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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
E2 Hand Wash
Generic Name
E2 Sanitizing Hand Soap
Active Ingredient
BenzalkoniumCategory
Standardized Chemical Allergen [EPC]
Salt Form
Chloride
Variants
2
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 1.3 mg/500mL | SOAP | TOPICAL | 74683-6400 |
| .13 mg/100mL | SOAP | TOPICAL | 74683-6300 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for E2 Hand Wash, you must consult a qualified healthcare professional.
Detailed information about E2 Hand Wash
Benzalkonium is a quaternary ammonium compound primarily used as an antiseptic, disinfectant, and preservative. Classified as a Standardized Chemical Allergen [EPC], it is widely found in topical, ophthalmic, and nasal medications.
For general skin antisepsis, Benzalkonium chloride is typically applied as a 0.1% to 0.13% solution to the affected area. Healthcare providers may recommend applying the solution 1 to 3 times daily. When used for surgical hand scrubs, specific institutional protocols should be followed.
Benzalkonium is generally considered safe for topical use in children over the age of 2 when used as directed for minor wounds. For children under 2 years of age, a healthcare provider must be consulted before use. It is not recommended for use on large areas of the body in infants due to the risk of increased systemic absorption.
Because topical absorption is minimal, dosage adjustments are typically not required for patients with kidney disease. However, caution is advised if applying to large areas of broken skin.
No specific dosage adjustments are established for patients with liver disease for topical applications.
Elderly patients may have thinner skin; therefore, healthcare providers suggest monitoring for signs of localized irritation or increased absorption.
Benzalkonium products are for external use only. If using a spray, hold the bottle 3-6 inches from the wound and apply a light mist. If using a solution, apply with a sterile gauze pad. For ophthalmic products containing Benzalkonium, avoid touching the dropper tip to any surface to prevent contamination. Store all products at room temperature (20°C to 25°C) and keep the container tightly closed.
If you miss a dose of a topical antiseptic, apply it as soon as you remember. If it is almost time for the next application, skip the missed dose and resume your regular schedule. Do not double the amount applied to catch up.
Signs of topical overdose include severe skin irritation, redness, or chemical burns. If Benzalkonium is accidentally swallowed, symptoms may include nausea, vomiting, abdominal pain, and in severe cases, respiratory distress or collapse. In the event of ingestion, contact a Poison Control Center or seek emergency medical attention immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or use the product on deep puncture wounds or animal bites without medical guidance.
Most patients tolerate topical Benzalkonium well. However, common localized reactions include:
Benzalkonium is a powerful chemical agent. It should never be applied to the eyes (unless specifically formulated as an ophthalmic product), internal cavities, or deep, contaminated wounds without medical supervision.
There are no FDA black box warnings for Benzalkonium at this time.
Benzalkonium is chemically incompatible with Anionic Surfactants (Soaps). Soaps and detergents can neutralize the antimicrobial activity of Benzalkonium, rendering it ineffective. Always rinse soap off thoroughly before applying Benzalkonium.
Benzalkonium must NEVER be used in the following situations:
Benzalkonium is classified as Pregnancy Category C by the FDA. There are no adequate and well-controlled studies in pregnant women. Because systemic absorption is minimal following topical application to intact skin, the risk to the fetus is considered low. However, it should be used during pregnancy only if clearly needed and under the advice of a healthcare provider.
It is not known whether Benzalkonium is excreted in human milk. Given its low systemic absorption, it is unlikely to pose a risk to the nursing infant. Care should be taken to avoid applying Benzalkonium to the breast area to prevent accidental ingestion by the infant.
Benzalkonium is approved for topical use in children for minor wound care. However, infants have a higher surface-area-to-body-weight ratio, which increases the risk of systemic toxicity if applied to large areas. It is not approved for use in the eyes of neonates unless specifically directed by a pediatric ophthalmologist.
Benzalkonium is a nitrogen-based cationic surfactant. Its primary mechanism involves the electrostatic attraction to the negatively charged bacterial cell wall. Once bound, the hydrophobic tail of the Benzalkonium molecule inserts into the lipid bilayer, causing mechanical disruption. This leads to increased membrane permeability, leakage of essential metabolites, and cell death. It also exhibits Ammonium Ion Binding Activity [MoA], which may play a role in its nitrogen-binding properties.
Benzalkonium provides rapid bactericidal action, often within minutes of contact. Its duration of effect is relatively short, as it can be neutralized by organic matter (like pus or blood) or anionic substances. It does not typically induce pharmacological tolerance, though some bacteria (like S. aureus) may develop reduced susceptibility over time through efflux pump mechanisms.
| Parameter | Value |
|---|---|
Common questions about E2 Hand Wash
Benzalkonium is primarily used as an antiseptic to prevent infection in minor cuts, scrapes, and burns. It is also a common preservative in many multi-dose healthcare products, such as eye drops and nasal sprays, to keep them free of bacterial growth. Additionally, healthcare providers use it as a standardized allergen to test patients for chemical sensitivities. Because of its ability to kill a wide range of germs, it is also found in some hand sanitizers and skin prep solutions used before medical procedures. Always use it as directed on the product label or by your doctor.
The most common side effects of Benzalkonium are localized skin reactions at the site of application. Patients often report a mild stinging, burning, or itching sensation shortly after applying the solution. Some people may also notice temporary redness or dryness of the skin. When used in eye drops, it can cause a temporary sandy or gritty feeling in the eyes. Most of these symptoms are mild and go away on their own once use is discontinued.
There are no known direct interactions between topical Benzalkonium and alcohol consumption. Since the drug is applied to the skin or eyes and very little enters the bloodstream, alcohol does not typically interfere with how the medication works. However, drinking alcohol can dehydrate your body and skin, which might make the skin more sensitive to irritation from the antiseptic. If you are using Benzalkonium for a serious wound, it is best to consult your doctor about lifestyle factors that could affect healing. Always follow the specific safety advice provided by your healthcare team.
Benzalkonium is categorized as FDA Pregnancy Category C, meaning its safety has not been fully established through human clinical trials. However, because it is applied topically and very little is absorbed into the body, many healthcare providers consider it low-risk for short-term use on small areas. It should only be used if the potential benefit outweighs the potential risk to the fetus. Pregnant women should avoid applying it to large areas of the skin or using it for long periods without medical supervision. Always discuss the use of any medication with your obstetrician during pregnancy.
Benzalkonium begins working almost immediately upon contact with the skin or the surface being treated. Its cationic surfactant properties allow it to disrupt bacterial cell membranes within seconds to minutes. For wound care, it provides rapid antisepsis to help prevent the onset of infection. However, it does not provide long-lasting protection, so wounds may need to be cleaned and treated again as directed by a healthcare provider. Its effectiveness can be reduced if the area is not first rinsed of soap or detergents.
Yes, you can typically stop using Benzalkonium products suddenly without experiencing withdrawal symptoms. Since it is a topical antiseptic and not a systemic medication like a blood pressure pill, your body does not develop a physical dependence on it. However, if you are using it to treat an active infection or as part of a prescribed wound care regimen, stopping too early could allow bacteria to regrow. If you experience an allergic reaction, you should stop using the product immediately. Always consult your healthcare provider before changing a prescribed treatment plan.
If you miss an application of a Benzalkonium-based antiseptic, apply it as soon as you remember. If it is nearly time for your next scheduled application, it is better to skip the missed dose and continue with your regular routine. Do not apply extra solution or use the product more frequently to make up for the missed dose, as this could increase skin irritation. For eye drops containing Benzalkonium, follow the same rule of thumb. Consistency is key for preventing infection, but over-application should be avoided.
There is no clinical evidence to suggest that Benzalkonium causes weight gain. Because it is applied topically to the skin or eyes, it does not interfere with the metabolic processes or hormones that regulate body weight. Even if a small amount were absorbed systemically, it would not be enough to affect your weight. If you notice unexpected weight changes while using any medication, you should discuss them with your doctor to find the underlying cause. Weight gain is more commonly associated with systemic medications like steroids or certain antidepressants.
Benzalkonium can generally be used alongside most systemic medications, but it has important interactions with other topical products. It is chemically incompatible with common soaps and detergents, which can stop it from working. If you are using other eye drops, Benzalkonium can increase the absorption of those drugs, potentially leading to more side effects in the eye. You should wait at least 5 to 10 minutes between applying different topical or ophthalmic treatments. Always provide your healthcare provider with a full list of all medications and skin products you are currently using.
Yes, Benzalkonium chloride is widely available as a generic product and is an ingredient in hundreds of over-the-counter and prescription formulations. You can find it in generic wound cleansers, hand sanitizers, and as a preservative in generic eye and nasal drops. Because it is an older, well-established chemical compound, it is generally very affordable. Generic versions are required by the FDA to meet the same standards of quality and efficacy as brand-name products. Your pharmacist can help you identify which generic products contain Benzalkonium.
Other drugs with the same active ingredient (Benzalkonium)
> Warning: Stop using Benzalkonium and call your doctor immediately if you experience any of the following:
Prolonged use of Benzalkonium as a preservative in eye drops has been linked to Benzalkonium Chloride-induced Ocular Surface Disease (OSD). This condition involves chronic inflammation of the conjunctiva and damage to the corneal epithelium, which may lead to dry eye syndrome. Long-term topical skin use may result in chronic irritant dermatitis or the development of a permanent allergy to the compound.
No FDA black box warnings are currently issued for Benzalkonium. However, it is strictly labeled for external use only and must be kept out of reach of children to prevent accidental poisoning.
Report any unusual symptoms or persistent irritation to your healthcare provider.
For standard topical use, routine lab tests are not required. However, for patients using ophthalmic Benzalkonium long-term, healthcare providers may perform:
Topical skin application does not typically affect the ability to drive. However, ophthalmic use may cause temporary blurred vision; patients should wait until their vision clears before operating heavy machinery.
There are no known direct interactions between topical Benzalkonium and alcohol consumption. However, alcohol can dry the skin, potentially worsening the irritant effects of Benzalkonium.
If a skin rash or irritation develops, discontinue use immediately. No tapering is required for this medication.
> Important: Discuss all your medical conditions, especially skin sensitivities and eye conditions, with your healthcare provider before starting Benzalkonium.
There are no known interactions between Benzalkonium and specific foods, including grapefruit or dairy, as the drug is not typically administered orally.
No significant interactions with herbal supplements like St. John's Wort or Ginkgo Biloba have been clinically documented for topical Benzalkonium use.
Benzalkonium is not known to interfere with standard blood or urine laboratory tests. However, its presence in a skin sample may interfere with certain microbiological culture results if not properly neutralized during the sampling process.
For each major interaction, the mechanism usually involves chemical incompatibility or surfactant-mediated membrane permeability changes. This can lead to reduced efficacy of the antiseptic or increased toxicity of co-administered ophthalmic drugs.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially any other skin or eye treatments.
Patients allergic to Benzalkonium may also react to other surfactants used in soaps, shampoos, and other preservatives. There is a noted cross-sensitivity with other members of the quaternary ammonium family.
> Important: Your healthcare provider will evaluate your complete medical history and any previous skin reactions before prescribing or recommending Benzalkonium.
Older adults may have increased skin fragility. Clinical studies have not identified significant differences in responses between the elderly and younger patients, but monitoring for localized skin breakdown is advised. In geriatric patients using eye drops, the risk of dry eye syndrome associated with Benzalkonium is higher.
No dosage adjustments are typically required for patients with renal impairment due to the lack of significant systemic absorption from topical routes.
No dosage adjustments are necessary for patients with hepatic impairment for standard topical or ophthalmic use.
> Important: Special populations require individualized medical assessment to ensure safety and efficacy.
| Protein Binding | Minimal (Systemic) |
| Half-life | Not well-defined (Minimal absorption) |
| Tmax | N/A (Local effect) |
| Metabolism | Minimal hepatic (if absorbed) |
| Excretion | Renal/Fecal |
Benzalkonium is classified as a Standardized Chemical Allergen [EPC] and a quaternary ammonium antiseptic. It is related to other compounds such as Cetrimide and Benzethonium chloride.