Sprays for stomatitis

In the local treatment of inflammation of the oral mucosa various means are used, including antiseptic and anesthetic spray from stomatitis.

The main names for sprays from stomatitis: Hexoral (other trade names - Hexaspree, Hexetidine, Stomatidin), Strepsils Plus, Hepilor (Givalex), Oracept, Miramistin Spray, Proposol.

In dentistry, as well as in otolaryngology, indications for the use of a spray from stomatitis include all inflammatory processes in the oral cavity and oropharynx resulting from the damage of the mucous membranes by bacteria Streptococcus spp., Staphylococcus aureus, Aerobacter spp. And others, as well as Candida fungi and some protozoa.

[1], [2], [3], [4]

Pharmacodynamics

The therapeutic effect, which has a 0.2% spray from stomatitis Hexoral (Hexaspree, Hexetidine, Stomatidin), is provided by the action of a local antimicrobial substance - the antiseptic hexetidine, which is an antagonist of the thiamine pyrophosphate necessary for bacterial development.

By replacing thiamine pyrophosphate, hexetidine suppresses oxidative processes in microorganism cells, and also disrupts the synthesis of membrane amino acids of fungi and protozoa. This preparation also contains eucalyptus and anise oils and ethyl alcohol.

Active substances of the spray Strepsils Plus - dichlorobenzyl alcohol, acting bactericidal, dehydrating bacteria cells, and the phenol derivative amyl methacreazole, which stops the production of microorganisms by proteins, which leads to cytolysis.

As an analgesic component in the composition of this agent there is a local anesthetic of lidocaine hydrochloride, which suppresses the sensitivity of nerve endings.

Pharmacodynamics spray Hepilor is based on the already named antiseptic hexetidine, and also on two components - analgesic and anti-inflammatory choline salicylate and analgesic substance chlorobutanol.

Orasepth oral spray also contains an antiseptic - 1,4% phenol (hydroxybenzene), which, due to its similarity with the coenzyme of bacterial cells, is absorbed by tyrosine-phenol-lyase, which leads to the death of microorganisms.

To remove irritation, the oral mucosa is promoted by glycerol, which is also part of this spray.

Miramistin spray is a cationic antiseptic, loosening the membranes of microbial cells and thereby suppressing the work of their enzyme systems. As a result, the metabolism of microorganisms and fungi ceases and their death occurs. Miramistin also exhibits antiviral activity.

The mechanism of action of the spray Proposol is associated with the propolis, which is part of the preparation with bee glue, known for its bactericidal, fungicidal and anti-inflammatory properties.

Pharmacokinetics

In official instructions to such medicines as Geksoral, Miramistin Spray and Proposol, it is noted that they do not enter the bloodstream and therefore are not transformed and have no systemic effect.

Pharmacokinetics of spray Strepsils Plus is not represented. And manufacturers of Hepilor's remedy report that the active substances of the drug are released gradually, which contributes to a fairly long-term therapeutic effect.

In the corresponding section of the Orasept spray instruction, there is information that significant absorption of the active component of the drug (1.4% phenol) into the blood and, consequently, no systemic effect on the body was noted. However, it is known that phenol freely penetrates into the blood through the skin.

Methods of application of a spray from stomatitis and signs of an overdose

Spray from stomatitis Geksoral and Strepsils Plus are sprayed onto the affected mucous membranes of the mouth, one dose corresponds to spraying for two seconds. The maximum allowable amount of Gesoral sprays is two times a day, Strepsils is six times, and the duration of treatment is five days. Hepilor is used in similar doses.

Adults and children over 12 years of spray Oracept recommended to use 4-5 sprays at intervals of 3-4 hours, children 2-12 years - three. The duration of the course of treatment is determined by the doctor on the basis of the examination of the oral cavity.

Miramistin spray is used up to six times a day, and Propofol - no more than three times.

Overdosing with the use of Hexoral is manifested as nausea and vomiting, and in children who can swallow ethyl alcohol, a sign of ethanol poisoning is possible.

Strepsils Plus in increased dosage causes an increase in the side effects of the drug. In addition, because of the presence of lidocaine, Strepsils Plus can cause tremors and convulsions of the limbs, as well as paralysis of the respiratory muscles. Overdose of Oracetta leads to nausea and vomiting.

In the instructions for the drugs Hepilor, Miramistin Spray and Proposol, there is no information on their overdose.

Use of a spray from stomatitis during pregnancy

When pregnancy is possible, the use of sprays Geksoral, Strepsils Plus, Oracet, Miramistin Spray and Proposol - provided that they are appointed by the attending physician, who must correlate the expected benefit to the mother with the potential for harm to the unborn child.

Manufacturers of the spray Strepsils Plus did not notice that to pregnant women.

Lidocaine hydrochloride should not be prescribed.

The instructions indicate that the Hepilor stomatitis spray during pregnancy and lactation is allowed to use under the same conditions as the above drugs. And breastfeeding women should stop breastfeeding while using Hepilor. However, there is no information in the manual on the negative effects of chlorobutanol on the CNS on the composition of this drug.

Contraindications for use

The main contraindications to the use of the spray of Geksoral and its synonyms, as well as Miramistin spray are the presence of hypersensitivity to their components; Also, Geksoral is not used in the treatment of stomatitis in children under three years of age.

Contraindications to sprays Strepsils Plus, Hepilor and Propposol is an age younger than 12 years. In the instructions for the spray Strepsils Plus for some reason it is not indicated that lidocaine (which is present in the composition of this drug) is contraindicated in cases of severe heart failure and bradycardia, as well as myasthenia gravis dysfunction of the liver and kidneys.

Oracept is not prescribed for children under two years of age, nor is it used in cases of severe kidney and liver failure.

[5], [6], [7], [8]

Side effects

Possible side effects of a spray from stomatitis:

Hexoral - allergic reactions, taste disorders, staining of tooth enamel;

Strepsils Plus - impaired taste, loss of sensitivity of the lips and tongue, as well as headache, heartbeat and blood pressure lowering (all side effects are caused by lidocaine);

Hepilor - allergic reactions, impaired perception of taste and smell;

Orapept - hyperemia and edema of the oral mucosa; phenol, which is part of this drug, is a toxic substance and, entering the bloodstream, can act on the brain. It manifests itself in a short excitation of the respiratory center of the brain (coughing and sneezing starts), and then his paralysis can follow;

Miramistin spray - a short burning sensation in the mouth.

Proposol - allergic reactions, burning and dryness in the oral cavity.

Interactions with other drugs

Clinically relevant interactions with other drugs, Geksoral, Strepsils Plus and Oracept are not described.

Read also:

• Ointments for stomatitis
• Antibiotics for stomatitis
• Gels for stomatitis

Hepilor and Propasol should not be used concomitantly with other antiseptics. A Miramistin spray with parallel antibiotics can increase their effect on microorganisms.

Storage conditions and shelf life

The storage conditions of the sprays from stomatitis mentioned in the review assume compliance with the general rules for storage of medicinal products and the temperature does not exceed + 25-27 ° C.

Shelf life of the drugs Geksoral, Strepsils Plus, Hepilor, Miramistin Spray and Proposol is 3 years; Spray from stomatitis Orapept is suitable for use within 24 months.