Caphosol For Prevention and Treatment of Mouth Sores

Caphosol for Mucositis During Cancer Chemotherapy and Radiation

Caphosol is sometimes recommended as a mouth rinse during chemotherapy for cancers such as breast cancer or radiation therapy for cancers around the head and neck. A combination of a phosphate and calcium solution, it works by lubricating oral tissues. While recent studies have questioned the effectiveness of Caphosol in alleviating the discomfort of mouth sores relative to other treatment options, many patients and oncologists believe it offers some relief. There are relatively few side effects associated with Caphosol use, it's important to carefully follow the package directions when using this product. Learn more about this mouth wash as well as other measures you can take to cope with mouth sores.

What Is Caphosol?

Caphosol is a mouth rinse that is used to prevent and treat oral mucositis. This solution combines a phosphate solution with a calcium solution and purified water to form a fluid that is rich in calcium and phosphate ions. The goal of treatment is to have Caphosol solution lubricate your oral tissues (mucosa) and soak into any mouth sores, reducing inflammation and encouraging healing.

Caphosol is not a painkiller (analgesic) but may reduce pain by softening and cleansing dry mouth tissues.

Generic Name: Artificial Saliva Solution

Caphosol Use For Cancer

Mouth sores can occur during different types of cancer treatment including chemotherapy, radiation therapy to areas near the mouth, and some targeted therapies.

Chemotherapy

Mucositis, or mouth sores, are a common side effect of chemotherapy. Mouth sores occur when the rapidly-dividing cells of the mucous membranes lining your mouth are attacked by chemotherapy drugs (chemotherapy drugs attack all rapidly growing cells including cancer cells and cells lining the mouth).

Mouth sores may occur on your mouth and your tongue (oral mucositis), and also further down in your digestive tract in your esophagus and intestines. These mouth sores can be painful and often limit the foods you are able to eat.

During chemotherapy, you might be asked to suck on ice chips or a popsicle while you have your chemotherapy infusion. The purpose of this is to decrease the size and number of mouth sores you develop.

Most of the time mouth sores are more of a nuisance than a problem, but when they are severe, they can limit your eating and lead to poor nutrition at a time when you need the best nutrition possible. This may be amplified if you have also developed taste changes due to chemotherapy.

Sometimes, mouth sores can become secondarily infected with either bacteria or yeast (oral thrush). If this occurs, your oncologist will likely prescribe an antibiotic or antifungal medication.

Radiation Therapy

Radiation therapy to the head and neck, especially when combined with chemotherapy, can lead to problematic mouth sores as well. In contrast to chemotherapy, these sores can persist for some time after treatment has been completed, and measures such as sucking on ice chips are ineffective in preventing the sores.

Bone Marrow Transplant

Mouth sores that develop following a bone marrow transplant require special attention, as it's important to distinguish mouth sores related to treatment from symptoms of graft versus host disease. If you've had a bone marrow or stem cell transplant it's important to talk to your oncologist before you try any type of mouth solutions.

Studies on Efficacy

To evaluate the effectiveness of Caphosol, a 2019 study compared the use of Caphosol with standard topical therapy with regard to both pain control and healing. It was found that Caphosol did not demonstrate any benefits superior to standard therapy. That said, people are not statistics (some people may respond better to Caphosol and some, worse), and it's important to talk to your oncologist about her experience with patients she has followed in the past.

A 2017 study looking at the use of Caphosol for people undergoing radiation therapy for head and neck cancer revealed similar findings, with no reduction in either the incidence or duration of mouth sores in people who used Caphosol.

Using Caphosol for Mouth Sores

If Caphosol has been recommended, it's helpful to know how it works and the how to properly use the solution.

How Caphosol Works To Relieve Oral Mucositis

Caphosol is an electrolyte solution made of sodium phosphate, calcium chloride, sodium chloride, and purified water. The solution must be mixed just before each dose to make sure the phosphate and calcium ions don't separate and become ineffective. Once mixed, Caphosol soaks into the tissues of your tongue, gums, hard and soft palette, restoring moisture into the cells, and lubricating sores and scratchy areas. It is thought that the calcium ions help reduce inflammation and improve circulation as well as promote healing. The phosphate ions may aid in the healing of mouth sores.

How Caphosol Is Packaged

Caphosol comes in a box of 30 doses, which you use at home. The doses are packed as two different solutions, Caphosol A and Caphosol B. You will mix these immediately before using the solution as a mouth rinse. This product can be kept at room temperature; it doesn't have to be refrigerated.

How to Use Caphosol

Follow these steps in order to use Caphosol most effectively:

  • Plan the timing of your dose so that you won't be eating or drinking anything for at least 15 minutes after you use Caphosol. This helps prevent dilution of the solution and gives it time to soak into dry mouth tissues.
  • Separate one blue container (Caphosol A) and one clear container (Caphosol B) from those in the pack of 30 doses.
  • Remove the caps from the blue and clear containers, and empty the contents together into a clean glass. Do not add water or any other fluid.
  • Swirl the glass of Caphosol around gently to mix the two solutions.
  • Immediately after mixing, use Caphosol as a mouth rinse.
  • Pour half of the solution into your mouth, then swish and gargle with it for one full minute. Do not swallow Caphosol.
  • Spit out the solution, and repeat your swish and gargle with the second half. Again, do not swallow Caphosol, but spit it out.
  • Do not eat or drink for the next 15 minutes.
  • Use Caphosol four times a day for relief of mucositis.

Side Effects and Precautions

Unlike the majority of treatments used for cancer, research and testing have found no notable side effects or interactions of Caphosol and other drugs or oral products.

Precautions

Caphosol works best if you use it according to the instructions on the package. This includes:

  • Not eating or drinking for 15 minutes after using Caphosol solution.
  • Talking to your doctor about using a smaller dose of Caphosol if you are on a low-sodium diet.
  • Letting your doctor know if your mucositis increases or the pain from mouth sores or dry tissues continues. At times, your oncologist may recommend using a higher dose or more frequent doses of Caphosol.
  • Keeping this and all other medications out of the reach of children.

Special Notes About Caphosol

The U. S. Food and Drug Administration has not yet approved Caphosol, but they are studying it and comparing it to similar artificial saliva solutions. Studies looking at the effect of Caphosol for the prevention and treatment of mouth sores during chemotherapy have been mixed. It appears to work better with the type of chemotherapy used for breast cancer than with the high-dose chemotherapy and stem cell transplants used for blood-related cancers.

Caphosol is made in Germany by Cytogen and can be prescribed for patients in the United States.

Coping With Mouth Sores

In addition to using mouth rinses as recommended by your oncologist, there are many things you can do yourself to cope with annoying mouth sores.

  • Avoid spicy foods
  • Avoid citrus foods: Foods such as orange juice and tomato juice can significantly increase pain
  • Avoid salty foods
  • Avoid sharp foods: Foods such as crackers, corn chips, toast, and more can be painful. Choose soft foods instead.
  • Drinking fluids and sometimes soups through a straw can sometimes keep the food away from painful mouth sores without reducing your intake

A Word From Verywell

Mouth sores can not only be uncomfortable during cancer treatment but can interfere with your ability to eat and get the nutrition you need. There are some reports that Caphosol appears to reduce the pain associated with mouth sores without any significant side effects or interactions, while other studies have found the solution offers no benefit over standard solutions. With any type of treatment, it's important to talk to your oncologist first. She many also have additional thoughts on how to improve your comfort during chemotherapy.

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