What Magic Mouthwash Is and How It Works

Magic mouthwash is a mouth rinse often prescribed for people with mouth sores (oral mucositis) caused by chemotherapy, radiation therapy, and some targeted therapies. It is also used for oral thrush and oral pain caused by certain infections. The mouthwash comes in variety of formulations, under different names, and can be used by both adults and children.

Other Names

Miracle mouthwash

Mary's magic mouthwash

Duke's mouthwash

Person pouring medication into a dosage cup
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Mouth sores typical of oral mucositis are characterized by red patches, swelling, or ulcers in the mouth. Magic mouthwash is used to diminish the pain from these symptoms, which are common in cancer patients being treated with chemotherapy and radiation.

In some cases, chemotherapy-induced mouth sores can be so painful that they cause problems with eating, swallowing, and talking.

Of great concern is the weight loss that can occur when mouth sores prevent a patient from eating. Cancer cachexia, a syndrome that includes the combination of decreased appetite, weight loss, and muscle loss, is thought to be the direct cause of death for 20% of people with cancer. Since cachexia is challenging to treat, preventing weight loss by addressing anything that interferes with eating is crucial.

Magic Mouthwash Ingredients

Some of the ingredients that may be in magic mouthwash include:

  • Local anesthetics (such as viscous lidocaine): Anesthetics work to numb the mouth and reduce pain.
  • Corticosteroids: Steroids can reduce inflammation, resulting in less redness and swelling.
  • Antihistamine/anticholinergics (such as Benadryl): Antihistamines also reduce swelling.
  • Antibiotics (such as tetracycline): Some preparations contain antibiotics that are added to reduce the chance of secondary infection.
  • Antifungals (such as nystatin): Antifungals may be added to reduce the chance of a secondary fungal infection (thrush).
  • Antacids (such as magnesium hydroxide/aluminum hydroxide): Several different types of antacids may be added for the purpose of coating the mouth and throat.
  • Mucosal protective agents (such as sucralfate): These agents may provide a barrier to protect the underlying mouth sore from irritation by substances in the mouth.
  • Flavoring: Some preparations add a flavoring agent to improve the taste.

Keep in mind that there are several different types of magic mouthwash and formulations vary from product to product.

Can You Make Your Own Magic Mouthwash?

There are make-your-own mouth rinses that you can put together with common kitchen ingredients, but these differ from most formulations of magic mouthwash. Magic mouthwash usually contains at least one (and often more) ingredients that require a doctor's prescription and a pharmacist to prepare.

How It’s Used

Here are the steps to follow for using these mouthwashes properly:

  1. Pour your prescribed dose of the mouthwash into a sterile spoon or measuring cap.
  2. Keep the liquid in your mouth and swish it around for a minute or two.
  3. Spit out the mouthwash. (Swallowing it can cause side effects such as an upset stomach.)
  4. Avoid eating or drinking anything for at least 30 minutes after using magic mouthwash.

Since there are so many different formulations, it's important to ask your pharmacist to confirm how to use yours properly.

Dosage and Frequency

For most preparations, instructions say to put 2 teaspoons of the solution in your mouth and swish it around or hold it for around two minutes. Then you'll spit out the mouthwash. The process is then repeated every four to six hours.

Cost and Insurance Coverage

As of 2021, the price of an 8-ounce bottle of magic mouthwash ranged from $35 to $65. It may or may not be covered by insurance, so be sure to call your provider.


There is currently controversy over the actual benefit of magic mouthwash, and the variations in formulas make it very difficult to study. Some health experts recommend against using it, saying there's not enough evidence it's more effective than salt or baking soda rinses.

That said, anecdotal reports from both physicians and patients attest to at least some benefit in reducing pain with some formulations, so magic mouthwash is frequently prescribed.

Ask your oncologist for their input on magic mouthwash. Since mouth sores are so common, they have likely had experience with what helps and doesn't help reduce the pain and will be able to give you guidance based on what has worked for other patients.


Risks of magic mouthwash depend on the ingredients in the formula. Formulations that contain a local anesthetic could potentially mask symptoms that would normally alert you to call your healthcare provider. This numbing effect could also make it more likely that you'll bite down on the inside of your mouth or even choke when eating. There are also potential risks associated with medications such as antihistamines, antibiotics, and antacids.

Side Effects

Side effects can vary depending on the formulation. Local side effects may include:

  • Allergic reactions: There is the potential of an allergic reaction to one of the ingredients. Unfortunately, some of the local side effects can be difficult to distinguish from an allergic reaction, and it is hard to tell which ingredient is causing the reaction.
  • Tingling or burning in your mouth: Burning is often temporary and only lasts a few minutes.
  • Change in taste. (This could compound the taste changes from chemotherapy that occur with some medications.)
  • Dry mouth

Systemic (bodywide) side effects may include:

Other Treatments for Mouth Sores

For mild mouth sores, homemade mouthwashes (such as baking soda mixtures) may reduce the risk of developing a secondary infection.

Other treatments that have been shown to be helpful include:

  • Morphine mouthwash: Some research has found that topical morphine mouthwashes worked better than magic mouthwash for treating mouth sores in cancer patients.
  • Doxepin mouthwash: Doxepin is a type of antidepressant in a category that is sometimes used for chronic pain. A 2019 study found that a mouthwash containing doxepin may be beneficial for reducing mouth pain caused by radiation.
  • Cryotherapy: Several studies have found cryotherapy (ice) to be beneficial, especially for more severe mouth sores.
  • Palifermin: Palifermin is a synthetic version of keratinocyte growth factor (KGF), a molecule that promotes healing of mouth sores. Palifermin is currently approved for treatment of mouth sores in patients with blood cancers.
  • Low-level laser therapy: Low-level laser therapy has been shown to reduce pain from oral mucositis and work more quickly in some cases than other methods.

Frequently Asked Questions

How long does magic mouthwash last?

It should be good for around 12 months once opened, but this may not be true for all formulations. Ask your pharmacist for details based on the formula you're using.

Where can I buy magic mouthwash?

Magic mouthwash requires a doctor's prescription and must be prepared by a pharmacist.

What happens if you swallow magic mouthwash?

It is not dangerous if you swallow magic mouthwash by accident, but it's better to spit it out because swallowing it can cause an upset stomach.

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10 Sources
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