Make Magic Mouthwash

“Magic Mouthwash” is one name for a mouthwash and gargle used to treat ailments from canker sores to sore throats, but particularly the painful oral mucositis (ulcers in the mouth and other mucous membranes) caused by certain kinds of radiation and chemotherapy for cancer. It is usually mixed by a pharmacy with a prescription from a doctor. While many insurance companies won’t cover the medication because it contains over-the-counter ingredients, your doctor should be happy to give you a prescription. Magic mouthwash is also easy and fairly inexpensive to make on your own.

Steps

Getting Magic Mouthwash by Prescription

  1. Talk to your doctor. Radiation and chemotherapy treatments for cancer often cause a side effect called oral mucositis. This is a painful and sometimes debilitating side effect, which causes soreness, swelling, and sensitivity in the mouth, sores on the mouth, gums, or tongue, and difficulty swallowing or talking. It can make it hard or even impossible to eat.[1]
    • Ask your doctor whether a magic mouthwash could help to relieve some of your discomfort. If she agrees, she will write you a prescription.
  2. Buy a pre-measured kit. Your doctor may write you a prescription for a pre-measured kit of magic mouthwash, which you will need to have filled at a pharmacy. First Mouthwash BLM or First BXM Mouthwash are two commonly stocked compounding kits. They contain a pain killer, usually “viscous lidocaine”; an anti-acid or coating agent like Maalox (this will coat the lining of your mouth); and an anti-inflammatory agent like Benadryl.[2]
    • The idea of the mixture is to provide pain relief (anesthetic) while killing bacteria, soothing the mouth, and coating its lining with an antacid. Some formulas also contain Nystatin, a drug that kills fungus and is used to treat conditions like oral thrush.[3]
    • You pharmacist will take the kit and mix it for you. Note that these formulas are not FDA approved.
  3. Have one prepared to order by your pharmacist. Another option is for your pharmacist to prepare you a made-to-order magic mouthwash. There are many recipes with different names, including “Duke’s Magic Mouthwash,” “Radiotherapy Mixture,” “Miracle Mouthwash,” and others. However, all follow the basic recipe: ingredients that will relieve pain, relieve inflammation, and coat your mouth.[4]

Making your own Magic Mouthwash

  1. Get a prescription for 2% Viscous Lidocaine. Lidocaine is a common treatment for mouth sores caused by cancer therapies. Many doctors will write you a prescription for this fairly readily, as it is not a controlled substance and has few negative side effects in adults.[5] Ask for a 100 mL vial. Viscous lidocaine is also fairly cheap and covered by most insurance plans.
    • Get your prescription filled by a pharmacist. Lidocaine will reduce the feeling in your mouth, possibly making it difficult to chew, so avoid eating for at least one hour after using the drug.
    • Lidocaine may not be safe for children under age 3, so make sure to keep the contain tightly closed and stored where children cannot access it.[6]
  2. Buy Diphenhydramine and liquid antacid. The common brand name for the first medication is Benadryl. You can find this easily at drug stores and it is often available in a generic or store brand. Make sure that you are purchasing the liquid (children’s) kind. One bottle of at least 100mL will be enough.[7]
    • Get a bottle of liquid antacid, as well, like Mylanta or Maalox. Again, you’ll be able to find these at any drug store, usually in a generic or store brand. A bottle of 100mL is again enough.[8]
    • You’ll see that these ingredients are fairly cheap. A vial of lidocaine will cost you about $20 and may or may not be covered by insurance.[9] Children’s Benadryl and Maalox will cost about $10 each.
  3. Mix ingredients in a 1:1:1 ratio. Viscous lidocaine usually comes in a 100mL bottle. It is easier to use the entire bottle in a batch, since the medication is thick and difficult to measure. Mix 100mL of each of the other two ingredients with the lidocaine.
    • For the last two ingredients, measure using a sterile medical measuring cup or, if you have purchased the proper amount in a bottle, use the entire bottle. Never measure medicines with household utensils. They are not always standard size and could give you the wrong dosage.[10]
    • Now, shake the solution until it appears uniform. Once you’ve done this, the mouthwash is ready to use.
    • Be sure to follow your doctor’s advice on dosage. Since this medication is used to treat a wide variety of conditions, your physician will give your instructions based on the specific treatment you are seeking. Usually doctors recommend that you use it once every four to six hours, for two minutes at a time.[11]



Sources and Citations

  1. ↑ http://www.oralcancerfoundation.org/complications/mucositis.php
  2. ↑ file:///C:/Users/RSW101-PAF/Downloads/230703.1963.pdf
  3. ↑ http://www.mayoclinic.org/tests-procedures/chemotherapy/expert-answers/magic-mouthwash/faq-20058071
  4. ↑ http://www.drotterholt.com/magicmouthwash.html
  5. ↑ https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682701.html
  6. ↑ http://www.medicinenet.com/lidocaine_viscous/page2.htm
  7. ↑ http://www.drugs.com/diphenhydramine.html
  8. ↑ http://pharmacistsletter.therapeuticresearch.com/pl/ArticleDD.aspx?nidchk=1&cs=&s=PL&pt=5&fpt=2&dd=230703&pb=PL
  9. ↑ http://www.drugs.com/price-guide/lidocaine-viscous
  10. ↑ http://www.safemedication.com/safemed/MedicationTipsTools/HowtoAdminister/How-to-Use-Liquid-Medications/Measuring-Devices
  11. ↑ [http://www.mayoclinic.org/tests-procedures/chemotherapy/expert-answers/magic-mouthwash/faq-20058071

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