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Cetylpyridinium Chloride for COVID-19
4 studies with 157 patients
Serious outcome risk
Cetylpyridinium Chloride
Control
Significantly lower risk for recovery and viral clearance.
One study shows significant benefit.
COVID-19 Cetylpyridinium Chloride studies · October 2026
Recent:
Widyarman
Mierzejewska
Hup.
Covid Analysis Cetylpyridinium Chloride reduces COVID-19 risk: real-time meta-analysis of 4 studies (Version 6)
Significantly lower risk is seen for recovery and viral clearance. One study shows significant benefit. Meta-analysis using the most serious outcome reported shows 38% [15‑55%] lower risk. Results are better for peer-reviewed s..
Apr 30
 Widyarman et al., Archives of Oral Biology, doi:10.1016/j.archoralbio.2026.106524 Mouthrinses differentially rewire salivary virus-microbiome interaction dynamics in COVID-19 patients: A randomized controlled trial
RCT 40 COVID-19 outpatients showing lower salivary SARS-CoV-2 viral load with cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and sodium chlorite (NaClO2) mouthrinses, without statistical significance. CPC and PVP-I selectively a..
Mar 17
 Mierzejewska et al., Langmuir, doi:10.1021/acs.langmuir.6c00207 Effect of Cationic Surfactants on the Molecular Organization of the Simplified Model Lipid Envelope of SARS-CoV-2 Virus─Insights from the Langmuir Monolayer and Liposome Studies
In vitro study showing potential antiviral benefit with cetylpyridinium chloride (CPC) through the destabilization of simplified SARS-CoV-2 lipid envelope models. Authors found that CPC, a cationic surfactant commonly used in mouthwashes ..
Feb 27
 Hup et al., Medical Science Monitor, doi:10.12659/MSM.950753 Efficacy of Mouthwashes Delivered via Dental Unit Waterlines in Reducing Aerosolized Surrogate SARS-CoV-2
In vitro study testing mouthwashes delivered through dental unit waterlines for reducing aerosolized surrogate SARS-CoV-2 (human coronavirus OC43). The study used suspension tests, carrier tests, and a novel 3D-printed aerosol model to ev..
Nov 7
2025
 Rösing et al., Brazilian Oral Research, doi:10.1590/1807-3107bor-2025.vol39.118 Extending regular oral hygiene reduces the incidence of upper respiratory symptoms
RCT 205 adults in Brazil showing reduced incidence and severity of upper respiratory symptoms with twice daily cetylpyridinium chloride (CPC) treatment. Participants were randomized to control (regular toothbrushing), gargling with 0.075%..
Sep 19
2025
 Ponphaiboon et al., MDPI AG, doi:10.20944/preprints202509.1594.v1 Efficacy of Nasal Spray, Mouth Spray, and Mouthwash Containing Limonene, Cetylpyridinium Chloride, and Monolaurin in COVID-19 Management: A Double-Blind, Randomized, Placebo-Controlled Trial
36% improved recovery (p=0.006). RCT 120 low-risk COVID-19 patients showing improved recovery with nasal and oral formulations containing cetylpyridinium chloride, D-limonene, and monolaurin (the nasal formulation contained D-limonene and cetylpyridinium chloride, while ..
Aug 8
2025
 Angjelova et al., Antibiotics, doi:10.3390/antibiotics14080815 Effects of Antiseptic Formulations on Oral Microbiota and Related Systemic Diseases: A Scoping Review
Review of oral antiseptic formulations and their effects on oral microbiota and systemic diseases. While antiseptics like chlorhexidine, essential oils, povidone-iodine, and cetylpyridinium chloride can effectively reduce pathogenic oral..
Jun 18
2025
 Thangamani et al., World Academy of Sciences Journal, doi:10.3892/wasj.2025.366 Rinsing away the threat: Antiviral mouthwashes and their efficacy
Review of antiviral mouthwashes and their efficacy against respiratory viruses, focusing on SARS-CoV-2. Authors examine povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), chlorhexidine (CHX), and phthalocyanine derivatives. PVP-I sh..
Mar 8
2025
 Ponphaiboon et al., Pharmaceutics, doi:10.3390/pharmaceutics17030349 In Vitro Development of Local Antiviral Formulations with Potent Virucidal Activity Against SARS-CoV-2 and Influenza Viruses
In vitro study showing potent virucidal activity of D-limonene (DLM), monolaurin (ML), and cetylpyridinium chloride (CPC) formulations against SARS-CoV-2 and influenza viruses. Authors developed two optimized formulations: an oral formula..
Feb 26
2025
 Muniz et al., PLOS ONE, doi:10.1371/journal.pone.0316807 Efficacy of regular gargling with a cetylpyridinium chloride plus zinc containing mouthwash can reduce upper respiratory symptoms
Non-COVID-19 specific RCT with 150 participants in Brazil showing reduced frequency (21.5% lower) and severity (11% lower) of upper respiratory symptoms with twice-daily gargling using a mouthwash containing 0.075% cetylpyridinium chlorid..
Dec 9
2024
 Graves et al., JDR Clinical & Translational Research, doi:10.1177/23800844241296840 A Cetylpyridinium Chloride Oral Rinse Reduces Salivary Viral Load in Randomized Controlled Trials
72% improved viral clearance (p=0.71). Two RCTs with a total of 247 recently diagnosed COVID-19 patients showing a significant reduction in salivary SARS-CoV-2 viral load 30 minutes after rinsing with a cetylpyridinium chloride (CPC) mouthwash compared to rinsing with saline o..
Oct 21
2024
 Okeke et al., Current Research in Microbial Sciences, doi:10.1016/j.crmicr.2024.100293 Antiseptics: An expeditious third force in the prevention and management of coronavirus diseases
Review of the use of nasopharyngeal/oropharyngeal virucidal agents such as povidone-iodine, chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and others for preventing the spread of COVID-19 and other coronavirus diseases. Autho..
Apr 25
2024
 Onozuka et al., BMC Oral Health, doi:10.1186/s12903-024-04246-1 Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial
RCT 90 low-risk asymptomatic to mildly symptomatic COVID-19 patients showing no significant difference in salivary viral load with cetylpyridinium chloride or on-demand aqueous chlorine dioxide mouthwash. Both treatments increased Ct valu..
Feb 19
2024
 Brito-Reia et al., Current Oral Health Reports, doi:10.1007/s40496-024-00368-1 Antiviral Mechanism and Clinical Benefits of Mouthwash Active Against SARS-CoV-2
Review of antiviral mechanisms and clinical benefits of mouthwashes for SARS-CoV-2, including chlorhexidine (CHX), cetylpyridinium chloride (CPC), ethyl lauroyl arginate (ELA), hydrogen peroxide (HP), povidone-iodine (PVP-I), and anionic..
Feb 16
2024
 Rius-Salvador et al., PLOS ONE, doi:10.1371/journal.pone.0297291 Cetylpyridinium chloride and chlorhexidine show antiviral activity against Influenza A virus and Respiratory Syncytial virus in vitro
In vitro study showing antiviral activity against influenza A virus and respiratory syncytial virus with cetylpyridinium chloride (CPC) and chlorhexidine (CHX). Authors found CPC and CHX decreased infectivity of both viruses by 90-99.9% d..
Dec 18
2023
 Bezinelli et al., PeerJ, doi:10.7717/peerj.15080 Reduction of SARS-CoV-2 viral load in saliva after rinsing with mouthwashes containing cetylpyridinium chloride: a randomized clinical study
RCT 95 hospitalized COVID-19 patients showing reduced salivary SARS-CoV-2 viral load after rinsing with cetylpyridinium chloride (CPC) or CPC plus zinc mouthwashes. CPC plus zinc mouthwash reduced viral load by 6.3-fold at 5 minutes, 3.6-..
Dec 7
2023
 Giulia et al., Journal of Clinical Periodontology, doi:10.1111/jcpe.13905 Eligibility and efficacy of a CPC‐ and CHX‐based antiviral mouthwash for the elimination of SARS‐CoV‐2 from the saliva: A randomized, double‐blind, controlled clinical trial
RCT 20 patients rinsing with CPC-CHX compared with 20 patients rinsing with water, showing no significant difference in short-term viral load via PCR and ELISA. Results are not clear. Figure 3 shows an increase in ELISA I/T between all ti..
Nov 30
2023
 Brookes et al., International Dental Journal, doi:10.1016/j.identj.2023.08.010 Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?
Review of the effects of commonly used mouthwashes on the oral microbiome, which includes bacteria, viruses, bacteriophages, and fungi. While certain mouthwashes have proven antimicrobial actions and clinical effectiveness, more recent me..
Nov 18
2023
 Gansky et al., NCT04409873 Antiseptic Mouthwash /​ Pre-Procedural Rinse on SARS-CoV-2 Load (COVID-19) (AMPoL)
60% improved recovery (p=1). Early terminated RCT with very limited information reported in the registry and only one patient showing symptoms. There is not enough information to assess the viral load results in the registry - the protocol indicates right-censoring f..
Oct 11
2023
 Sbricoli et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2023.09.003 Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis
Systematic review and network meta-analysis evaluating the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 viral load in saliva based on data from 14 randomized clinical trials and 21 in vitro studies. The study found that ..
Oct 11
2023
 Zhang et al., BMC Infectious Diseases, doi:10.1186/s12879-023-08669-z Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis
Systematic review and meta-analysis of 13 randomized controlled trials with a total of 832 participants analyzing the efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms in COVID-19 patients. Authors fou..
Aug 4
2023
 Perussolo et al., Scientific Reports, doi:10.1038/s41598-023-39308-x Efficacy of three antimicrobial mouthwashes in reducing SARS-CoV-2 viral load in the saliva of hospitalized patients: a randomized controlled pilot study
RCT 40 late stage (mean 8 days from onset) patients, showing no significant difference in short-term viral load measured by PCR with cetylpyridinium chloride mouthwash.
Jun 12
2023
 Ting et al., Biomedicines, doi:10.3390/biomedicines11061694 Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Systematic review of 14 RCTs, showing significant reductions in short-term viral load with mouth rinses cetylpyridinium chloride, β-cyclodextrin and citrox, hydrogen peroxide, chlorhexidine, povidone-iodine, hypochlorous acid, saline, and..
May 22
2023
 Rengifo et al., Revista Estomatologia, doi:10.25100/re.v31i1.12669 A Mouthwash with Cetylpyridinium Chloride is reducing salivary SARS-CoV-2 viral load in +COVID-19
83% improved viral clearance (p=0.06). RCT 23 patients in Colombia, showing improved viral clearance with cetylpyridinium chloride plus chlorhexidine mouthwash.
Mar 21
2023
 Bonn et al., Journal of Dental Research, doi:10.1177/00220345231156415 Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial
85% improved viral clearance (p=0.2). RCT 61 COVID+ patients showing improved reduction in viral infectivity with a mouthwash containing 0.05% cetylpyridinium chloride (CPC) and 0.05% chlorhexidine digluconate (CHX), compared to 0.9% NaCl. The study only analyzes short-term c..
Nov 28
2022
 Tarragó-Gil et al., Journal of Clinical Periodontology, doi:10.1111/jcpe.13746 Randomized clinical trial to assess the impact of oral intervention with cetylpyridinium chloride to reduce salivary SARS‐CoV‐2 viral load
80 patient RCT testing cetylpyridinium chloride (CPC) mouthwash, showing significantly increased detection of SARS-CoV-2 nucleocapsid protein, indicating viral lysis. CPC inactivates SARS-CoV-2 by degrading its membrane, exposing the nucl..
Jul 31
2022
 Ting et al., International Journal of Translational Medicine, doi:10.3390/ijtm2030030 The In Vitro Virucidal Effects of Mouthwashes on SARS-CoV-2
Review of in vitro studies of mouthwashes, showing antiviral activity for SARS-CoV-2 with many compounds including PVP-I, cetylpyridinium chloride, chlorohexidine gluconate, dequalinium chloride, benzalkonium chloride, anionic phthalocyan..
Jul 27
2022
 Sánchez Barrueco et al., Emerging Microbes & Infections, doi:10.1080/22221751.2022.2098059 Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial
73% improved viral load. RCT hospitalized patients testing viral load shortly after a single mouthwash with PVP-I, hydrogen peroxide, cetylpyridinium chloride, chlorhexidine, and water. For CPC, there was significantly lower culture-based viral load one hour late..
Jun 30
2022
 Saud et al., Journal of Lipid Research, doi:10.1016/j.jlr.2022.100208 The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses
In vitro study and small RCT of mouthwashes. The in vitro study characterized the lipid composition of the SARS-CoV-2 envelope and showed that oral rinses containing lipid-disrupting chemicals can reduce infectivity, meeting European viru..
Jun 21
2022
 Alemany et al., Journal of Dental Research, doi:10.1177/00220345221102310 Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial
118 patient RCT testing cetylpyridinium chloride (CPC) mouthwash, showing significantly increased detection of SARS-CoV-2 nucleocapsid protein, indicating viral lysis. CPC inactivates SARS-CoV-2 by degrading its membrane, exposing the nuc..
Feb 28
2022
 Xie et al., NCT04931004 Oral Rinse to Reduced Expelled Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During COVID-19 Infection
Estimated 90 patient cetylpyridinium chloride early treatment RCT with results not reported over 4 years after estimated completion.
Jan 28
2022
 Akash et al., Frontiers in Drug Delivery, doi:10.3389/fddev.2023.1164671 (date from preprint) On a model-based approach to improve intranasal spray targeting for respiratory viral infections
Computational fluid dynamics study of nasal spray administration in 2 subjects showing 100x improvement in nasopharyngeal drug delivery using a new spray placement protocol. The study also found the optimal droplet size range for nasophar..
Dec 14
2020
 Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9 Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore
Small mouthwash RCT with 4 PVP-I patients and 2 water patients concluding that PVP-I may have a sustained effect on reducing the salivary SARS-CoV-2 level in COVID-19 patients. ISRCTN95933274.