Cetylpyridinium

Identification

Summary

Cetylpyridinium is a compound used to reduce plaque and gingivitis, as well as whiten teeth.

Brand Names
Cepacol Antibacterial Mouthwash, Crest Mouthwash, Orajel Bleeding Gum Rinse, Orasep Reformulated Dec 2013
Generic Name
Cetylpyridinium
DrugBank Accession Number
DB11073
Background

Cetylpyridinium is a quaternary ammonium with broad-spectrum antiseptic properties. Its salt form, cetylpyridinium chloride, is typically found as an active ingredient in mouthwashes, toothpastes, lozenges, throat sprays, breath sprays, and nasal sprays. In these products, it generally mediates an antiseptic activity and protective action against dental plaque and reducing gingivitis.

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 304.541
Monoisotopic: 304.299876648
Chemical Formula
C21H38N
Synonyms
  • 1-hexadecylpyridinium

Pharmacology

Indication

Typically employed as the cetylpyridinium chloride salt, this compound is commonly used as an active ingredient in various over-the-counter mouthwashes, toothpastes, lozenges, and mouth sprays where it is generally indicated for antiseptic actions, gingivitis and plaque prevention, as well as action or prevention against some other oropharyngeal bacterial infections 1,3,4.

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Prevention ofGingivitis••• ••••••••• ••••••••
Used in combination to treatOral infectionCombination Product in combination with: Lidocaine (DB00281)•••••••••••••••••••
Used in combination to treatOral painCombination Product in combination with: Lidocaine (DB00281)••• •••••••••
Used in combination for symptomatic treatment ofOrofacial painCombination Product in combination with: Benzocaine (DB01086)••••••••••••••••••
Used in combination for symptomatic treatment ofOrofacial painCombination Product in combination with: Choline salicylate (DB14006)••• ••••••
Associated Therapies
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Pharmacodynamics

Cetylpyridinium chloride is considered a cationic disinfectant with properties and uses similar to other such cationic surfactants 5. In particular, cetylpyridinium chloride has demonstrated a rapid bactericidal and fungicide effect on gram-positive pathogens and yeasts, respectively 1. Cetylpyridinium chloride is subsequently utilized in a variety of preparations for the local treatment of minor infections 5. Despite the variety of formulations in which cetylpyridinium chloride may appear as an active ingredient, it is generally accepted that it only elicits a local effect 5 owing to the compound's relatively poor absorption by route of exposure 6.

Mechanism of action

When incorporated into mouthwashes, toothpastes, lozenges, or mouth sprays, cetylpyridinium chloride is expected to elicit a mechanism of action that decreases new dental plaque growth, decreases or removes existing dental plaque, diminishes the growth of pathogenic bacteria, and inhibits the production of virulence factors 3. Cetylpyridinium chloride is a quaternary ammonium compound that demonstrates a broad spectrum anti-bacterial activity 3. It possesses a cationic surface active agent surfactant which can absorb readily to oral surfaces 3. The molecules of this agent have both hydrophilic and hydrophobic groups 3. In action, the positively charged hydrophilic region of cetylpyridinium chloride molecules enables the compound to interact with microbial cell surfaces and even integrate into the bacterial cytoplasmic membrane 3. Consequently, there is a resultant disruption of bacterial membrane integrity causing a leakage of bacterial cytoplasmic components, interference with cellular metabolism, inhibition of cell growth, and ultimately - cell death 3. Moreover, cetylpyridinium chloride can also inhibit the synthesis of insoluble glucan by streptococcal glucosyltransferase, adsorb to pellicle-covered enamel, and inhibit co-adhesion of bacteria, and bind streptococcus mutans biofilms 3. This ability of cetylpyridinium chloride to be able to adsorb to pellicle covered enamel imparts substantivity to the compound molecules - that is retention in the mouth and continued antimicrobial activity for a period of time after rinsing 3. Taking these mechanisms into consideration, cetylpyridinium chloride may be considered an active ingredient that is effective in the treatment and prevention of bacterial or fungal disorders of the oropharyngeal cavity 1.

Absorption

Most available formulations consisting of cetylpyridinium chloride as an active ingredient are either mouthwashes, tootpastes, lozenges, or mouth sprays. The oral retention of cetylpyridinium chloride given as 1 min mouth rinse of 10 mL of 2.2 MMOL solution was recorded as 65% of the administered dose 7.

Additionally, it has been recorded that quaternary ammonium compounds like Cetylpyridinium chloride are generally poorly absorbed by the oral route 6. Furthermore, although systemic absorption from the parenteral route of administration is possible, systemic effects from percutaneous absorption through intact skin is considered rare 6.

Volume of distribution

No readily available data regarding the volume of distribution of cetylpyridinium chloride is available 6 and various products that actually contain cetylpyridinium chloride as an active ingredient suggest that no pharmacokinetic data are available for the agent 8.

Protein binding

No readily available data regarding the protein binding of cetylpyridinium chloride is available 6 and various products that actually contain cetylpyridinium chloride as an active ingredient suggest that no pharmacokinetic data are available for the agent 8.

Metabolism

No readily available data regarding the metabolism of cetylpyridinium chloride is available 6 and various products that actually contain cetylpyridinium chloride as an active ingredient suggest that no pharmacokinetic data are available for the agent 8.

Route of elimination

As the quaternary ammonium compound cetylpyridinium chloride is poorly absorbed by oral route, relatively large amounts of the compound are therefore eliminated in faeces 6.

Half-life

No readily available data regarding the half-life of cetylpyridinium chloride is available 6 and various products that actually contain cetylpyridinium chloride as an active ingredient suggest that no pharmacokinetic data are available for the agent 8.

Clearance

No readily available data regarding the clearance of cetylpyridinium chloride is available 6 and various products that actually contain cetylpyridinium chloride as an active ingredient suggest that no pharmacokinetic data are available for the agent 8.

Adverse Effects
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Toxicity

Ingestion of cetylpyridinium chloride in large doses may cause gastric upset and central nervous system depression 9. However, such overdose symptoms are only observed in doses 70 times greater than the concentrations of cetylpyridinium chloride found in most over-the-counter cetylpyridinium chloride products 9.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Not Available
Food Interactions
No interactions found.

Products

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Product Ingredients
IngredientUNIICASInChI Key
Cetylpyridinium bromideO77BKZ14DE140-72-7DVBJBNKEBPCGSY-UHFFFAOYSA-M
Cetylpyridinium chlorideD9OM4SK49P6004-24-6NFCRBQADEGXVDL-UHFFFAOYSA-M
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
ACT Advanced Care Plaque Guard Antigingivitis Antiplaque Clean MintMouthwash0.7 mg/1mLOralChattem, Inc.2015-02-022021-09-22US flag
ACT Advanced Care Plaque Guard Antigingivitis Antiplaque Frosted MintMouthwash0.7 mg/1mLOralChattem, Inc.2015-02-022021-01-22US flag
Advanced GuardRinse1 mg/100mLOralH-E-B2013-06-25Not applicableUS flag
Alcohol FreeMouthwash0.7 mg/1mLOralH-E-B2009-04-16Not applicableUS flag
Alcohol Free AntisepticRinse0.07 mg/100LOralDemoulas Super Markets Inc2012-04-16Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
(badiful) Antibacterial WipesCetylpyridinium chloride (5 mg/100mL) + Benzalkonium chloride (13 mg/100mL) + Chlorphenesin (2 mg/100mL) + Propylene glycol (2 mg/100mL)SwabTopicalZHANGZHOU KANGBEI HYGIENIC PRODUCTS CO., LTD.2020-05-31Not applicableUS flag
Above Mouthwash AntisepticCetylpyridinium chloride (0.075 mg/500g) + Menthol (0.3 mg/500g) + Methyl salicylate (0.25 mg/500g)MouthwashBuccal; DentalBaston Industria de Aerossóis Ltda2023-07-24Not applicableUS flag
ActisepCetylpyridinium chloride (0.1 g/100mL) + Benzocaine (2 g/100mL) + Menthol (0.5 g/100mL)SprayTopicalActipharma, Inc2015-12-28Not applicableUS flag
ActisepCetylpyridinium chloride (0.1 g/100mL) + Benzocaine (2 g/100mL) + Menthol (0.5 g/100mL)SolutionTopicalActipharma, Inc2015-12-28Not applicableUS flag
Alcohol Wet TissueCetylpyridinium chloride (0.05 g/100g) + Benzalkonium chloride (0.1 g/100g) + Chlorphenesin (0.05 g/100g) + Didecyldimethylammonium chloride (0.1 g/100g) + Ethanol (75 g/100g)SwabTopicalSHANDONG PROVINCE RUNHE SANITARY MATERIALS CO.,LTD.2020-04-13Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
(badiful) Antibacterial WipesCetylpyridinium chloride (5 mg/100mL) + Benzalkonium chloride (13 mg/100mL) + Chlorphenesin (2 mg/100mL) + Propylene glycol (2 mg/100mL)SwabTopicalZHANGZHOU KANGBEI HYGIENIC PRODUCTS CO., LTD.2020-05-31Not applicableUS flag
Breath mellow Azalea PeachCetylpyridinium chloride (0.0085 g/17mL)SprayTopicalCurescript2021-02-01Not applicableUS flag
Breath mellow Water LilyCetylpyridinium chloride (0.0085 g/17mL)SprayTopicalCurescript2021-02-01Not applicableUS flag
Cool Sense Stick GargleCetylpyridinium chloride (0.05 g/100mL)LiquidDentalDOCSMEDI OralBiome Co., Ltd.2023-02-01Not applicableUS flag
Denti Whoo Bubble Concentrated GargleCetylpyridinium chloride (2.296 g/100mL)LiquidDentalSUN LIFE SCIENCE CO LTD2022-04-06Not applicableUS flag

Categories

ATC Codes
D08AJ03 — CetylpyridiniumB05CA01 — CetylpyridiniumR02AA06 — CetylpyridiniumD09AA07 — Cetylpyridinium
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as pyridinium derivatives. These are compounds containing a pyridinium ring, which is the cationic form of pyridine.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Pyridines and derivatives
Sub Class
Pyridinium derivatives
Direct Parent
Pyridinium derivatives
Alternative Parents
Heteroaromatic compounds / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Hydrocarbon derivatives / Organic cations
Substituents
Aromatic heteromonocyclic compound / Azacycle / Heteroaromatic compound / Hydrocarbon derivative / Organic cation / Organic nitrogen compound / Organonitrogen compound / Organopnictogen compound / Pyridinium
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
pyridinium ion (CHEBI:32914)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
CUB7JI0JV3
CAS number
7773-52-6
InChI Key
NEUSVAOJNUQRTM-UHFFFAOYSA-N
InChI
InChI=1S/C21H38N/c1-2-3-4-5-6-7-8-9-10-11-12-13-14-16-19-22-20-17-15-18-21-22/h15,17-18,20-21H,2-14,16,19H2,1H3/q+1
IUPAC Name
1-hexadecylpyridin-1-ium
SMILES
CCCCCCCCCCCCCCCC[N+]1=CC=CC=C1

References

General References
  1. Pitten FA, Kramer A: Efficacy of cetylpyridinium chloride used as oropharyngeal antiseptic. Arzneimittelforschung. 2001;51(7):588-95. [Article]
  2. Albert-Kiszely A, Pjetursson BE, Salvi GE, Witt J, Hamilton A, Persson GR, Lang NP: Comparison of the effects of cetylpyridinium chloride with an essential oil mouth rinse on dental plaque and gingivitis - a six-month randomized controlled clinical trial. J Clin Periodontol. 2007 Aug;34(8):658-67. [Article]
  3. The Role of Cetylpyridinium Chloride Mouthwash In The Treatment of Periodontitis. [Link]
  4. Electronic Medicines Compendium: Cetylpyridinium chloride formulations [Link]
  5. Electronic Medicines Compendium: Covonia Cold & Flu Formula Monograph [Link]
  6. IPCS INCHEM: Quaternary ammonium profile [Link]
  7. Pubchem: Cetylpyridinium Chloride Profile [Link]
  8. Electronic Medicines Compendium: Lemsip Cough for Mucus Cough & Catarrh 100mg/2.5mg/5ml Oral Solution Monograph [Link]
  9. Electronic Medicines Database: Calgel Teething Gel Monograph [Link]
  10. DailyMed: Advanced Guard (cetylpyridinium chloride) oral rinse [Link]
  11. Lloyd's Farmacia: Neo Formitrol (cetylpyridinium chloride) buccal tablets [Link]
PubChem Compound
2683
PubChem Substance
347827886
ChemSpider
2582
BindingDB
80992
RxNav
2286
ChEBI
32914
ChEMBL
CHEMBL305906
ZINC
ZINC000006845963
Wikipedia
Cetylpyridinium_chloride
MSDS
Download (48.2 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedPreventionCoronavirus Disease 2019 (COVID‑19) / Infections, Coronavirus / Mouthwashes / Polymerase Chain Reaction / Saliva / Viral Load1
4CompletedPreventionDental Decay1
4CompletedPreventionGeneralized Aggressive Periodontitis1
4CompletedPreventionGingivitis / Periodontal Disease / Plaque, Dental1
4CompletedTreatmentGingivitis2

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
MouthwashBuccal; Dental
MouthwashOral0.7 mg/1mL
SprayTopical
RinseOral0.07 mg/100L
Tablet, chewableOral
SolutionBuccal; Oral500 mg
TabletOral600 MG
RinseOral0.07 kg/100L
RinseOral0.7 mg/1mL
MouthwashOral0.07 kg/100L
MouthwashBuccal0.05 %
MouthwashBuccal0.5 mg/1mL
SolutionOral0.1 %
MouthwashBuccal0.7 mg/1mL
SolutionBuccal; Oral
LiquidDental
SprayOral0.1 g/100mL
LiquidOral0.1 g/100mL
SprayTopical0.0085 g/17mL
MouthwashTopical0.3394 g/473mL
KitDental; Oral
RinseOral.75 mg/1mL
SprayOral0.85 mg/1mL
Tablet, chewableBuccal
SolutionOral
LiquidOral0.05 g/100mL
LozengeOral1.4 mg
LozengeOral1.4 mg / loz
MouthwashBuccal
MouthwashBuccal0.5 mg / mL
Liquid; mouthwashBuccal
MouthwashOral
SolutionTopical
SolutionTopical2 MG/ML
TabletOral
SolutionOral0.283 g/473mL
LiquidOral0.75 g/1mL
SolutionBuccal0.075 % w/w
MouthwashBuccal0.075 % w/w
RinseDental0.75 mg/1mL
RinseDental15 mg/20mL
MouthwashDental10.5 mg/20mL
RinseDental15 mg/20L
MouthwashDental15 mg/20mL
LiquidDental0.05 g/100mL
RinseOral0.5 mg/1mL
SprayTopical1.11 g/13.0mL
RinseTopical0.014 g/20mL
RinseOral0.014 g/1mL
RinseOral0.02 g/20mL
RinseOral0.05 g/1mL
MouthwashBuccal0.07 % w/w
RinseOral0.014 g/20mL
MouthwashOral
Kit; rinseBuccal0.5 mg/1mL
SolutionTopical
LiquidDental2.296 g/100mL
GelDental
GelSubmucosal0.1 % w/w
LozengeOral3 mg
GelOral
GelSubmucosal10 mg/g
LozengeOral3.0 mg
LozengeOral1.5 mg
ClothTopical
SwabTopical
SolutionTopical5 g/100g
MouthwashOral2.30 g/100mL
LiquidTopical0.05 g/100mL
PasteDental0.0023 g/100mL
PasteDental2.296 g/100mL
MouthwashDental1 mg/1mL
LozengeOral1.33 mg
LiquidDental0.005 g/100mL
MouthwashOral0.07 g/1mL
OintmentTopical
LozengeOral1.34 mg / loz
SolutionOral2.296 g
PowderTopical
RinseOral0.07 g/100mL
LozengeOral1.2 MG
SprayOral
RinseOral0.07 g/20mL
SolutionOral0.07 g/100mL
PasteDental
Tablet, solubleOral
PastilleOral1.5 MG
LozengeOral
LiquidOral0.7 mg/1mL
LiquidBuccal; Topical
SprayOral0.05 g/100mL
KitOral
KitOral0.0005 mg/1mL
LozengeBuccal
MouthwashOral0.5 mg/1mL
RinseOral1 mg/100mL
TabletBuccal; Oral
SprayTopical0.05 g/100g
SprayTopical0.05 mL/100mL
Liquid; mouthwashOral.05 %
RinseDental0.07 g/100g
MouthwashOral.05 %
TabletOral1.5 MG
TabletOral1 MG
ClothExtracorporeal
TabletBuccal
LiquidOral0.5 mg/1mL
LiquidOral.001 mL/1mL
MouthwashBuccal; Topical
RinseOral0.07 g/1mL
MouthwashOral.47 mL/474mL
LiquidDental500 ug/1mL
MouthwashDental0.07 % w/w
RinseOral
LiquidOral70 mg/1mL
MouthwashOral70 mg/1mL
LozengeOral1.66 mg
MouthwashBuccal0.75 % w/w
KitOral.5 mg/1mL
KitBuccal; Oral.5 mg/1mL
RinseBuccal; Oral0.5 mg/1mL
Kit; mouthwashBuccal
RinseBuccal
RinseBuccal5 [iU]/1mL
KitBuccal
KitBuccal; Oral
SprayTopical.027 mL/60mL
LiquidTopical
LiquidOral1 mg/100mL
SprayOral
TabletTransmucosal
SwabBuccal0.5 mg/1mL
KitBuccal0.5 mg/1mL
KitOral; Topical
KitDental500 mg/20mL
Kit; liquidDental500 mg/20mL
LozengeOral
GelOral0.01 % w/w
KitOral0.5 mg/1mL
RinseBuccal0.5 mg/1mL
RinseOral0.01 mg/20mL
MouthwashBuccal0.05 % w/w
RinseOral0.0005 g/1g
RinseOral0.015 mg/20mL
RinseOral0.075 mg/0.1mL
KitBuccal.5 [iU]/1mL
TabletOral
Paste, dentifriceDental
LozengeOral0.46 mg
LozengeOral0.33 mg
LozengeOral0.5 mg
LozengeOral0.35 mg
LiquidOral0.07 g/100g
AerosolOral; Topical
Lozenge
LozengeOral1.5 mg
TabletOral0.33 mg
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility6.53e-06 mg/mLALOGPS
logP3.18ALOGPS
logP3.47Chemaxon
logS-7.7ALOGPS
Physiological Charge1Chemaxon
Hydrogen Acceptor Count0Chemaxon
Hydrogen Donor Count0Chemaxon
Polar Surface Area3.88 Å2Chemaxon
Rotatable Bond Count15Chemaxon
Refractivity99.14 m3·mol-1Chemaxon
Polarizability42.21 Å3Chemaxon
Number of Rings1Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-0059-3940000000-1eee64b743c1c4eb885a
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-180.02032
predicted
DeepCCS 1.0 (2019)
[M+H]+182.57063
predicted
DeepCCS 1.0 (2019)
[M+Na]+189.5891
predicted
DeepCCS 1.0 (2019)

Drug created at December 03, 2015 16:51 / Updated at April 16, 2024 12:20