Magic mouthwash is a medicated mouthwash to treat oral (mouth) mucositis, a condition caused by cancer treatment. The effectiveness of magic mouthwash depends on the type of mouthwash used and the type of sores an individual has.

Magic mouthwash is a medicated mix in liquid form. It’s a common treatment for a sore mouth. You may get mouth sores or blisters because of cancer treatments or an infection. This condition is called oral (mouth) mucositis.

Magic mouthwash goes by a variety of names, including:

  • miracle mouthwash
  • mixed medicated mouthwash
  • Duke’s magic mouthwash
  • Kaiser’s magic mouthwash
  • Mary’s magic mouthwash

There are several kinds of magic mouthwash, which may account for the different names. Each has slightly different ingredients in varying amounts.

Both adults and children can use magic mouthwash.

Children and younger adults are more likely to develop mouth sores. This is because they shed older cells faster. However, older adults with mouth sores usually heal slower than children and younger people.

In many adults, the most likely causes of mouth sores are chemotherapy and radiation treatments.

Other causes of mouth sores include:

  • Oral thrush. Oral thrush looks like small white bumps on the tongue and inside the mouth. Caused by yeast overgrowth, this condition is also known as thrush and oral candidiasis.
  • Stomatitis. Stomatitis is a general term for soreness or inflammation inside the lips or mouth. Two main kinds are cold sores and canker sores. Stomatitis may be caused by the herpes virus.
  • Hand, foot, and mouth disease. This viral infection is caused by the coxsackievirus, and it spreads easily. Hand, foot, and mouth disease causes sores in the mouth and rashes on the hands and feet. It’s most common in children under 5 years old.

Magic mouthwash is a mixture of powder and liquid medications.

There are several formulas for this mixture, and it typically contains a combination of at least three of the following:

  • an antibiotic to prevent or stop a bacterial infection, such as tetracycline
  • an antifungal medication to prevent or stop a fungal infection, such as nystatin
  • a numbing medication to soothe pain, such as lidocaine
  • an antihistamine to bring down swelling, such as diphenhydramine
  • a steroid to reduce redness and swelling from inflammation, such as:
    • dexamethasone
    • hydrocortisone
  • an antacid to help the mouthwash coat the mouth, such as:
    • aluminum hydroxide and magnesium hydroxide, which are found together in Maalox and Mylanta
    • kaolin
    • sucralfate

According to the National Cancer Institute, one formulation combines:

  • nystatin
  • diphenhydramine
  • dexamethasone

Another popular formulation combines:

  • viscous lidocaine 2 percent
  • diphenhydramine
  • aluminum hydroxide, Maalox, or Mylanta

At-home recipes

Avoid at-home recipes for magic mouthwash. They won’t have the same quality of ingredients.

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Magic mouthwash is only available by prescription. It may need to be created in a compounding pharmacy, a special facility where pharmacists mix custom medications, including those that aren’t easily commercially available.

You can typically keep a bottle of magic mouthwash in the refrigerator for up to 90 days.

Here’s how to use magic mouthwash:

  1. Pour a dose of the magic mouthwash with a sterile spoon or measuring cap.
  2. Hold the liquid in your mouth and gently swish it around for 1 or 2 minutes.
  3. Spit out the liquid. Swallowing it may cause side effects, like an upset stomach.
  4. Avoid eating or drinking anything for at least 30 minutes after taking magic mouthwash. This helps the medication stay in the mouth long enough to work.

Dosage and frequency

A doctor or pharmacist will recommend the right dosage of magic mouthwash for you. This depends on the type of magic mouthwash they prescribe and the condition of your mucositis.

In a 2015 study, the magic mouthwash dose was 10 milliliters every 3 hours for up to six times per day. This dose was taken for 6 days.

However, according to an older 2005 study, most institutions in the United States recommend you only take magic mouthwash every 4 or 6 hours.

Your doctor may continue, lower, or stop your dosage depending on how the magic mouthwash is working for you.

Cost of magic mouthwash

Not all insurance companies pay for magic mouthwash. Check with your insurance provider to see if it’s covered.

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Magic mouthwash contains strong medications. Like any other medication, it may have side effects.

Magic mouthwash can make some oral symptoms worse. It can lead to mouth problems, such as:

It can also cause side effects, such as:

The side effects of magic mouthwash usually go away a few days to a few weeks after you stop using it.

Magic mouthwash may help treat a sore mouth and ease mucositis symptoms. A doctor may also recommend it to help prevent mouth sores.

It’s difficult to know how well it works, though. In some cases, other treatments for mouth sores may work better.

According to a 2015 study, a treatment called oral cryotherapy may be better for some people, because it doesn’t usually cause side effects. This treatment uses cold therapy to treat infected or irritated areas in the mouth.

A small 2015 study found that morphine mouthwash may be better than magic mouthwash at treating mouth sores. The study subjects included 30 adults who were being treated for head and neck cancer. More research is needed to confirm the results.

A 2011 study compared magic mouthwash with 0.15 percent benzydamine hydrochloride. Benzydamine hydrochloride is a medication that helps bring down inflammation, swelling, and pain.

The researchers concluded that magic mouthwash was just as effective as the 0.15 percent benzydamine hydrochloride in helping prevent the development of mouth sores in people undergoing radiotherapy for head and neck cancer.

In addition to morphine mouthwash and 0.15 percent benzydamine hydrochloride, other possible treatments for mouth sores include:

  • chlorhexidine mouthwash, which is only available by prescription
  • calcium phosphate rinse
  • a rinse made with baking soda and salt
  • MuGard, an oral gel that may be swallowed or swished around in the mouth like a mouthwash

Products that may be used to help prevent mouth sores include:

  • palifermin (Kepivance), an intravenous (IV) medication that’s used to treat and prevent mouth sores from cancer treatment
  • honey

More conclusive research is needed to confirm how effective they are. However, the American Academy of Nursing states that many alternatives are at least as effective as magic mouthwash.

Magic mouthwash may sound harmless, but it’s made of powerful medications. Follow a healthcare professional’s instructions closely, and don’t use more than prescribed.

If you’re undergoing cancer treatment, talk with your doctor about how to help prevent a sore mouth. Ask a nutritionist about the best foods to eat with a sore mouth.

Like other medications, magic mouthwash may not work for everyone. It can also cause side effects.

Tell your doctor immediately if you experience any negative effects or if you think it’s not working for you. Your doctor may recommend other treatments for your mouth sores.