Hexigel

Choline Salicylate (8.7% w/w) + Cetalkonium Chloride (0.01% w/w)
Price: ₹80 - ₹110 for 15 ml bottle
Mfr: Indoco Remedies Ltd | Form: Mouth Paint (Solution with dropper)

📋 Clinical Overview

A topical analgesic and anti-inflammatory solution primarily used for the relief of mild to moderate pain and inflammation associated with sore throat, pharyngitis, and tonsillitis. Choline Salicylate is a non-steroidal anti-inflammatory drug (NSAID) derivative of salicylic acid, providing local analgesic and anti-inflammatory effects. Cetalkonium Chloride is a quaternary ammonium compound (quat) antiseptic that provides local antibacterial and antifungal activity, helping to reduce microbial load in the oropharyngeal cavity. This combination is formulated as a mouth paint or gargle solution.

💊 Dosage & Administration

Adult: Apply 1 ml of the solution (approx. 20 drops) undiluted to the affected area of the throat using the provided applicator or as a gargle (diluted with equal part water) 3 to 4 times daily, or as directed by the physician. For gargle, use for 30 seconds then spit out. Do not swallow.

Note: Shake the bottle well before use. Use the calibrated dropper or applicator. Tilt head back, apply solution to the back of the throat. Avoid eating or drinking for at least 15-20 minutes after application. For gargle, dilute with an equal amount of water, gargle for 30 seconds, and spit out completely. Do not swallow the solution. Do not use for more than 5 consecutive days without medical advice.

⚠️ Contraindications

  • Known hypersensitivity (allergy) to salicylates (including aspirin) or any component of the formulation
  • History of asthma induced by salicylates or other NSAIDs
  • Children and adolescents under 16 years with viral infections (due to risk of Reye's syndrome, although topical risk is low)
  • Active peptic ulcer disease
  • Severe renal impairment
  • Severe hepatic impairment
  • Third trimester of pregnancy

🔬 Mechanism of Action

Choline Salicylate exerts its local analgesic and anti-inflammatory effects by inhibiting the enzyme cyclooxygenase (COX), both COX-1 and COX-2, at the site of application. This inhibition reduces the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever. Its choline component may enhance local penetration. Cetalkonium Chloride is a cationic surfactant that disrupts microbial cell membranes, leading to leakage of cellular contents and death of bacteria and fungi. It provides a broad-spectrum antiseptic action, reducing secondary infection risk in inflamed tissues.

🤕 Side Effects

  • Transient local burning or stinging sensation at application site
  • Altered taste perception (bitter/metallic taste)
  • Temporary numbness of tongue or mouth
  • Dryness of mouth

🤰 Special Populations

Pregnancy: Category D (Australian categorization for salicylates). Avoid in third trimester due to risk of premature closure of ductus arteriosus, prolonged labor, and increased maternal and neonatal bleeding risk. Use in first and second trimesters only if potential benefit justifies potential risk to fetus. Topical use minimizes risk, but systemic absorption is possible.

Driving: Generally safe. However, if systemic absorption occurs (e.g., from overdose), dizziness or tinnitus may impair ability to drive or operate machinery.

🔄 Drug Interactions

Anticoagulants (Warfarin, Acenocoumarol)Increased risk of bleeding due to additive antiplatelet effect of salicylate.Major
Other NSAIDs (Ibuprofen, Diclofenac)Increased risk of gastrointestinal side effects and reduced antiplatelet effect of aspirin (if used).Moderate
MethotrexateSalicylates can decrease renal clearance of methotrexate, increasing its toxicity.Major
Sulfonylureas (Glibenclamide, Glimepiride)Salicylates may potentiate hypoglycemic effect.Moderate
Valproic AcidSalicylates can displace valproic acid from protein binding sites, increasing its free concentration and toxicity.Moderate
Corticosteroids (e.g., Prednisolone)Increased risk of gastrointestinal ulceration.Moderate
ACE Inhibitors (e.g., Ramipril)Salicylates may reduce the antihypertensive effect.Moderate
DiureticsSalicylates may reduce the efficacy of diuretics in heart failure.Moderate
ProbenecidSalicylates antagonize the uricosuric effect of probenecid.Major

🔁 Alternatives to Hexigel

Same composition (Choline Salicylate (8.7% w/w) + Cetalkonium Chloride (0.01% w/w)), different brands:

Throatsil Sore Throat Paint Throat-All