Survey of topical oral solutions for the treatment of chemo-induced oral mucositis

J Oncol Pharm Pract. 2005 Dec;11(4):139-43. doi: 10.1191/1078155205jp166oa.

Abstract

Purpose: The objectives of this study were (1) to describe the usage of topical oral solutions in patients experiencing chemotherapy-induced oral mucositis (CIOM); and (2) to survey the care of oral mucositis provided to patients by clinical oncology pharmacists in institutional settings.

Methods: Surveys were distributed to institutional pharmacists in the US, who were asked to provide the components of their 'magic mouthwash'. Other questions included whether an institutional mucositis management guideline is available and what is the involvement of clinical pharmacy in mucositis care.

Results: Forty institutions returned surveys during the study period. The top five ingredients used to compound the magic mouthwash are diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin and corticosteroids. Most institutions administer the mouthwash every 4 hours (36%) or every 6 hours (36%). Of the surveyed institutions, 33% currently possess guidelines for the management of CIOM.

Conclusions: Most institutions in the country formulate their topical solution, or magic mouthwash, with a variety of ingredients. There is a need to standardize the ingredients used to compound the magic mouthwash, in order to fully evaluate the efficacy of the solution to manage CIOM.

MeSH terms

  • Administration, Buccal
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / chemistry
  • Aluminum Hydroxide / administration & dosage
  • Aluminum Hydroxide / adverse effects
  • Aluminum Hydroxide / chemistry
  • Diphenhydramine / administration & dosage
  • Diphenhydramine / adverse effects
  • Diphenhydramine / chemistry
  • Drug Compounding
  • Drug Utilization Review / methods
  • Drug Utilization Review / statistics & numerical data*
  • Humans
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects
  • Lidocaine / chemistry
  • Magnesium Hydroxide / administration & dosage
  • Magnesium Hydroxide / adverse effects
  • Magnesium Hydroxide / chemistry
  • Mouth Diseases / chemically induced*
  • Mouthwashes / administration & dosage
  • Mouthwashes / adverse effects*
  • Mouthwashes / chemistry
  • Mucositis / chemically induced*
  • Nystatin / administration & dosage
  • Nystatin / adverse effects
  • Nystatin / chemistry
  • Pharmaceutical Services / classification
  • Pharmaceutical Services / statistics & numerical data
  • Reproducibility of Results
  • Surveys and Questionnaires

Substances

  • Adrenal Cortex Hormones
  • Mouthwashes
  • Nystatin
  • Aluminum Hydroxide
  • Diphenhydramine
  • Lidocaine
  • Magnesium Hydroxide