Hexachlorophene

Hexachlorophene
Skeletal formula of hexachlorophene
Ball-and-stick model of the hexachlorophene molecule
Names
Trade namespHisoHex, Gamophen, Septisol, Turgex, Germa-Medica, others
IUPAC name
  • 2,2'-methylenebis(3,4,6-trichlorophenol)-3,4,6-trichloro-2-[(2,3,5-trichloro-6-hydroxyphenyl)methyl]phenol
Clinical data
Drug classAntiseptic[1]
Main usesClean hands[1]
External links
AHFS/Drugs.comMonograph
Legal
Legal status
  • US: ℞-only for human use
  • Rx-only for human use
Chemical and physical data
FormulaC13H6Cl6O2
Molar mass406.89 g·mol−1
3D model (JSmol)
Density1.71 g/cm3
Melting point163 to 165 °C (325 to 329 °F)
Boiling point471 °C (880 °F)
SMILES
  • C1=C(C(=C(C(=C1Cl)Cl)CC2=C(C(=CC(=C2Cl)Cl)Cl)O)O)Cl
InChI
  • InChI=1S/C13H6Cl6O2/c14-6-2-8(16)12(20)4(10(6)18)1-5-11(19)7(15)3-9(17)13(5)21/h2-3,20-21H,1H2
  • Key:ACGUYXCXAPNIKK-UHFFFAOYSA-N

Hexachlorophene, also known as pHisoHex, is an antiseptic which was used by health care workers to clean their hands before surgery.[1] Before the 1970s it was also used to wash newborns.[2] It is applied to the skin.[1]

Common side effects include dermatitis, sunburn, and dry skin.[1] Other side effects may include neurotoxicity with seizures and potentially death.[1] Small amounts stop bacterial from growing; however exactly how this occurs is unclear.[1]

Hexachlorophene came into medical use in 1948.[3] In the United States a bottle of 150 mL of 3% solution was about 36 USD.[4] It has subsequently been discontinued in the United States and most other countries.[1][5]

Uses

In medicine, hexachlorophene is useful as a topical anti-infective, anti-bacterial agent. It is also used in agriculture as a soil fungicide, plant bactericide, and acaricide.[6]

It was once used routinely to bath newborns, but this was stopped in the 1970s due to toxicity.[2]

Side effects

The LD50 (oral, rat) is 59 mg/kg, indicating that the compound is relatively toxic. It is not mutagenic nor teratogenic according to Ullmann's Encyclopedia,[6] but "embryotoxic and produces some teratogenic effects" according to the International Agency for Research on Cancer.[7] 2,3,7,8-Tetrachlorodibenzodioxin (TCDD) is always a contaminant in this compound's production. Several accidents releasing many kilograms of TCDD have been reported. The reaction between 2,4,5-trichlorophenol and formaldehyde is exothermic. If the reaction occurs without adequate cooling, TCDD is produced in significant quantities as a byproduct and contaminant. The Seveso disaster and the Times Beach, Missouri, contamination incident exemplify the industrial hazards of hexachlorophene production.

Chemistry

It is an organochlorine compound. The compound occurs as a white odorless solid, although commercial samples can be off-white and possess a slightly phenolic odor. It is insoluble in water but dissolves in acetone, ethanol, diethyl ether, and chloroform.

Production

Hexacholorophene is produced by alkylation of 2,4,5-trichlorophenol with formaldehyde. Related antiseptics are prepared similarly, e.g., bromochlorophene and dichlorophene.[6]

Society and culture

Regulation

French deaths

In 1972, the "Bébé" brand of baby powder in France killed 39 babies. It also did great damage to the central nervous systems of several hundred other babies. The batch of toxic "Bébé" brand of powder was mistakenly manufactured with 6% hexachlorophene. This industrial accident directly led to the removal of hexachlorophene from consumer products worldwide.[8][9]

United States

In 1972, the U.S. Food and Drug Administration (FDA) halted production and distribution of products containing more than 1% of hexachlorophene.[10] After that point, most products that contain hexachlorophene were available only with a doctor's prescription.[11] The restrictions were enacted after 15 deaths in the United States and 39 deaths in France were reported following brain damage caused by hexachlorophene.[12]

Several companies manufactured over-the-counter preparations which utilised hexachlorophene in their formulations. One product, Baby Magic Bath by The Mennen Company, was recalled in 1971, and removed from retail distribution.

Two commercial preparations using hexachlorophene, pHisoDerm and pHisoHex, were widely used as antibacterial skin cleansers in the treatment of acne, (with pHisoDerm developed for those allergic to the active ingredients in pHisoHex). During the 1960s, both were available over the counter in the US. After the ban, pHisoDerm was reformulated without hexachlorophene, and continued to be sold over-the-counter, while pHisoHex, (which contained 3% hexachlorophene - 3 times the legal limit imposed in 1972),[12] became available as a prescription body wash. In the European Community countries during the 1970s and 1980s, pHisoHex remained available over the counter. A related product, pHisoAc, was used as a skin mask to dry and peel away acne lesions whilst pHiso-Scrub, a hexachlorophene-impregnated sponge for scrubbing, has since been discontinued. Several substitute products (including triclosan) were developed, but none had the germ-killing capability of hexachlorophene. (Sanofi-Aventis was the sole manufacturer of pHisoHex, while The Mentholatum Company owns the pHisoDerm brand today. Sanofi-Aventis discontinued production of several forms of pHisoHex in August 2009 and discontinued all production of pHisoHex in September 2013).[13]

The formula for Dial soap was modified to remove hexachlorophene after the FDA ended over-the-counter availability in 1972.[11]

Bristol-Myers' discontinued Ipana toothpaste brand at one time contained hexachlorophene. [14]

Germany

In Germany, cosmetics containing hexachlorophene have been banned since 1985.

Austria

In Austria, the sale of drugs containing the substance has been banned since 1990.[15]

Trade names

Trade names for hexachlorophene include: Acigena, Almederm, AT7, AT17, Bilevon, Exofene, Fostril, Gamophen, G-11, Germa-Medica, Hexosan, K-34, Septisol, Surofene, M3.[16][17]

References

  1. 1 2 3 4 5 6 7 8 "Hexachlorophene Monograph for Professionals". Drugs.com. Archived from the original on 5 September 2015. Retrieved 10 December 2021.
  2. 1 2 Martin, Richard J.; Fanaroff, Avroy A.; Walsh, Michele C. (4 October 2010). Fanaroff and Martin's Neonatal-Perinatal Medicine E-Book: Diseases of the Fetus and Infant. Elsevier Health Sciences. p. 828. ISBN 978-0-323-08111-5. Archived from the original on 11 December 2021. Retrieved 10 December 2021.
  3. ↑ Pilapil, Virgilio R. (1 March 1966). "Hexachlorophene Toxicity in an Infant". Archives of Pediatrics & Adolescent Medicine. 111 (3): 333. doi:10.1001/archpedi.1966.02090060143023. {{cite journal}}: |access-date= requires |url= (help)
  4. ↑ "PHisoHex Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 10 December 2021.
  5. ↑ Mehlhorn, Heinz (2008). Encyclopedia of Parasitology: A-M. Springer Science & Business Media. p. 1442. ISBN 978-3-540-48994-8. Archived from the original on 2021-12-11. Retrieved 2021-12-10.
  6. 1 2 3 Fiege H, Voges HM, Hamamoto T, Umemura S, Iwata T, Miki H, et al. (2000). "Phenol Derivatives". Ullmann's Encyclopedia of Industrial Chemistry. Weinheim: Wiley-VCH. doi:10.1002/14356007.a19_313. ISBN 3-527-30673-0.
  7. ↑ "Hexachlorophene". International Agency for Research on Cancer (IARC) - Summaries & Evaluations. IPCS Inchem. 20: 241. 1998 [1979]. Archived from the original on 2021-03-04. Retrieved 2021-08-17.
  8. ↑ "Talcum Suspected in Deaths of 21 French Babies". No. 29 August 1972. New York Times. p. 10. Archived from the original on 31 October 2021. Retrieved 18 March 2020.
  9. ↑ "FDA CURBS USE OF GERMICIDE TIED TO INFANT DESTHS". No. 23 September 1972. New York Times. p. 1. Archived from the original on 31 October 2021. Retrieved 18 March 2020.
  10. ↑ Germicide Limit Stirs Confusion, New York Times, September 24, 1972, pg. 53.
  11. 1 2 "The Milwaukee Sentinel: "US Order Curbs Hexachlorophene" (UPI), September 23, 1972. From Google News". Archived from the original on April 2, 2016. Retrieved August 17, 2021.
  12. 1 2 "Ocala Star Banner, "15 Deaths Cited In Use of Germ Killer, Hexachlorophene" (AP), March 21, 1973. From Google News". Archived from the original on September 5, 2021. Retrieved August 17, 2021.
  13. ↑ "Drug Shortages". American Society of Health-System Pharmacists. Archived from the original on 10 September 2014.
  14. ↑ "1959 Ipana Toothpaste Ad". YouTube. Archived from the original on 2021-09-05. Retrieved 2021-08-17.
  15. ↑ Rechtsinformationssystem des österreichischen Bundeskanzleramtes Archived 2021-09-05 at the Wayback Machine (in German)
  16. ↑ "Hexachlorophene". PharmGKB. Archived from the original on 2014-11-17. Retrieved 2012-12-28.
  17. ↑ Dept. of Health, Education, and Welfare (1972). "Consumer news". Office of Consumer Affairs. 2 (21): 10.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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