I've heard that "magic mouthwash" might help with mouth sores from chemotherapy. What is it?
Answer From Timothy J. Moynihan, M.D.
Magic mouthwash is the term given to a solution used to treat mouth sores (oral mucositis) caused by some forms of chemotherapy and radiation therapy.
Oral mucositis can be extremely painful and can result in an inability to eat, speak or swallow. Magic mouthwash may provide some relief, but it's unclear how effective it is. That's because of the lack of standardization in the formulations of mouthwash, and poorly designed studies done to gather data.
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.
Magic mouthwash usually contains at least three of these basic ingredients:
- An antibiotic to kill bacteria around the sore
- An antihistamine or local anesthetic to reduce pain and discomfort
- An antifungal to reduce fungal growth
- A corticosteroid to treat inflammation
- An antacid that helps ensure the other ingredients adequately coat the inside of your mouth
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.
In addition to magic mouthwash, medications and other treatments may help relieve your discomfort. For example, researchers found that an anti-inflammatory mouthwash helps reduce the risk of mouth sores in people taking the targeted therapy drug everolimus (Afinitor).
Talk with your doctor about your specific cancer treatments and which solutions for coping with mouth sores might be best for you.
Nov. 02, 2018
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- Lalla VR, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120:1453.
- Clarkson JE, et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001973.pub4/abstract. Accessed Nov. 20, 2017.
- McElhiney LF. Magic mouthwashes: A literature review and discussion of common compositions. International Journal of Pharmaceutical Compounding. 2011;15:377.
- Rugo HS, et al. Prevention of everolimus-related stomatitis in women with hormone receptor-positive, HER2-negative metastatic breast cancer using dexamethasone mouthwash (SWISH): A single-arm, phase 2 trial. The Lancet Oncology. 2017;18:654.