Instillagel (Chlorhexidine Gluconate, Lidocaine Hydrochloride)

Instillagel, a combined antiseptic and local anaesthetic, is used in urological procedures to manage infection risk and discomfort.

• Urethral antisepsis: Reduces bacterial colonisation of the urethra during catheter insertion or manipulation.
• Prevention of urinary tract infection during catheterisation: Lowers incidence of catheter‑associated urinary tract infections in patients requiring short‑term or long‑term catheter use.
• Urethral analgesia: Provides temporary numbness to ease discomfort during catheterisation, cystoscopy or other urethral interventions.

• Chlorhexidine Gluconate exerts its antiseptic effect by binding to bacterial cell membranes, disrupting membrane integrity and precipitating intracellular contents, leading to cell death. Lidocaine Hydrochloride blocks voltage‑gated sodium channels on peripheral nerve fibers, inhibiting depolarisation and producing reversible local anaesthesia of the urethral mucosa. The combined action provides simultaneous antimicrobial protection and pain relief during urological procedures.

Instillagel may cause local or systemic reactions, although most users experience minimal irritation.

Common Side Effects

• Burning sensation: Transient mild burning or stinging at the application site.
• Redness: Local erythema of the urethral mucosa.
• Discomfort: Brief discomfort or urge to void following instillation.
• Mild headache: Occasional headache not directly related to the urethra.

Serious or Rare Side Effects

• Allergic reaction: Urticaria, angioedema, or anaphylaxis requiring immediate medical attention.
• Severe urethral irritation: Persistent pain, swelling, or ulceration of the urethral tissue.
• Systemic toxicity: Signs of lidocaine toxicity such as dizziness, tinnitus, or cardiac arrhythmia.
• Infection: Secondary infection if sterility is compromised.

When using Instillagel, consider the following precautions to ensure safety and efficacy.

• Patient assessment: Verify absence of known hypersensitivity to chlorhexidine, lidocaine or related compounds before administration.
• Contraindications: Avoid use in patients with a history of severe allergic reactions to antiseptics or local anaesthetics.
• Pregnancy and lactation: Use only if the potential benefit outweighs the potential risk; data are limited.
• Interaction with other urethral products: Do not combine with other antiseptic solutions or medicated gels without professional guidance.
• Monitoring: Observe the patient for signs of local irritation or systemic reactions during and after instillation.
• Store at ambient temperature: Keep the gel below 25 °C in the original container, protected from moisture and direct sunlight.

Instillagel can interact with certain medications or substances; awareness of these interactions helps prevent adverse outcomes.

Major Interactions (Avoid)

• Systemic lidocaine: Concurrent high‑dose systemic lidocaine may increase risk of toxicity.
• Other chlorhexidine products: Simultaneous use can lead to excessive antiseptic exposure and mucosal irritation.

Moderate Interactions (Monitor Closely)

• Anticoagulants: Chlorhexidine may potentiate bleeding risk if mucosal integrity is compromised.
• Beta‑blockers: Lidocaine can enhance the effects of beta‑blockers on cardiac conduction.
• Local irritants: Use with other irritating urethral agents may exacerbate discomfort.