Magic mouthwash recipe, cost and ingredients to treat chemotherapy mouth sores and oral mucositis

Magic mouthwash is the name given to a liquid solution used as oral rinse to treat mouth sores (oral mucositis) due to chemotherapy and radiation therapy. Also known as “Miracle mouthwash”, it helps to relieve painful mouth sores due to oral ulcers and upper throat irritation. 

Miracle mouthwash for oral mucositis

Oral mucositis is a painful inflammation of the mouth tissue. It may lead to a wide range of symptoms:

• Mouth sores.
• Throat irritation.
• Pain on the gums or tongue.
• Swallowing eating and even talking difficulty.

Magic mouthwash for chemo patients

Chemo patients exposed to radiation therapy due to head or neck cancer are at high risk to develop oral mucositis. Symptoms are more severe than simple pain in the mouth. Many people report a strange taste change while eating. In many cases it causes decreased appetite and weight loss.

Other oral mucositis causes include: mouth infection, poor oral hygiene, dehydration, oxygen therapy, abuse of alcohol and/or tobacco.

Magic mouthwash for oral thrush

Oral thrush or candidiasis is a yeast infection causing white lesions on tongue or inner cheeks. Babies and older adults are the most affected because of reduced immunity.

The most common oral thrush symptoms include:

• Lesions with cheese-like appearance.
• Soreness, burning and redness.
• Taste loss.

In chemo patients with weakened immune system symptoms are more severe.

Three main magic mouthwash ingredients

The most common magic mouthwash recipe includes three ingredients:

• An antihistamine is included to reduce inflammation and pain. Its commercial name is Benadryl.
• An anesthetic: for numbing the painful area in the mouth or throat. The most used is called Lidocaine and it needs the doctor prescription.
• A coating agent: commercially known as Maalox and Mylanta. They are included in the magic mouthwash recipe because make the active ingredients to remain longer on the open sores and affected areas of the mouth and throat.

Example of magic mouthwash prescription:

• Viscous lidocaine 2%.
• Maalox or Mylanta.
• Diphenhydramine 12.5 mg each 5 ml.

The magic mouthwash ingredients listed above should be mixed in equal parts (1:1:1).

Many articles and studies report the three ingredients as “ben/lid/maal” standing for Benadryl Lidocaine Maalox.

The ingredients in magic mouthwash recipe may vary from brand to brand or based on your specific prescription.

Radiation therapy and/or chemotherapy may cause different side effects. Each patient had his/her own tolerance level. That’s why the prescription may include or exclude certain ingredients.

Here is a brief list of most common magic mouthwash ingredients your pharmacist should include in the formula based on the medical prescription:

• Tetracycline: is an antibiotic to kill bacteria that cause the oral infection.
• Diphenhydramine: has the scope to reduce pain and discomfort.
• Nystatin: an antifungal to effectively fight oral thrush (candidiasis).
• Hydrocortisone: a corticosteroid to heal inflammation.
• Maalox or Mylanta: ensure other ingredients effectively coat the oral cavity and the upper part of the throat.

Magic mouthwash dosage

For prescribed product.

The most common magic mouthwash dosage for adults is 15 ml (two teaspoon) every 4–6 hours.
In alternative you should follow your dentist directions.

For over the counter product (Otc).

For adults and children over 12 years of age, use it every 3 hours or as described in the product label. Do not use the rinse more than 8 times per day.

Directions

• Shake well before using the compounded oral rinse.
• Prescribed formula or over the counter magic mouthwash can be used as regular oral rinse.
• Swish the compounded mixture around in your mouth, gargle to relieve throat irritation and spit it.
• The rinsing procedure shouldn’t last more than 15 seconds to 2 minutes depending on the formula.
• In case of esophagitis, your doctor may advise you to swallow magic mouthwash. The scope is to gently numb that area and give you temporary pain relief.
• If the taste is unpleasant or too strong, dilute the mouthwash dosage with water.
• After rinsing your oral cavity, wait for 30 to 40 minutes before to eat or drink again. This avoids washing away the active ingredients from the sore areas.

Magic mouthwash expiration date and storage

The oncology mouth rinse should be stored at room temperature 20° to 25°C (68° to 77°F).

The expiration date is commonly indicated as beyond-use dating (BUD). The expiration date of mouth rinse with lidocaine should be 21 days maximum. For more info, feel free to read this study published by NCBI website.

In order to avoid unwanted side effects, Dottox.com staff recommends you to ask your pharmacist more info about the date of expiration. You can find it on the prescribed mouth rinse bottle. Over the counter products contains the indication label in the box.

Do not use the rinse containing tetracycline beyond the expiration date. Antibiotic degradation is highly dangerous for your health.

Is magic mouthwash safe during pregnancy and breastfeeding?

During Pregnancy

During pregnancy it is better to avoid Miracle mouthwash because of category D antibiotics like tetracycline.

While breastfeeding

Benadryl is not indicated while breastfeeding.
Lidocaine and tetracycline pass in the breast milk. Although lidocaine is not dangerous for toddlers, it makes breast milk to taste bitter.

Miracle mouthwash for kids and toddlers

There are not enough available indications for miracle mouthwash pediatric dosage. USP (United States Pharmacopeia) recommends not to exceed 3 mg / kg of 2% lidocaine per dose in topical use.

Parents should wait at least 2 hours between one administration and the next.

Some pediatric formula may include artificial or natural flavors. It makes the taste of topical rinsing more enjoyable for kids.

Tetracycline in children younger than 8 years may cause two main side effects:

• Teeth discoloration.
• Abnormal bone growing.

Side effects

1. Numb your mouth especially your tongue. If that happen, pay attention not to bite the inside part of your cheek.
2. Burning mouth. Usually, the burning feeling disappears after a few minutes).
3. Unpleasant taste (metallic feeling).
4. Dizziness and headache.
5. Swallowing magic mouthwash may cause you nausea, constipation, or drowsiness.
6. If the taste of the oral rinse or the burning mouth sensation is too strong, talk to your doctor. He/she will change or modify the formula.

Cost without insurance

How much does magic mouthwash cost without insurance? This is the one-million dollar question!

Since there are several recipes containing different ingredients, it is very difficult to indicate a single price.

Many patients reported a cost range from $45 to $84 for dentist prescribed mouthwash that was 8 oz.

Homemade formulas are cheaper (about $15 to $40). However they cannot contain active ingredients like lidocaine, antibiotics, antifungal or corticosteroid.

Insurance coverage

The oncology oral rinses used to relieve chemotherapy mouth sores and tongue ulcers are not covered by health insurance. The reason is because they are compounded medication. Nevertheless some of the prescribed active elements may be covered by the insurance. It depends on your own plan.

What to do if some of prescribed drugs are not covered by your insurance. Ask your doctor to replace them with those accepted by your insurance company’s drug formulary.

Top 3 magic mouthwash brands and manufacturers

Here is a brief list of the best magic mouthwash brands and manufacturers you can find by online store like Amazon and Walgreens:

1. Ulcer Ease – Anesthetic Oral Rinse for Relief of Mouth Sores and Throat Irritations (Price: $17.38);
2. Prevention Oncology Mouth Rinse (Price: $17.95);
3. Uncle Harry’s Natural Alkaline Miracle Mouthwash (Price: $39.99).

Alternatives

chlorhexidine gluconate oral rinse.

Final words

Miracle mouthwash may sound a silly name, but this oral rinse is made up of powerful drugs. We highly suggest you to follow your doctor instructions or the label indication in the product box.

If you are a chemo patient, your oncologist will help you in case of oral mucositis. Stay away from DIY or homemade recipes. They do not contain the right ingredients and may cause severe side effects.

If miracle mouthwash is not working for you, do not overdose. Instead, let it know to your oncologist so he can prescribe you a different treatment for oral mucositis and mouth sores.