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 a 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
spukkato / Getty Images

Uses

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 can commonly develop due to chemotherapy and radiation treatments.

In some cases, chemotherapy-induced mouth sores can be so painful that they cause problems with eating, swallowing, and talking. Sometimes secondary bacterial or fungal infections can develop.

Weight loss, which is concerning in people with cancer, can occur when mouth sores make it painful to eat. Cancer cachexia, a syndrome that involves decreased appetite, weight loss, and muscle loss, is thought to be the direct cause of death for 20% of people with cancer. Since cachexia isn't easily treatable, preventing weight loss by managing any problem that interferes with eating is crucial.

Magic Mouthwash Ingredients

There is no standard recipe for magic mouthwash. Most formulations include some combination of the following ingredients:

  • Antihistamine/anticholinergics: Antihistamines such as Benadryl can reduce swelling.
  • Antacids: Several different antacids, such as magnesium hydroxide/aluminum hydroxide, may be added to coat the mouth and throat.
  • Anesthetics: Anesthetics such as viscous lidocaine work to numb the mouth and reduce pain.
  • Antifungals: Antifungals such as nystatin may be added to reduce the chance of a secondary fungal infection (thrush).
  • Antibiotics: Some preparations, such as tetracycline, contain antibiotics added to reduce the chance of secondary bacterial infection.
  • Corticosteroids: Steroids can reduce inflammation, resulting in less redness and swelling.

How to Use

Here are the steps to follow for using magic mouthwash properly:

  1. Pour your prescribed dose of the mouthwash into a sterile spoon or measuring cup.
  2. Keep the liquid in your mouth and swish it around for a minute or two.
  3. Spit out the mouthwash since 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 how to use the one prescribed to you.

Dosage and Frequency

For most preparations, instructions are to put 2 teaspoons of the solution in your mouth and swish it around or hold it for about two minutes. Then you'll spit out the mouthwash.

The process is repeated every four to six hours.

Cost

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

Benefits

The benefit of magic mouthwash has come into question. The variations in formulas make it difficult to study. Some health experts recommend against using it, saying there's not enough evidence that it's more effective than saltwater or baking soda rinses.

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

Ask your treating cancer physician (oncologist) for their input about magic mouthwash. Mouth sores are common in people with cancer, so oncologists have insight into what may help reduce the pain. Your oncologist will be able to give you guidance based on what has worked for other patients.

Risks

The 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: This is an adverse reaction to one of the ingredients.
  • Tingling or burning in your mouth: Burning often is 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

Some of the side effects can be difficult to distinguish from an allergic reaction, and it is hard to tell which ingredient is causing the reaction.

Systemic (body-wide) 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 are helpful include:

  • Morphine mouthwash: Some research has found that topical morphine mouthwashes work better than magic mouthwash for treating mouth sores in cancer patients.
  • 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 the healing of mouth sores. Palifermin is currently approved for treating 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?

    Magic mouthwash should be good for around 12 months once opened, but this may not be true for all formulations. Ask your pharmacist and read the label regarding 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. Swallowing it can cause an upset stomach.

  • Does magic mouthwash need to be refrigerated?

    No, magic mouthwash usually doesn't need to be refrigerated. Check your product, however, to see if it indicates otherwise.

  • 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 medical formulations of magic mouthwash. Magic mouthwash usually contains at least one (and often more) ingredient that requires a pharmacist to prepare and requires a doctor's prescription to obtain.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Kerksick CM, Arent S, Schoenfeld BJ, et al. International society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2017;14:33. doi:10.1001/jamainternmed.2018.6223

  5. Brown TJ, Gupta A. Management of cancer therapy–associated oral mucositis. JCO Oncology Practice 2020 16:3, 103-109. doi:10.1200/JOP.19.00652

  6. American Society of Clinical Oncology. Mouth sores or mucositis.

  7. National Cancer Institute. Relieving mouth sores from cancer treatment: The discovery of palifermin.

  8. Anschau F, Webster J, Capra MEZ, de Azeredo da Silva ALF, Stein AT. Efficacy of low-level laser for treatment of cancer oral mucositis: a systematic review and meta-analysis. Lasers Med Sci. 2019;34(6):1053-1062. doi:10.1007/s10103-019-02722-7

  9. Cleveland Clinic. What is magic mouthwash?

By Blyss Splane
Blyss Splane is a certified operating room nurse working as a freelance content writer and former travel nurse. She works as a freelance content writer for healthcare blogs when she's not spending time with her husband and dog.

Originally written by Lisa Fayed