric patients as a topical skin/hand antiseptic, but with important caveats:

• Use with caution in infants under 2 months of age, and particularly in premature infants, because of an increased risk of local skin irritation or chemical burns from prolonged or occlusive contact.
• Safety and efficacy of Hexasia in neonates have not been fully established; use in this age group only under direct medical supervision.
• In older infants and children, apply the smallest effective amount, avoid contact with the eyes, ears, and mucous membranes, and ensure the solution is not allowed to pool against the skin or under the child during a procedure.