I've heard that "magic mouthwash" might help with mouth sores from chemotherapy. What is it?
Answer From Karthik Giridhar, M.D.
Magic mouthwash is the term given to a solution used to treat mouth sores caused by some forms of chemotherapy and radiation therapy.
Mouth sores (oral mucositis) can be extremely painful and can result in an inability to eat, speak or swallow.
Magic mouthwash doesn't have a standard formula, but it usually contains at least three of these basic ingredients:
- An antihistamine or anticholinergic agent, which may help relieve pain
- A local anesthetic to reduce pain and discomfort
- An antacid that helps ensure the other ingredients adequately coat the inside of your mouth
- An antifungal to reduce fungal growth
- A corticosteroid to treat inflammation
- An antibiotic to kill bacteria around the sore
Most formulations of magic mouthwash are intended to be used every four to six hours, and to be held in your mouth for one to two minutes before being either spit out or swallowed. It's recommended that you don't eat or drink for 30 minutes after using magic mouthwash so that the medicine has time to produce an effect.
Side effects of magic mouthwash may include problems with taste, a burning or tingling sensation in the mouth, drowsiness, constipation, diarrhea, and nausea.
Magic mouthwash may provide some relief, but it's unclear how effective it is. Studies of magic mouthwash have had conflicting results. Some have found no benefit. One recent study found that it was better at relieving pain than was a flavored water mouthwash for mouth sores in people receiving radiation to the head and neck.
Since there isn't a standard formula for the solution, it's hard to draw conclusions across the studies. Some medical organizations don't recommend magic mouthwash because there isn't enough evidence that it works.
There are several versions of magic mouthwash. Some are available in pre-measured kits that can be mixed together by pharmacists, while others are prepared to order by a pharmacist. If it's determined that magic mouthwash might be helpful, your doctor will write a prescription.
Talk with your doctor about your specific cancer treatments and which solutions for coping with mouth sores might be best for you.
Nov. 23, 2019
Karthik Giridhar, M.D.
See more Expert Answers
- Sio TT, et al. Effect of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash vs placebo on radiotherapy-related oral mucositis pain. JAMA. 2019; doi:10.1001/jama.2019.3504.
- Magic mouthwash: An update. Pharmacist's Letter. https://pharmacist.therapeuticresearch.com/Content/Detail-Documents/PRL/2009/Nov/Magic-Mouthwash-An-Update-251103#. Accessed Oct. 28, 2019.
- Lalla VR, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014; doi:10.1002/cncr.28592.
- Clarkson JE, et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database of Systematic Reviews. 2010; doi:10.1002/14651858.CD001973.pub4.
- McElhiney LF. Magic mouthwashes: A literature review and discussion of common compositions. International Journal of Pharmaceutical Compounding. 2011;15:377.
- Magic mouthwash. American Academy of Nursing. https://www.aannet.org/initiatives/choosing-wisely/choosing-wisely---magic-mouthwash. Accessed Oct. 28, 2019.
- Giridhar KV (expert opinion). Mayo Clinic. Nov. 11, 2019.