Magic Mouthwash and Mouth Sores

A common side effect of breast cancer treatment is mouth and throat sores, called mucositis. Mouth sores look like ulcers and can be red, swollen, and painful. They can make it hard to eat, drink, chew, swallow, and talk. Chemotherapy, radiation, and some targeted therapies for breast cancer can all cause mouth and throat sores. 

Some people use magic mouthwash for mouth sores. Magic mouthwash is a liquid you rinse your mouth with, just like normal mouthwash. But instead of fighting plaque, magic mouthwash eases pain from mouth sores and similar conditions.

Magic mouthwash is a compounded medication. This means a pharmacist mixes together the ingredients according to your health care provider’s directions. They choose ingredients specifically to match your needs. There are no brands of magic mouthwash, and it does not come pre-packaged. There are at least 20 formulations of magic mouthwash that doctors prescribe.

Because of this, the ingredients in magic mouthwash can vary. Talk to your doctor about which formula would work best for you.

The following ingredients are commonly found in magic mouthwash.

This type of medication is most known for treating allergies. In magic mouthwash, it reduces oral swelling. A common antihistamine used in magic mouthwash is diphenhydramine, also known as Benadryl. It can cause drowsiness as a side effect.

Antacids are usually used to reduce stomach acid, indigestion, and heartburn. In magic mouthwash, antacids help the other drugs coat the mouth. Common antacids used in magic mouthwash are magnesium hydroxide and aluminium hydroxide.

This local anesthetic numbs the nerves in the mouth to reduce pain. Lidocaine is the most common numbing agent used in magic mouthwash, but the rinse may include others too.

This category of drugs is used to treat a variety of inflammatory conditions, including inflammation from mouth and throat sores. A common corticosteroid found in magic mouthwash is dexamethasone. A mouthwash consisting only of dexamethasone is often prescribed for patients taking the oral cancer drug everolimus (Afinitor).

Sometimes cancer treatment can directly cause mouth sores. But sometimes it damages the mouth in a way that allows for bacterial and fungal infections. So, some magic mouthwashes contain antibiotics and antifungals to kill bacteria or fungi that may be causing the sores. A common antifungal used in magic mouthwash is nystatin, and a common antibiotic is tetracycline.

Magic mouthwash is commonly used to ease pain from mouth and throat sores caused by cancer treatment, but it can also relieve pain from mouth sores caused by:

• Sponsor Message

  oral thrush: A fungal infection caused by too much Candida albicans in the mouth. Oral thrush is more likely in people with a weakened immune system, including those with cancer.

• Sponsor Message

  infection: An overgrowth of harmful bacteria or a virus can cause mouth sores. Often, the bacteria that causes mouth sores is streptococcus, the same type that causes strep throat. Many viruses can cause mouth sores or cold sores, including the herpes virus.

• Sponsor Message

  canker sores: These mouth sores have many causes, including stress and injury to the inside of the mouth. Often on the tongue or inside of the cheeks, they also are called aphthous ulcers. 

• Sponsor Message

  Behcet’s disease: A rare disorder in which inflammation of blood vessels in the mouth causes sores. 

There is not enough evidence to prove that magic mouthwash eases pain from mouth sores more than other mouth rinses, such as a salt and baking soda rinse. Not many studies have looked into it. One reason why is that it’s hard to study magic mouthwash because there’s no standard formula.

Scientists who have investigated it have found mixed results. Because of this, the International Society of Oral Oncology does not recommend magic mouthwash for mouth sores caused by cancer treatment. Still, many oncologists prescribe it.

Magic mouthwash usually requires a prescription because it contains a mix of over-the-counter and prescription drugs. Sometimes a provider will give you instructions to make your own magic mouthwash using only over-the-counter ingredients.

Each formulation of magic mouthwash has a different price because it includes different ingredients. In general, a bottle costs around $50. Many insurance companies do not cover compounded medicines, including magic mouthwash.

Just like there are no standard ingredients in magic mouthwash, instructions can also vary. Be sure to follow the instructions your provider gives you. They may say how much magic mouthwash to use and how often.

Generally, you will swish and gargle a mouthful of magic mouthwash for one to two minutes every four to six hours. Your instructions may say to spit, or they may say to swallow if you have sores in your throat. Only swallow the rinse if your instructions say to. You may need to avoid eating or drinking for a period of time afterward — a half hour is common.

If you have any questions about how to use the magic mouthwash you are prescribed, ask your pharmacist or healthcare provider.

Depending on what ingredients are in your magic mouthwash, they may cause side effects like:

• Sponsor Message

  numbness or tingling of the mouth

• Sponsor Message

  sleepiness

• Sponsor Message

  nausea

• Sponsor Message

  diarrhea

• Sponsor Message

  constipation

Swallowing magic mouthwash when your instructions say to spit it out may cause other unwanted side effects, but it’s unlikely to seriously harm you. Similarly, swallowing more magic mouthwash than is recommended may raise the risk of side effects.

Your healthcare provider may give you instructions on how to make your own magic mouthwash with over-the-counter ingredients. This is safe so long as you follow the directions carefully. Your provider may have you do this if you can’t afford prescription medication, or if you don’t have access to a pharmacy that makes compounded medicine.

Without a doctor’s instructions, you shouldn’t try to make your own magic mouthwash. It won’t be possible to make it with prescription medications, of course, since you won’t be able to get them. But you shouldn’t try with over-the-counter ingredients, either, because it can be hard to get the dosing of ingredients right, and using the wrong mix of ingredients could be ineffective or dangerous to your health.