Chlorhexidine gluconate (Peridex, Periogard, and others)

How Medicare covers it

Part D (prescription mouth rinse used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

A prescription antiseptic mouth rinse (0.12%) used between dental visits as part of a professional program to treat gingivitis — gum inflammation with redness, swelling, and bleeding when the gums are probed. It has not been tested in acute necrotizing ulcerative gingivitis (ANUG).

What it is for, in depth

Chlorhexidine gluconate in this package is a prescription antiseptic mouth rinse used between dental visits as part of a professional program to treat gingivitis. Gingivitis is gum inflammation with redness, swelling, and bleeding when the gums are probed. The label says it has not been tested in acute necrotizing ulcerative gingivitis. Rinsing with it reduces the bacteria in the mouth that cause gum inflammation, which helps the gums heal between professional dental cleanings. Use starts right after a dental cleaning. The formulary lists it as a 1.2 MG/ML mouthwash. It is used undiluted, rinsed for 30 seconds twice a day, morning and evening after brushing, and then spit out.

How it works

Chlorhexidine is an antiseptic. Rinsing with it reduces the bacteria in the mouth that cause gum inflammation, which helps the gums heal between professional dental cleanings.

How it is taken

Start right after a dental cleaning (prophylaxis). Rinse twice a day for 30 seconds, morning and evening after brushing, with 15 mL (about one capful) of the undiluted rinse. Spit it out — do not swallow it. Do not rinse with water or other mouthwashes, brush, or eat right after using it. A dental recheck and cleaning should be done at least every 6 months.

Common side effects

The most common side effects are increased staining of the teeth and other surfaces in the mouth, increased tartar (calculus) build-up, and changes in taste. Oral irritation and local allergy-type symptoms have also been reported.

Serious warnings

Anaphylaxis and other serious allergic reactions have been reported with dental products containing chlorhexidine. Other reported problems include mouth sores and ulceration, swelling of the parotid (salivary) glands, inflammation of the salivary glands, and peeling or irritation of the lining of the mouth. Tell your dentist if these occur.

Who should be careful

Do not use it if you are known to be sensitive to chlorhexidine gluconate or any ingredient in the rinse. If you have both gingivitis and periodontitis, your dentist should advise you, because treating the gingivitis can unmask periodontitis that needs its own treatment. Staining and tartar can be removed by your dentist and may be worse if you do not brush and floss as directed.

Major interactions

The label for this mouth rinse lists no specific drug interactions.

Why it is in its tier

Chlorhexidine gluconate is most often placed on Tier 1. It is listed by 100.0% of Part D plans, and 88.55% of listing plans place it on Tier 1. Tier 1 is the lowest-cost tier, usually for preferred generic drugs, so it is typically in the lowest cost-share group a plan offers. That fits what the data show. This mouth rinse is a generic product, and the CMS dashboard average spending per beneficiary was $8.24, labeled here as CMS program average spending, not a copay. The strong share on one tier also shows plans mostly agree on this placement. Individual plans vary, so readers should check their own plan's formulary to confirm their tier and cost.

Sources

• CHLORHEXIDINE GLUCONATE 0.12% ORAL RINSE (CHLORHEXIDINE GLUCONATE) LIQUID [RISING PHARMA HOLDINGS, INC.] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Chlorhexidine mouth rinse

What official patient guides say

Chlorhexidine comes as a solution (liquid) to use as a mouth rinse, used twice a day in the morning and evening after brushing your teeth, at around the same times every day. To use it, measure 1/2 ounce (15 mL) of the solution or fill to the mark in the cap, rinse or swish it in your mouth for 30 seconds, then spit it out — do not swallow it, and do not rinse your mouth with water or mouthwash, brush your teeth, or eat immediately after using it. If you miss a dose, use it as soon as you remember, but if it is almost time for the next dose, skip the missed dose and continue your regular schedule — do not use a double dose. Keep the medication in the container it came in, tightly closed and out of reach of children, stored at room temperature and away from excess heat and moisture (not in the bathroom).

Source: MedlinePlus — Chlorhexidine mouth rinse

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 0.00806 per unit (CHLORHEXIDINE 0.12% RINSE) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Chlorhexidine gluconate (Peridex, Periogard, and others) — 100% of plans. Most of those plans put it on Tier 1: 4,866 plans, 88.5% of the plans that list it. Other plans place it on Tier 2 (629 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 1; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 1; Aetna Medicare Value Plus (PPO) puts it on Tier 1. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.