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Magic Mouthwash is a compounded topical oral rinse used as a standard of care for managing pain associated with radiation-induced oral mucositis, particularly in patients with head and neck cancer undergoing chemoradiation. It is not a single proprietary drug but rather a non-standardized formulation whose ingredients vary by institution. Common components include a local anesthetic (typically viscous lidocaine), an antihistamine (diphenhydramine), and an antacid or coating agent (such as magnesium aluminum hydroxide or sodium bicarbonate). Some formulations may also include antifungal agents like nystatin or corticosteroids such as dexamethasone. The preparation works by providing local analgesia, reducing inflammation, and coating the oral mucosa to protect against irritation. It is frequently used as a comparator arm in clinical trials for mucositis treatments, such as the Vanderbilt-Ingram Cancer Center phase III trial (NCT02480114).
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