What Is Magic Mouthwash & Does It Work for Mouth Sores?

Made at a pharmacy by compounding several different medications to make it, magic mouthwash is a common topical treatment for mouth sores. It is available by prescription only. It is commonly prescribed to patients being treated with radiotherapy or chemoradiotherapy for head and/or neck cancer.

There are conflicting views as to how effective, and even how safe, magic mouthwash is. It can potentially help to reduce pain caused by mouth sores, but since the formulations can vary, it can also contain medications that can make things worse.

You will generally have to rinse with the magic mouthwash several times a day to get relief. Often, you will need additional medications or treatments as well.

What Is Magic Mouthwash?

Magic mouthwash is also called Mary’s Magic Mouthwash or Duke’s Magic Mouthwash. It is a topical prescription treatment for oral mucosa, or mouth sores. It is made by a pharmacy by compounding several other medications together.

Magic mouthwash can contain any of the following:

• Numbing medication, such as lidocaine for topical pain relief

• Antacid to coat the mouth

• An antifungal medication like nystatin

• Antihistamine diphenhydramine to dry out the mouth

• A steroid, such as hydrocortisone, to minimize swelling

• An antibiotic for eliminating bacteria

As a mixed medication formula, magic mouthwash is not always exactly the same. It can contain only a few of these medications or most of them.

Treatments With Magic Mouthwash

Over 80 percent of patients with head and neck cancer who are being treated with chemoradiotherapy or radiotherapy develop debilitating mouth sores that can impact eating, drinking, and talking. Often, they become so severe that hospitalization is necessary.

Magic mouthwash is often one of the standards of care in treating oral mucosa. It is a topical agent that applies directly to the affected area and therefore will not interact with other medications.

Magic mouthwash can also be used to treat mouth sores that occur for the following reasons:

• Infection, either bacterial or viral

• Oral thrush

• Behcet’s disease

• Autoimmune disorders

Safety & Efficacy of Magic Mouthwash

A study published by JAMA found that magic mouthwash was effective in controlling pain caused by mouth sores in cancer treatment patients. However, the study also concluded that more research was needed on the long-term efficacy and safety of the mixed medication.

The American Academy of Nursing actually recommends against using magic mouthwash. They say the formulations can differ too much; it can become pricey; and it can even have the potential to cause more irritation and pain.

Using Magic Mouthwash

A typical dose of magic mouthwash is 30 ml taken every four to six hours. Generally, you will use a small syringe or measuring cup to get the proper dosage, which you will then pour into your mouth and swish around for one minute. You will need to swish and swirl it around your mouth to coat the entire thing. Try not to swallow too much of the mouth wash, and spit it out after the one minute is up.

Ingesting magic mouthwash can cause you to become nauseous and experience numbness in your throat. After you spit out the mouthwash, do not rinse your mouth, or eat or drink anything for at least 30 minutes. This allows the mouthwash to take effect.

How to Get Magic Mouthwash

Magic mouthwash is available by prescription only. You will need to see your doctor for a prescription for magic mouthwash. A pharmacy will then make it for you. Be sure that the prescription contains the exact formulation that your doctor recommends for you since compounds of magic mouthwash can vary.