Prescription
Prescription RequiredCompoundedMagic Mouthwash
This compounded mouthwash, often called “magic mouthwash,” helps ease pain, fight infection, and reduce swelling inside the mouth. Nystatin targets yeast and other fungi, lidocaine numbs sore areas, and diphenhydramine calms irritation. It is commonly used for mouth sores caused by chemotherapy, radiation, braces, or other conditions. Your prescriber customizes the exact formula and how long you should use it.
Requires a valid prescription from your provider. Not sure if it's right for you? Ask a pharmacist.
These statements have not been evaluated by the Food and Drug Administration. Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. This information is for educational purposes only and is not medical advice — always consult your healthcare provider before starting any new treatment.
Clinical information
Medication information for patients and providers.
Use as directed by your healthcare provider. Swish the prescribed amount in your mouth for the recommended time, then spit or swallow only if instructed. If you miss a dose, use it as soon as you remember unless it is almost time for your next dose. Do not double up on doses. Your provider will decide how long you should continue treatment.
Nystatin sticks to fungal cell walls and makes them break apart, killing yeast that can grow in sore mouths. Lidocaine blocks nerve signals on contact, so pain begins to lessen within minutes and relief lasts about 30–60 minutes. Diphenhydramine blocks histamine, which helps lower swelling and itching. Together, the rinse reduces pain, controls infection, and improves comfort so eating and drinking are easier. Most people feel numbing right away and notice less soreness after a few days of regular use.
Do not use if you are allergic to nystatin, lidocaine, diphenhydramine, or similar medicines (such as other “-caine” anesthetics or antihistamines). Do not use if you have severe mouth bleeding or a rare condition called para-aminobenzoic acid (PABA) allergy. Avoid if you are under 2 years old unless directed by a pediatric specialist, as swallowing lidocaine can cause serious side effects in young children. Talk to your provider before use if you are pregnant, breastfeeding, have heart rhythm problems, myasthenia gravis, glaucoma, or severe liver disease.
Using other medicines that make you sleepy (opioid pain pills, benzodiazepines, alcohol, sleep aids) may increase drowsiness from diphenhydramine—use caution. Beta-blockers (like propranolol), antiarrhythmic drugs (such as amiodarone), and large doses of cimetidine can raise lidocaine levels and increase risk of numbness in lips or tongue. Do not use other topical lidocaine products at the same time unless your doctor approves. Swish-and-spit antifungal rinses have few interactions, but swallowing nystatin with the antifungal ketoconazole can lower ketoconazole’s effect. Always give your pharmacist a full list of medicines, vitamins, and herbal supplements you take.
Very common (more than 1 in 10): temporary mouth numbness, slight tingling or mild bitter taste that lasts up to 1 hour. Common (1–10 in 100): drowsiness, dry mouth, mild stomach upset if swallowed, slight burning at first use. Uncommon (1–10 in 1,000): dizziness, nausea, swollen lips or tongue, mild diarrhea. Rare but serious: allergic reaction with rash, trouble breathing, or swelling of face and throat; irregular heartbeat or severe dizziness (from lidocaine overdose); severe mouth irritation or bleeding. Most side effects fade within 30–60 minutes. Stop use and call your doctor or seek emergency help if serious signs occur.
Store tightly closed in the refrigerator (36–46 °F, 2–8 °C) for best taste and stability, or at room temperature below 77 °F (25 °C) if refrigeration is not possible. Protect from direct sunlight and do not freeze. Shake well before each use. Discard any unused rinse 14 days after the date it was made, or sooner if it changes color, smell, or texture. Keep out of reach of children and pets. Return leftover medicine to a pharmacy take-back program, or mix with coffee grounds in a sealed plastic bag before throwing away in household trash.
Frequently asked questions.
Measure the amount your provider prescribed, swish it around all parts of your mouth for about 1 minute, then spit it out unless your doctor tells you to swallow. Avoid eating or drinking for 30 minutes afterward so the medicine can work.
The lidocaine starts numbing within minutes, giving fast pain relief. Fighting infection and reducing swelling take a few days, so most people notice steady improvement after 3–5 days of regular use.
Only swallow if your prescriber specifically instructs you to do so. In most cases, you should spit it out to limit side effects. If accidentally swallowed, it is usually safe in small amounts, but call your provider if you feel dizzy or have a racing heartbeat.
Usually yes, but some drugs can raise lidocaine levels or increase drowsiness. Tell your pharmacist about heart medicines, sleep aids, allergy pills, or any topical products with lidocaine. They can check for problems and suggest safe timing.
Children under 2 should not use it unless a pediatric specialist says it is safe, because swallowing lidocaine can be harmful. Pregnant or breastfeeding women should use it only if the benefits outweigh the risks; discuss this with your doctor first.
Yes, refrigeration keeps the ingredients stable and the cool temperature can soothe sores. If you must travel, you may keep it at room temperature below 77 °F for short periods, but avoid heat or freezing.
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