What are magic mouthwash alternatives that you would recommend?

Many of our patients will make their own DIY MMW per Phil's My Pharmacist (YouTube) instructions -- uses benzocaine/Cepacol lozenges -- they say it's much more effective than the compounded one from the pharmacy. It is also more economical.

If the majority of bothersome mucositis is in the oral cavit...

For patients with mild to moderate sore throat or esophagitis who are still able to maintain po intake, I recommend Throat Coat tea (licorice, marshmallow, and slippery elm) with honey TID. This is a safe level of licorice which should not impact BP.

I use Oramagic Plus which has benzocaine as a topical anesthetic. It is a liquid that does not coat the entire mouth and is preferred by patients. I also recommend ice chips.

Alliance A221304 is a phase III randomized trial supporting the use of doxepin for this indication (Sio et al., PMID 30990550). This trial compared placebo with magic mouthwash to doxepin oral rinse, with both doxepin and magic mouthwash showing very similar effect sizes compared to placebo. There w...

There have been a few studies that suggest generic honey may be useful in reducing the severity of oral mucositis. Hunter et al., Exploratory Research and Hypothesis in Medicine 2020, (University of Canberra) did a retrospective review of 10 small studies concluding that there was potential to reduc...

Wonderful answers. Love this question.

I would add to this:

• Consider aloe vera rinses at intervals
• Absolutely avoid any mouth products with alcohol
• Consider ginger tea (hot or iced) or homemade ginger tea ice pops
• Ice if patients can tolerate it e.g. chemo effect and CTDs like systemic sclerosis ...

In conjunction with our dietary department, we had made capsaicin pops compounding the powder with honey and freezing it. Patients started them one week before treatment and then throughout and we found a reduction in pain associated with mucositis (unpublished).

Had to give it up when the nutrition...

Doxepin mouthwash

Sio et al., PMID 30990550

Anecdotally from my patients, cultured buttermilk sipped throughout the day helps. However, this is a hard sell to nonSoutherners.