Magic Mouthwash

Magic mouthwash is a compounded prescription mouthwash used to treat mouth sores, also known as oral mucositis. These mouth sores are commonly caused by cancer chemotherapy and radiation therapy, though they can also result from oral surgery, thrush, or other conditions.

Since mouth sores can be very painful and disrupt eating and drinking, effective treatment is essential for patient comfort and nutrition.

The active ingredients vary depending on the degree of ulceration and the symptoms being treated. Your doctor and our compounding pharmacists will determine the best combination for you.

Common Magic Mouthwash formula:
Diphenhydramine 0.075%, hydrocortisone 0.125%, nystatin 7500u/mL, and lidocaine 0.4%

Super Magic Mouthwash:
Diphenhydramine 0.125%, dexamethasone 0.00033%, tetracycline 1.25%, and lidocaine 1%

Pink Lady:
Xylocaine Viscous 2% mixed with Maalox (1:1 ratio)

Modified Pink Lady:
Xylocaine Viscous 2%, Maalox, and Benadryl Elixir (1:1:1 ratio)

Prescription mouthwashes may include combinations of:

• Antihistamines (diphenhydramine, chlorpheniramine) — create an anesthetic effect
• Corticosteroids (hydrocortisone, dexamethasone, clobetasol) — reduce inflammation and aid healing
• Antibiotics (tetracycline) — prevent bacterial infections
• Antifungals (nystatin, clotrimazole) — prevent fungal infections
• Topical anesthetics (tetracaine, lidocaine) — reduce pain and irritation
• Liquid antacid — helps the medication coat the mouth tissues
• Sucralfate — provides a protective coating and promotes healing
• Gabapentin — reduces pain and burning

Always follow the specific directions prescribed by your doctor.

Generally, 5–15 mL is swished in the mouth for 1–2 minutes, two to four times per day. Depending on the formulation:

• Swish and spit — most common
• Swish and swallow — if treating esophageal sores (only if directed by your doctor)

Do not swallow unless instructed. Measuring syringes are provided to help you measure your dose accurately.