Benzalkonium (Monograph)

Drug class: Astringents, Anti-infective

Medically reviewed by Drugs.com on May 10, 2024. Written by ASHP.

Introduction

Benzalkonium chloride, a mixture of alkyldimethylbenzylammonium chlorides, is rapidly germicidal for many pathogenic bacteria and fungi.

Uses for Benzalkonium

Properly diluted, benzalkonium chloride is used for the prophylactic disinfection of the intact skin and in the treatment of superficial injuries and infected wounds. It is also used to preserve the sterility of surgical instruments and rubber articles during storage, and to preserve the sterility of ophthalmic solutions.

Benzalkonium Dosage and Administration

Tincture of benzalkonium chloride 1:750 is used for the preoperative disinfection of unbroken skin or treatment of superficial injuries. For preoperative disinfection of mucous membranes and denuded skin, benzalkonium chloride solution in concentrations of 1:10,000 to 1:2,000 is used. For irrigation of the eye, a solution 1:10,000 to 1:5,000 is used. For preservation of ophthalmic solutions, a solution 1:7,500 to 1:5,000 is used. For vaginal douche and irrigation, benzalkonium chloride solution 1:5,000 to 1:2,000 is used. For urinary bladder and urethral irrigation, a solution 1:5,000 to 1:20,000 is used; for retention irrigation of the bladder, a solution 1:20,000 to 1:40,000 is used. For infected, widely denuded areas, benzalkonium chloride solution should be used in concentrations of 1:2,000 to 1:5,000. For irrigation of infected deep wounds, concentrations of 1:20,000 to 1:3,000 may be employed. For the sterile storage of metallic instruments and rubber articles, benzalkonium chloride solution 1:750, with sodium nitrite 0.5% to prevent corrosion, is used.

Spectrum

Benzalkonium chloride is rapidly germicidal for many pathogenic bacteria and fungi.

Resistance

Strains of Mycobacterium tuberculosis and Pseudomonas aeruginosa are often resistant and it is not effective against spore-forming organisms.

Related/similar drugs

Betadine, ethanol topical, iodine topical, silver nitrate topical, sodium hypochlorite topical, Dakins Full Strength Solution

Chemistry and Stability

Chemistry

Benzalkonium chloride is a mixture of alkyldimethylbenzylammonium chlorides in which the alkyls range from C₈H₁₇ to C₁₈H₃₇. Benzalkonium chloride is a cationic wetting agent possessing detergent, keratolytic, and emulsifying action.

Stability

Benzalkonium chloride is inactivated by anionic compounds such as soap. Before applying quaternary ammonium compounds to the skin for preoperative disinfection, all traces of soap should be removed with water and with 70% alcohol.

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

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