Triple Mix to Relieve Pain of Mouth Sores After Chemotherapy

Triple Mix for Mucositis From Chemotherapy

Mouth sores, also called mucositis or stomatitis, are a very common side effect of chemotherapy and can cause people a lot of discomfort. Fortunately, there are treatments that can help relieve the pain.

This article will review why mouth sores occur, how they can be treated, and what to do if the sores are severe.

Young woman rinsing mouth, leaning over sink
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What Is Mucositis (Mouth Sores)?

Mucositis is an inflammation of the mucous membranes, the cells that line the gastrointestinal tract. Starting at your mouth (oral mucositis), damage to these cells can continue down your esophagus (esophageal mucositis) and through your digestive system (intestinal mucositis).

The inflammation can be caused by chemotherapy or by radiation therapy. It can feel like a sunburn inside your body. Other symptoms of mucositis include:

  • Redness in your mouth
  • Open sores in your mouth with ulcerations
  • Swelling of the tongue or other areas of the mouth

Mucositis often begins shortly after starting chemotherapy, but the severity can depend on which chemotherapy medication is given. It is important that someone who has mouth sores talk with their oncology team to help determine the best plan for treatment.

The pain from mouth sores can keep people from getting enough nutrition, which is one of the most important things someone needs while recovering from cancer treatment.

What Is Triple Mix?

Triple mix is a combination of three liquid medications that treat and soothe oral and esophageal mucositis. The exact medications can vary, and is usually only available by prescription. The usual mix contains drugs that will stop pain, reduce inflammation, and sometimes treat a bacterial or fungal infection.

Your healthcare provider must prescribe this drug, and your pharmacist will need time to create it. Triple mix must be compounded when it is ordered—meaning it has to be made at the pharmacy and does not come already mixed.

Triple mix often contains:

  • Maalox (to coat and sooth sores)
  • Lidocaine (a topical anesthetic to numb the sores)
  • Benadryl (diphenhydramine, an antihistamine)

Other ingredients may include:

  • Nystatin (an antifungal medication that is used to treat thrush)
  • A steroid (to decrease inflammation)
  • Antibiotics

There are several variations on this mix, and your oncologist has an opinion on which mix seems to work best. Make sure to ask them, preferably before you begin chemotherapy and develop mouth sores.

You may hear of solutions with names other than triple mix. These include:

  • Triple Solution
  • Magic Mouthwash
  • GI (Gastrointestinal) Cocktail

How to Use Triple Mix

The exact instructions on how to take triple mix will come from your oncologist. It can be used as a rinse, swished around in the mouth to coat the sores and tongue. In this instance, the solution isn't swallowed, but is spit out.

Triple mix can also be rinsed and then swallowed, to coat the back of the throat and esophagus. This can be helpful when the sores are located in these areas. If it is swallowed, wait at least 30 minutes after using triple mix before eating or drinking anything.

Complications of Mouth Sores

Problems caused by mucositis go beyond having pain. Mouth sores can interfere with your ability to eat, and eating healthy is very important to maintain your strength during cancer treatment. Other symptoms, such as a loss of appetite, nausea, or taste changes can make the problem worse.

Oral thrush is a complication that can be seen with mucositis. This infection, caused by the fungus Candida albicans, usually causes a white coating to develop on the tongue and the insides of the cheeks. Thrush can cause burning that adds to the pain from mouth sores. It is usually treated with a topical cream such as nystatin or oral Diflucan (fluconazole).

Managing Mouth Sores From Chemotherapy

Triple mix can be helpful in treating the pain and discomfort from mouth sores. Other things that can be helpful to improve pain can include:

  • Rinsing with salt or baking soda mixed in water
  • Avoiding mouthwash that has alcohol or peroxide
  • Avoiding spicy or acidic foods and drinks
  • Eating foods that are moist and cool in temperature

For Severe Mucositis

The use of triple mix and dietary modifications can be enough to control symptoms, yet some people require treatments beyond these. Other options, such as cryotherapy, can be very effective in treating even the most severe mouth sores.

If you are experiencing mouth sores that are not improving with what you're currently doing, call your oncology team right away. They can offer suggestions and recommend additional therapies if needed.

Summary

Mouth sores can be a painful side effect of cancer treatment. A medication such as triple mix can help soothe the sores in the mouth or esophagus and allow you to continue to eat and drink adequately. Sometimes prescription treatments may be needed as well, especially if a fungal or bacterial infection is present.

A Word From Verywell

If you are suffering from chemotherapy-induced mucositis, please speak with your healthcare provider about strategies for pain relief. Never hesitate to reach out to your oncology team for help managing mouth sores or any other side effect from cancer treatment. Your quality of life during cancer treatment is very important.

Frequently Asked Questions

  • How long does triple mix last?

    Typically, triple mix needs to be used every four to six hours, but your oncologist will provide exact instructions. As each prescription for triple mix may be a little different, it is difficult to say how long it will last.

  • Can I swallow triple mix?

    Yes, triple mix can be swallowed, and it may be prescribed that way if sores are in the back of the mouth, throat, or esophagus. Your oncologist will give you specific instructions on how to take it.

  • Does triple mix need to be refrigerated?

    Triple mix doesn't usually need to be refrigerated, but keeping it in the fridge may make it more soothing to your mouth. Check with your pharmacist for specific instructions.

Originally written by
Pam Stephan
Pam Stephan is a breast cancer survivor.
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4 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.
  1. Chaveli-López B, Bagán-Sebastián JV. Treatment of oral mucositis due to chemotherapyJ Clin Exp Dent. 2016;8(2):e201-e209.

  2. Cancer.net. Mouths sores or mucositis.

  3. American Cancer Society. Mouth sores and pain.

  4. Centers for Disease Control and Prevention. Candida infections of the mouth, throat, and esophagus.

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