"Duke's Magic Mouthwash": contains: Nystatin, Hydrocortisone, Diphenhydramine "Powell's Suspension": contains: Nystatin, Hydrocortisone, Tetracycline, diphenhydramine "Stomafate suspension (Methodist standard)": contains: Sucralfate, water, diphenhydramine, Maalox "Mary's Magic Potion" "Benacort-Tetrastat” contains: Tetracycline, Nystatin powder, Diphenhydramine, Hydrocortisone Weisman's Philadelphia Mouthwash" contains: Maalox, lidocaine, diphenhydramine (ratio of 3:3:1) Here are some other mouthwashes sometimes referenced, but are lesser known and don't have the measurements listed: (more convenient easier billing higher cost less compounding flexibility)įIRST Kits Mouthwash (diphenhydramine, Maalox, simethicone, lidocaine) Premade compounding kits from AzurityPharma: Sucralfate may block absorption of other drugs and therefore do not take sucralfate within 2 hours of other enteral medications. Sucralfate tablets are generally less expensive and more readily available, but unless crushed and suspended, taken as a pill, it would not treat proximal to the stomach. May be swallowed for pharyngeal or esophageal involvement. Note: Sucralfate works by making a protective coating over a mucosal wound. Sig: swish and spit 10 mL after meals and before bed (or four times a day). Note: Long-term (usually longer than 2 week) use of chlorhexidine may discolor the teeth brown or yellow. Swabbing this rinse on oral surfaces in an incapacitated patient is also sometimes performed.
Sig: swish and SPIT 15 mL after meals and before bed (or four times a day). Sig: Rinse, gargle, and spit after meals and before bed as needed. Note: tetracycline and doxycycline are relatively contraindicated in children under 8 years of age due to tooth enamel hypolasia and discoloration. May be swallowed for pharyngeal or esophageal involvement, but prescriber should consider systemic dosing. Sig: Swish thoroughly, gargle, and spit one teaspoonful (5 mL) after meals and before bed. Magic Mouthwash Recipe 2 (also called "Xyloxadryl," "BMX," or “Radiotherapy Mixture”)ħ0 mL Maalox (do not substitute Kaopectate)ħ0 mL diphenhydramine (Benadryl) (of the elixir, which is 12.5 mg per 5 mL)ħ5 mL Maalox (do not substitute Kaopectate)ģ8 mL diphenhydramine (Benadryl) 12.5 mg per 5 ml elixirĥ0 mL sucralfate (Carafate) 1 gm per 10 mlġ00 mL dexamethasone (of the elixir, which is 0.5 mg per 5 mL)Ħ0 mL nystatin (100,000 U/5 mL) suspensionġ00 mL diphenhydramine (Benadryl) (of the elixir, which is 12.5 mg per 5 mL)ġ500 mg tetracycline powder (contents of 3 capsules tetracycline, 500 mg each) Note: may substitute 3 capsules of doxycycline, 100 mg each. Oral, pharyngeal, and/or laryngeal numbness increases risk for aspiration, and therefore I tell my patients to use this after eating or drinking, not before, which may seem counterintuitive. May be swallowed if the pharynx or esophagus is involved, but prescriber should consider systemic dosing as well as precautions against alimentation while the pharynx and larynx are numb.
Additionally, care may be needed to avoid treating symptoms only while an underlying process progresses.ĥ0 mL diphenhydramine (Benadryl) at 12.5 mg per 5 ml elixirĥ0 mL nystatin (100,000U per 5 mL) suspensionĥ0 mL prednisolone at 15mg per 5ml solution The term “stomatitis cocktail” is also used with the same meaning as “magic mouthwash.” Downsides of using magic mouthwash include potential unnecessary medication use, the cost (which may be significant given frequent need for a compounding pharmacy and multiple ingredients), as well as non-specificity of the term “magic mouthwash,” leading to potential ambiguity when communicating prior therapies to a physician. The following is not medical advice, but a compilation of some reported recipes.
#Swish and swallow trial
Different mixtures may be used depending on the intended effects, though a trial of a magic mouthwash is sometimes used for a broad treatment strategy without necessarily having a specific diagnosis confirmed. Magic Mouthwash formulas The term “magic mouthwash” has no single defined composition, but is a general phrase used to reference a soothing or therapeutic oral rinse of multiple ingredients.
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