What is the composition and use of magic mouthwash (mouth rinse)?

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Last updated: March 28, 2025 • View editorial policy

From the Guidelines

The composition of magic mouthwash, also known as prophylactic mouth rinses, can vary significantly, but often includes ingredients such as antibiotics, antihistamines, antifungals, corticosteroids, and antacids, with bland mouth rinses using sodium bicarbonate or the NSAID benzydamine being recommended due to limited evidence supporting the effectiveness of other ingredients 1. The use of magic mouthwash is primarily for the prevention and treatment of mucositis, pharyngitis, and esophagitis, which can be caused by certain cancer treatments, such as systemic therapy, head and neck radiation, or hematopoietic stem cell transplant.

  • Key ingredients that may be included in magic mouthwash formulations are: + Antibiotics + Antihistamines + Antifungals + Corticosteroids + Antacids + Sodium bicarbonate + Benzydamine, an NSAID with some evidence supporting its use in oral rinses for mucositis prevention and treatment 1
  • Local anesthetics, such as lidocaine, may also be used to treat mucositis, either as a component of a mouth rinse or separately, in a liquid or gel formulation. The effectiveness of magic mouthwash ingredients in preventing or treating mucositis varies, and due to this, bland mouth rinses using ingredients such as sodium bicarbonate are often recommended 1.
  • To use magic mouthwash, patients typically swish the rinse in their mouth for 1-2 minutes before spitting it out or swallowing as directed, usually every 4-6 hours as needed. It is essential to note that magic mouthwash requires a prescription and should be used as directed by a healthcare provider, as overuse can mask symptoms of more serious conditions requiring different treatment.

From the Research

Composition of Magic Mouthwash

  • The composition of magic mouthwash may vary, but common ingredients include: + Diphenhydramine 2 + Viscous lidocaine 2, 3 + Magnesium hydroxide/aluminum hydroxide 2, 3 + Nystatin 2, 4 + Corticosteroids 2
  • The specific formulation of magic mouthwash can differ between institutions, with some using a combination of these ingredients 2

Use of Magic Mouthwash

  • Magic mouthwash is used to manage oral mucositis, a common side effect of cancer treatment 3, 2, 5, 6
  • It is typically administered every 4-6 hours, with patients receiving 10 ml of the solution for every 3 hours, six times a day, for 6 days 3
  • The effectiveness of magic mouthwash in reducing the severity of oral mucositis has been evaluated in several studies, with mixed results 3, 2, 6
  • Topical treatments, including magic mouthwash, can help alleviate and prevent oral mucositis by modulating oral bacteria and replacing saliva 5

References

Guideline

adult cancer pain, version 3.2019, nccn clinical practice guidelines in oncology.

Journal of the National Comprehensive Cancer Network : JNCCN, 2019

Research

Survey of topical oral solutions for the treatment of chemo-induced oral mucositis.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 2005

Research

Nystatin and lidocaine pastilles for the local treatment of oral mucositis.

Pharmaceutical development and technology, 2017

Research

TOPICAL AGENTS FOR THE PREVENTION AND TREATMENT OF ORAL MUCOSITIS.

Wiadomosci lekarskie (Warsaw, Poland : 1960), 2022

Research

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2013

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.