Benzalkonium chloride: Applications, Effects, and Other Things to Know

April 2021

Benzalkonium chloride (BAK), also known as "chloroxylenol" (ClO) is a chemical compound that has been used as a medical antiseptic in non-woven and woven medical dressings. BAK has strong activity against Gram-negative organisms such as Escherichia coli, Klebsiella and Pseudomonas species. It is also effective in destroying yeast and mycobacterium species.

The mode of action is due to its destruction of the cytoplasmic membrane and inhibition of protein synthesis. BAK also has an inhibitory effect on the respiratory chain. BAK is therefore considered a synthetic quaternary ammonium antiseptic and bactericide.

Benzalkonium chloride as an antiseptic agent is marketed under many brand names, but the most common is chloroxylenol (trade name Cibacil) or isotonic sodium chloride (trade name Salutar). It can be used as a 'cleaner' for wounds and surgical incisions when used as an antiseptic or disinfectant. It can be added to cleaning fluids to allow better penetration of air-dried surfaces by water-detergent liquids.

Benzalkonium chloride is a chemical used as an antiseptic, especially in toothpaste. It is a mixture of benzyl alcohol, alkyl (or alkylene) polyethylene glycols, and benzoic acid. It can be prepared by reacting benzyl chloride with ethylene oxide followed by hydrolysis to give the monoethanolamide of benzoic acid, followed by reaction with sodium hydroxide or potassium hydroxide to give the salt

The compound is used as a preservative in mouthwash, toothpaste, antiperspirant, and many other cosmetic products. As a preservative it is used to control bacteria and fungi content in these items. It inhibits the growth of "Streptococcus mutans" and "Streptococcus salivarius", which are bacteria that can form dental plaque. 

In toothpaste it is present as an antimicrobial agent at concentrations from 0.05% to 0.2%. In a laboratory setting it has been shown to be effective in killing methicillin-resistant Staphylococcus aureus (MRSA). Because of its similarity in structure to the main ingredient in antiperspirants, Parabens, it has been assumed to have the same effect on armpit microorganisms.

Benzalkonium chloride is used as a preservative for pharmaceuticals. It is often applied to pills and ointments to increase their stability under environmental exposure. In addition, benzalkonium chloride is also an active ingredient in eye drops intended for the prevention of bacterial contamination and irritation after minor eye surgery or laser procedures (e.g., LASIK).

Benzalkonium chloride is used as a desiccant for air conditioning systems. Benzalkonium chloride is water-soluble and can absorb moisture from the air during humid days.

Benzalkonium chloride is also an active ingredient in Listerine mouthwash, a product that is used to treat the mouth after performing dental work and prevent any bacterial dangers such as cavitation from occurring.

Benzalkonium chloride has been shown to have antimicrobial properties against Streptococcus vaginalis, which causes prematurity in newborn babies. The compound has been shown to have antiviral effects against HIV-1.

Benzalkonium chloride is a disinfectant and antiseptic that is used in hospitals and other healthcare facilities. It is present in many water-based hand sanitizers. It's been shown to be effective at killing bacteria like E. coli, but it can react with some chemicals, such as nitrite, in explosive ways. This makes it a potential health risk to people who use these chemically reactive compounds or mix them intentionally with benzalkonium chloride products.

Benzalkonium chloride has been linked to causing contact dermatitis and respiratory symptoms for some patients who come into contact with it, even when their conditions are rare or unlisted on the product label.

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