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Stomatitis sprays
Medical expert of the article
Last reviewed: 03.07.2025
In local treatment of inflammation of the oral mucosa, various means are used, including antiseptic and pain-relieving spray for stomatitis.
The main names of sprays for stomatitis are: Hexoral (other trade names - Hexasprey, Hexetidine, Stomatidin), Strepsils Plus, Hepilor (Givalex), Orasept, Miramistin spray, Proposol.
In dentistry, as well as in otolaryngology, indications for the use of a spray for stomatitis include all inflammatory processes in the oral cavity and oropharynx that occur as a result of damage to the mucous membranes by bacteria Streptococcus spp., Staphylococcus aureus, Aerobacter spp., etc., as well as Candida fungi and some protozoa.
[ Pharmacodynamics
The therapeutic effect of the 0.2% spray for stomatitis Hexoral (Hexaspray, Hexetidine, Stomatidin) is provided by the action of a local antimicrobial substance - the antiseptic hexetidine, which is an antagonist of thiamine pyrophosphate, which is necessary for the development of bacteria.
By replacing thiamine pyrophosphate, hexetidine suppresses oxidative processes in the cells of microorganisms and disrupts the synthesis of membrane amino acids in fungi and protozoa. This preparation also contains eucalyptus and anise oils and ethyl alcohol.
The active ingredients of the Strepsils Plus spray are dichlorobenzyl alcohol, which has a bactericidal effect by dehydrating bacterial cells, and the phenol derivative amylmetacresol, which stops the production of proteins by microorganisms, leading to cytolysis.
The analgesic component in this product is the local anesthetic lidocaine hydrochloride, which suppresses the sensitivity of nerve endings.
The pharmacodynamics of Hepilor spray is based on the already mentioned antiseptic hexetidine, as well as two more components - the analgesic and anti-inflammatory choline salicylate and the pain-relieving substance chlorobutanol.
The Orasept spray for stomatitis also contains an antiseptic - 1.4% phenol (hydroxybenzene), which, due to its similarity to the coenzyme of bacterial cells tyrosine-phenol-lyase, is absorbed by them, which leads to the death of microorganisms.
Glycerin, which is also included in this spray, helps relieve irritation of the oral mucosa.
Miramistin spray is a cationic antiseptic that loosens the membranes of microbial cells and thereby suppresses the work of their enzyme systems. As a result, the metabolism of microorganisms and fungi stops and they die. Miramistin also exhibits antiviral activity.
The mechanism of action of the Proposol spray is associated with the bee glue propolis, which is part of the drug and is known for its bactericidal, fungicidal and anti-inflammatory properties.
Pharmacokinetics
The official instructions for such drugs as Hexoral, Miramistin spray and Proposol state that they do not enter the bloodstream and therefore do not undergo transformation and do not have any systemic effects.
The pharmacokinetics of Strepsils Plus spray is not presented. And the manufacturers of Hepilor report that the active ingredients of the drug are released gradually, which contributes to a fairly long-term therapeutic effect.
The relevant section of the instructions for the Orasept spray contains information that significant absorption of the active component of the drug (1.4% phenol) into the blood and, accordingly, systemic effects on the body have not been noted. However, it is known that phenol freely penetrates into the blood through the skin.
Methods of using spray for stomatitis and signs of overdose
Spray for stomatitis Hexoral and Strepsils Plus are sprayed on the affected mucous membrane of the mouth, one dose corresponds to spraying for two seconds. The maximum permissible number of sprays of Gesoral is twice a day, Strepsils - six times, and the duration of treatment is five days. Hepilor is used in similar doses.
Adults and children over 12 years of age are recommended to use Oracept spray 4-5 sprays at intervals of 3-4 hours, children 2-12 years of age - three. The duration of the course of treatment is determined by the doctor based on the results of an examination of the oral cavity.
Miramistin spray is used up to six times a day, and Proposol – no more than three times.
Overdose when using Hexoral manifests itself in the form of nausea and vomiting, and in children who may swallow ethyl alcohol, signs of ethanol poisoning are possible.
Strepsils Plus in high dosage causes increased side effects of the drug. In addition, due to the presence of lidocaine, Strepsils Plus can cause tremors and cramps of the limbs, as well as paralysis of the respiratory muscles. An overdose of Oracept leads to nausea and vomiting.
The instructions for the drugs Hepilor, Miramistin spray and Proposol indicate the absence of any information regarding their overdose.
Using a Canker Sore Spray During Pregnancy
During pregnancy, it is possible to use Hexoral, Strepsils Plus, Orasept, Miramistin spray and Proposol sprays, provided that they are prescribed by the attending physician, who is obliged to correlate the expected benefit for the mother with the potential for harm to the unborn child.
The manufacturers of Strepsils Plus spray did not indicate that it is suitable for pregnant women.
Lidocaine hydrochloride should not be prescribed.
The instructions indicate that the spray for stomatitis Hepilor is allowed to be used during pregnancy and lactation under the same conditions as the above-mentioned drugs. And nursing women should refrain from breastfeeding while using Hepilor. However, the instructions do not contain information about the negative impact on the central nervous system of chlorobutanol, which is part of this drug.
Contraindications for use
The main contraindications to the use of Hexoral spray and its synonyms, as well as Miramistin spray, are the presence of hypersensitivity to their components; also, Hexoral is not used in the treatment of stomatitis in children under three years of age.
Contraindications for Strepsils Plus, Hepilor and Proposol sprays are age under 12 years. For some reason, the instructions for Strepsils Plus spray do not indicate that lidocaine (which is part of this drug) is contraindicated in severe heart failure and bradycardia, as well as in myasthenia gravis, liver and kidney dysfunction.
Orasept is not prescribed to children under two years of age, and is also not used in cases of severe renal and hepatic insufficiency.
Side effects
Possible side effects of stomatitis spray:
Hexoral – allergic reactions, taste disturbances, staining of tooth enamel;
Strepsils Plus – taste disturbances, loss of sensitivity of the lips and tongue, as well as headache, irregular heartbeat and decreased blood pressure (all side effects are caused by lidocaine);
Hepilor – allergic reactions, disturbances of taste and smell perception;
Orasept - hyperemia and swelling of the oral mucosa; phenol, which is part of this drug, is a toxic substance and, when it enters the bloodstream, can affect the brain. This manifests itself in a short excitation of the respiratory center of the brain (coughing and sneezing begin), and then its paralysis may follow;
Miramistin spray – short-term burning sensation in the mouth.
Proposol - allergic reactions, burning and dryness in the mouth.
Interactions with other drugs
Clinically significant interactions with other drugs of Hexoral, Strepsils Plus and Oracept sprays have not been described.
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Hepilor and Propasol should not be used simultaneously with other antiseptics. And Miramistin spray, when taken in parallel with antibiotics, can enhance their effect on microorganisms.
Storage conditions and shelf life
The storage conditions for the sprays for stomatitis listed in the review require compliance with the general rules for storing medicines and a temperature not exceeding +25-27°C.
The shelf life of the drugs Hexoral, Strepsils Plus, Hepilor, Miramistin spray and Proposol is 3 years; the spray for stomatitis Orasept is suitable for use for 24 months.
Attention!
To simplify the perception of information, this instruction for use of the drug "Stomatitis sprays" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.