What are the ingredients of magic mouthwash (mouth rinse)?

From the Guidelines

Magic mouthwash is a compounded medication that typically contains equal parts of diphenhydramine, antacid, and viscous lidocaine. The ingredients of magic mouthwash are designed to provide pain relief, antihistamine effects, and coating protection to soothe irritated tissues in the mouth and throat. According to the most recent guidelines, specifically the nccn guidelines® insights: management of immunotherapy-related toxicities, version 2.2024 1, the formulation of magic mouthwash includes equal parts of diphenhydramine, antacid, and viscous lidocaine.

Some key points to consider when using magic mouthwash include:

• The medication should be used every 4-6 hours as needed
• Patients should avoid eating or drinking for 30 minutes after use to maximize effectiveness
• The specific ingredients may vary depending on the prescribing healthcare provider and the patient's needs
• Other ingredients like nystatin, hydrocortisone, or antibiotics may be added to the formulation in some cases

The use of magic mouthwash is recommended for the management of persistent mucositis or if the oropharynx/larynx is involved, especially if there is moderate or severe inflammation 1. It is essential to follow the instructions provided by the healthcare provider and to use the medication as directed to ensure optimal effectiveness and minimize potential side effects.

From the Research

Ingredients of Magic Mouthwash

The ingredients of magic mouthwash are not standardized, but some common components include:

• Diphenhydramine 2
• Viscous lidocaine 2, 3
• Magnesium aluminum hydroxide 4, 2, 3
• Nystatin 2
• Corticosteroids 2

Variations in Formulation

Different institutions and studies have used varying formulations for magic mouthwash, with some including additional ingredients such as:

• Lidocaine 4
• Morphine is sometimes used as an alternative to magic mouthwash, particularly for patients who do not respond to traditional magic mouthwash formulations 5, 3

Administration and Usage

The administration and usage of magic mouthwash vary, but common practices include:

• Administering the mouthwash every 4 hours or every 6 hours 2
• Using 10 ml of the solution for every 3 hours, six times a day, for 6 days 3