Magic Mouthwash for Canker Sores

Often known as Duke’s Magic Mouthwash because the original recipe was first developed at Duke University, this special concoction may help relieve the pain and inflammation of severe mouth sores. The formula  is often used for people undergoing chemo or radiation because a frequent side effect of these cancer treatments  is oral ulcers. Some people, particular those who suffer from recurring aphthous ulcers (RAS) also use it for treating their mouth sores.

Duke's Magic Mouthwash is sometimes prescribed to relieve severe canker sores.Ingredients

What makes up magic mouthwash can vary. There is no one recipe and it must be prescribed by a physician. The mouthwash is usually made in a compounding pharmacy with ingredients specified by a doctor. While there are numerous variations that make up the formula, most contain at least three ingredients. Common elements  include Maalox, Benadryl , antibiotics and viscous lidocaine. The reasoning for the formulation is that it combines a variety of ingredients to treat a range of conditions that  may be going on within the mouth. Common recipe components include:

  • Diphenhydramine, a common ingredient in  Benadryl. It is an antihistamine and analgesic, which helps reduce inflammation and pain.
  • Lidocaine – a topical anesthetic for pain relief; it will temporarily numb the area.
  • Maalox or Kaopectate – an antacid which helps coat the ingredients on the sore
  • Tetracycline – antibiotic to reduce bacteria around the lesion
  • Glucocorticoids – anti-inflammatory steroid
  • Nystatin – an antifungal agent that may be added for candidiasis (more typically for cancer patients)

There may be other ingredients added such as Sulcralfate, a coating agent, or Erythromycin, an antibiotic.


If you have multiple canker sores in the mouth, the typical dose is 5ml swished around the mouth and then spat out. For mouth ulcers far back in the throat or on the roof of the mouth, the solution can be gargled. If you only have one sore,  you might just dab the compound  on your ulcer using an eyedropper  or  a  cotton swab.

The mixture can be used every four to six hours, or as your doctor has prescribed.  You should wait at least 30 minutes after using magic mouthwash before eating or drinking anything, or you may reduce the effectiveness of the treatment.

How Well Does It Work

While there have been very few studies to evaluate the effectiveness of magic mouthwash for pain and inflammation relief, it is fairly widely prescribed and used. One controlled study found there was no difference in effectiveness versus salt water or baking soda and water rinses. However, patients who have tried the compounded mouthwash may beg to differ. When oral ulcers cause so much pain and inflammation that eating and drinking are excruciating, using magic mouthwash may soothe the pain. Further, the addition of antibiotics can help prevent severe mouth sores from getting infected.

Side Effects

There is some concern about safety because there is no standard formula. To reduce the possibility of drug interactions or allergic reactions, the pharmacist must be very clear on what the prescribing physician has specified and compound the formula exactly as prescribed. For instance, some people are allergic to Lidocaine or to certain antibiotics such as Erythromycin.

Home Made Alternative

As mentioned, the real “magic mouthwash” contains prescription medications and must be prescribed by a doctor and made in a pharmacy. If you want to try a modified recipe for home use, you can combine equal part of maalox, kaopectate  or Milk of Magnesia and Benadryl Childrens Allergy Liquid Medicine.  Why the child’s formula? The adult version contains alcohol, which may cause burning or stinging or dry out oral tissues.

You can rinse your mouth with your home made mixture several times a day. While you shouldn’t swallow it, it isn’t necessary and you should spit it out. There are also over-the-counter numbing liquids such as Chloraseptic throat spray that are used for relieving sore throats. You might want to add this to your  mix to help temporarily relieve the pain. The best part is that you can easily find all the over-the-counter ingredients for your own mouthwash at your local CVS, Walgreens, Walmart or other drugstore.

10 comments for “Magic Mouthwash for Canker Sores

  1. Marilyn Hoch
    January 24, 2014 at 5:38 am

    I’ve been sick which feels like for ever acute bronchitis and strep throat. Wondering why I’m not getting any relief with. The pain of swallowing and coughing every minute of the day I decided to check with Google to see what Magic Mouthwash consists of. I am highly allergic to tetracycline and erythromycin and guess what? That’s what I’ve been gargling with. pLUS. The label on the Magic Mouthwash says swish in mouth then swallow. Who can anyone trust today ? The label instructs me to swallow 10 ml every 8. Hrs.

    • Marilyn Hoch
      January 24, 2014 at 11:54 am

      I called the pharmacy to ask how they made this Magic Mouthwash when he finished telling me the ingredients I asked him about the antibiotics, since I read it under canker sore remedy, he said no antibiotics were in my Magic Mouthwash prescription. I was grasping for any information as to why I’ve been sick for over 3 weeks and for the moment I believed that was the reason I wasn’t getting well. Sorry I jumped to conclusions. Please disregard my earlier reply

      • Valerie Grant
        January 24, 2014 at 12:12 pm

        It’s good you checked, Marilyn. As the article states, the ingredients for Magic Mouthwash vary, the ingredients listed were examples of common ones. Not all may be included.

  2. suzy tobin
    January 26, 2015 at 6:49 pm

    my prescription as per DR. is to swish and swallow. The thought of swallowing this is a gag reflex in itself. It is like swallowing a mouthful of snot it doesn’t matter what the flavor is. I have thrush and was prescribed by my DR. IT IS AWFUL.

  3. B
    November 30, 2016 at 7:07 pm

    I have a cluster of 7-10 canker sores and my dentist prescribed Magic Mouthwash with antacid, diphenhydramine and lidocaine. It is orange in color and tastes pretty good. I have been using it for 24 hours now and am seeing a remarkable improvement with the canker sores.

    • Rob Sandler
      January 7, 2017 at 9:55 am

      Me, too!
      Less than 24 hrs.

  4. Brenda Lavallee
    February 19, 2017 at 8:02 pm

    I have had a small hole on the right under side of my tongue for over 3 weeks, my Doctor referred me to an ENT the that specialist said it looked like an ulcer, I did some research on the kind of lesion if you will under my tongue, my symptoms were sore throat, very very painful to talk at times, tongue paining, trouble eating and swallowing. so she put me on this Magic Mouthwash for 2 weeks she said if it doesn’t clear by then she will have to do a biopsy which for me means a possibility of mouth cancer is there anyone who can relate to my story? I try not to worry and wait and see if this will work and its just a ULCER!!!!!

    • Janet Horton
      March 4, 2017 at 5:27 pm

      U may very well have oral lichen planus which is an inflammatory autoimmune disease. U must be biopsied in order for them to diagnose this. Sounds like OLP.

  5. Max
    March 3, 2017 at 12:41 pm

    You should absolutely get it biopsied. If it turns out to be cancerous, don’t despair, I had tongue cancer in 2004 and you can beat it. Do not delay or put it off because you’re scared. Better to get it checked out.

  6. Cindy Hess
    June 20, 2017 at 6:23 am

    I have chronic mucositis since 12/2015 as a result of stem cell transplant (found that on Google). Continues to get worse, can’t wear dentures most of the time. Help.

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