diphenhydramine + hydrocortisone + nystatin + tetracycline

This is a compounded multi-ingredient oral rinse formulation containing **diphenhydramine**, **hydrocortisone**, **nystatin**, and **tetracycline**. Often categorized as a variant of 'Magic Mouthwash,' this combination is primarily used for the prophylaxis and treatment of stomatitis (oral mucositis), particularly in patients undergoing cancer therapies such as everolimus. The formulation works through a multi-mechanistic approach to manage the complex environment of the oral cavity during treatment: diphenhydramine acts as an antihistamine with local anesthetic properties to provide pain relief; hydrocortisone is a corticosteroid that mitigates local inflammation; nystatin is an antifungal agent that binds to ergosterol in fungal membranes to prevent oral candidiasis (thrush); and tetracycline is a broad-spectrum antibiotic that inhibits bacterial protein synthesis via the 30S ribosomal subunit to prevent secondary infections. It is typically administered using a 'swish and expectorate' method to ensure topical coverage of the oral mucosa.

Brand names

FIRST Duke's MouthwashFIRST Mary's Mouthwash

Other names

Magic MouthwashMiracle MouthwashMary's Magic MouthwashMary's Miracle Mouthwash