Magic Mouthwash

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You really need to get outta GA!
 
:laugh: You're right!! I just worked all weekend and studied so there wasn't much to compete with. After the October PCAT I am planning a trip to go camping in the Smoky Mountains. Until then I have one objective: get into pharmacy school!!

Yeah I just looked up Nystatin Oral Suspension...that's for mouth sores or something? I thought Magic Mouthwash was for sore throat. I guess it makes sense for chemo patients to need a good soothing mouthwash though.
 
That stuff is fun to make. 🙂 I made it in hospital, and I make it in retail.
 
Just curious what's your recipe? I'm usually writing it for aphthous ulcers or severe pharyngitis...the recipe I was taught was 1:1:1 Decadron:Benadryl:Lidocaine. I've also seen those that included nystatin if fungal but I'm not sure what the other ingredients were.
Good to know as an urgent care PA....thanks 🙄
 
primadonna22274 said:
Just curious what's your recipe? I'm usually writing it for aphthous ulcers or severe pharyngitis...the recipe I was taught was 1:1:1 Decadron:Benadryl:Lidocaine. I've also seen those that included nystatin if fungal but I'm not sure what the other ingredients were.
Good to know as an urgent care PA....thanks 🙄
Click to expand...

the times I have seen it, it has also included maalox.
 
Mary's Magic Mouth Wash

Nystatin Oral Suspension 10,000units/ml x 60ml
Hydrocortisone 20mg tabs x 3-4 tabs
Tetracycline 500 capsules x 3-4 capsules
Benadryl liquid x 180ml
to make total 240ml

I do know some MD use cephalexin instead of tetracycline.
the strength of hydrocortisone and tetracycline depends on MD.🙂
 
geez, talk about covering our bases....... 🙄

fiorio said:
Mary's Magic Mouth Wash

Nystatin Oral Suspension 10,000units/ml x 60ml
Hydrocortisone 20mg tabs x 3-4 tabs
Tetracycline 500 capsules x 3-4 capsules
Benadryl liquid x 180ml
to make total 240ml

I do know some MD use cephalexin instead of tetracycline.
the strength of hydrocortisone and tetracycline depends on MD.🙂
Click to expand...
 
primadonna22274 said:
Just curious what's your recipe? I'm usually writing it for aphthous ulcers or severe pharyngitis...the recipe I was taught was 1:1:1 Decadron:Benadryl:Lidocaine. I've also seen those that included nystatin if fungal but I'm not sure what the other ingredients were.
Good to know as an urgent care PA....thanks 🙄
Click to expand...

I have seen it written 3 different ways:

Benadryl:Maalox:Visc Lidocaine 1:1:1

Benadryl:Sulcrafate:Visc Lidocaine 1:1:1

Benadryl:Sulcrafate:Maalox 1:1:1

On occasion I have also see it with tetracycline and prednisone.

I think it is always good practice to write out exactly what you want instead of a writting "magic mouth wash".
 
primadonna22274 said:
Just curious what's your recipe? I'm usually writing it for aphthous ulcers or severe pharyngitis...the recipe I was taught was 1:1:1 Decadron:Benadryl:Lidocaine. I've also seen those that included nystatin if fungal but I'm not sure what the other ingredients were.
Good to know as an urgent care PA....thanks 🙄
Click to expand...

Our recipe is Benadryl:Maalox:Visc Lidocaine: Nystatin 1:1:1:1
 
it seems like there are a bajillion variations.

Our standard is benadryl:viscous lidocaine: maalox as 1:1:1

but we'll make up custom ones as needed.
 
one of the reasons ours is the formulation is it is to help r/o AMI. That mix should take out a killer heartburn, no? So if there's enough time/clinically stable/yada yada sometimes a doc will order some stat for a CP patient.
 
and as far as hem/onc uses, even if mucositis is already present won't the lidocaine help a tiny bit with the pain? our adult onc unit probably uses it the most than any other unit.
 
njac said:
and as far as hem/onc uses, even if mucositis is already present won't the lidocaine help a tiny bit with the pain? our adult onc unit probably uses it the most than any other unit.
Click to expand...

They may use it, but available evidence says it is no better than saline rinses.
 
Thanks guys.
You're probably right...it's all voodoo anyway...but mommies are usually happier with me if I give them "something" for the munchkins with sore mouths.
Speaking from the FP/urgent care/ED perspective, NOT oncology.
 
primadonna22274 said:
Thanks guys.
You're probably right...it's all voodoo anyway...but mommies are usually happier with me if I give them "something" for the munchkins with sore mouths.
Speaking from the FP/urgent care/ED perspective, NOT oncology.
Click to expand...

They're probably happier when you give them antibiotics for viral upper respiratory tract infections also. Just sayin'.
 
Last edited:
It's like that basketball game 21. Everyone knows the gist of it everywhere across the country but if you go a few states over, they have crazy ass rules you've never heard of. Like when I was in Philly last month, the losers that got less than 10 points got to carry them over to the next game. WTF is up with that?
 
I typically see magic mouthwash as 1:1:1 maalox:benadryl:visc. lidocaine as well. McKesson has a kit that you can order that includes all 3 under one NDC. It's more expensive than billing for the three ingredients separately, but Idaho medicaid won't pay for compounds, so it's a way to get around that roadblock.

I think that it's a lot of fun to make other than the fact that I never seem to be able to get more than about 95 mls of lidocaine out of the 100ml bottle. Any hints?
 
Just warn people, especially seniors, about swallowing lidocaine as it can effect heart rhythm.....
 
yup, just like they shouldn't chew their tessalon pearls.
 
Moxxie said:
I typically see magic mouthwash as 1:1:1 maalox:benadryl:visc. lidocaine as well. McKesson has a kit that you can order that includes all 3 under one NDC. It's more expensive than billing for the three ingredients separately, but Idaho medicaid won't pay for compounds, so it's a way to get around that roadblock.

I think that it's a lot of fun to make other than the fact that I never seem to be able to get more than about 95 mls of lidocaine out of the 100ml bottle. Any hints?
Click to expand...

squeeze really hard....
 
If the nurse calls in Magic Mouthwash on the voicemail with no recipe, does that grant implicit permission to pick the ingredients (such as 1:1:1:1 benadryl, lidocaine, nystatin, antacid)?
 
waiter said:
If the nurse calls in Magic Mouthwash on the voicemail with no recipe, does that grant implicit permission to pick the ingredients (such as 1:1:1:1 benadryl, lidocaine, nystatin, antacid)?
Click to expand...
No. You need them to clarify. Could be BLM. Might have nystatin. Might have dexamethasone. Might have eye of newt.
 
Wonder whatever happened to SexyPlexi, hellooo zombie thread!
 
If someone has a sore throat why is Magic Mouthwash better than just plain lidocaine? What is the point of the other ingredients?

Is the recipe with Maalox/Lidocaine used for heartburn or something?

What's the point of the Q-dryl? Why add Nystatin?

This never made sense to me.
 
ldiot said:
If someone has a sore throat why is Magic Mouthwash better than just plain lidocaine? What is the point of the other ingredients?

Is the recipe with Maalox/Lidocaine used for heartburn or something?

What's the point of the Q-dryl? Why add Nystatin?

This never made sense to me.
Click to expand...

Benadryl for flavor. Maalox for coating. Lidocaine for numbing.
 
ldiot said:
If someone has a sore throat why is Magic Mouthwash better than just plain lidocaine? What is the point of the other ingredients?

Is the recipe with Maalox/Lidocaine used for heartburn or something?

What's the point of the Q-dryl? Why add Nystatin?

This never made sense to me.
Click to expand...
From: http://pharmacistsletter.therapeuti...entFileID=4149&DetailID=230703&SegmentID=1963

There are numerous magic mouthwash formulations. Most contain at least three ingredients. Concoctions may contain a combination of an antibiotic (to reduce the bacterial flora around the lesion), antihistamine (for local anesthetic effect), antifungal (to stop any fungal growth), steroid (to reduce inflammation), a local anesthetic/pain reliever, or an antacid (to enhance coating of the ingredients on the mouth).4

The most popular formulation includes topical anesthetics such as lidocaine viscous and diphenhydramine plus Maalox (aluminum/ magnesium hydroxide) to enhance coating of the ingredients in the mouth. Other formulations include antifungals, corticosteroids, or antibiotics for infections or inflammations.4,5

Also, here are some recipe variants: http://prescribersletter.therapeuti...&DocumentFileID=0&DetailID=230703&SegmentID=0
 
Lidocaine and Bendaryl for the numbing, Maalox to hold it all together.

Made it in a pinch sans Lidocaine for my toddler with hand/foot/mouth
 
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