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Mouth - Lip Preparations by Category

Mouth/Lip Preparations
Topical Agents
 
Canker sores / ulcers                            [Top]
amlexanox 
Aphthasol ®
Aphthous ulcers: apply 1/4" paste four times daily.  
Supplied
: [paste 5%] 
Benzocaine Orabase-B ®, Hurricaine ® etc.Apply as directed (3-4 times daily as needed). Limit therapy to 2 days.  

Supplied: 
[ Aerosol (oral spray): Hurricaine® 20%;  Gel (oral):  Anbesol® 6.3%, Orajel® 7.5%, Anbesol/Orajel Maximum strength-20%, Orabase-B 20%. Zilactin-B 10%;  
Oral Liquid: Anbesol (6.3%), Orasol, Hurricaine (20%). Dental protective paste - Apply 3-4 times daily as needed. ]
carbamide peroxide Gly-Oxide ®Canker sores: apply several drops up to four times/day (after meals and at bedtime).
Kenalog in Orabase ® (triamcinolone 0.1% )Indications: Treatment of steroid responsive disorders of the oral mucosa, including inflammatory and ulcerative lesions. Dosage: Coat the lesion with a thin film, preferably at bedtime. Do not rub in. It may be necessary to apply the preparation 2 or 3 times a day, preferably after meals. Prolonged and intensive treatment may cause atrophic changes in the skin, such loss of elasticity, thinning, dilation of superficial blood vessels, telangiectasis, ecchymosis and purpura particularly when occlusive dressings are used. Note: Should be used for short courses only.
Phenol Chloroseptic ® sprayApply as needed for sore throat/mouth irritation (q2-4h as needed)
chlorhexidine gluconate Peridex ®Gingivitis: 15 ml oral rinse 0.12% - swish for 30 seconds then expectorate - repeat twice daily.  
Skin disinfection
: 4% solution applied for 2 minutes, dry and repeat for 2 minutes.   

Administration: Do not swallow oral rinse. Keep out of eyes/ears.  Oral rinse should be used after toothbrushing - do not rinse with water, mouthwash, or eat immediately after using. 
Candidiasis                        [Top]
clotrimazole Mycelex ®Candidiasis - oropharyngeal: dissolve 1 troche in mouth 5 times/day for 2 weeks.  Candidiasis- oropharyngeal, prophylaxis:  dissolve 1 troche in mouth 3 times/day during chemotherapy or until corticosteroids are reduced to maintenance levels. 
[Supplied: 10 mg troche]
Nystatin 
Mycostatin ® 
Thrush: 5 ml (one teaspoonful) swish & swallow four times daily. 
Cold Sores                           [Top]
Penciclovir 
Denavir ®
herpes labialis (cold sores): apply cream every 2 hours while awake x 4 days.
docosanol Abreva ®Adult (usual) Herpes labialis: apply topically to lesions 5 times a day until lesions have healed.  Begin treatment at the first symptom or signs of an episode. 

[Supplied: 10% cream - 2 grams.]
Mucositis                      [Top]
Gelclair ®: (maltodextrin + propylene glycol)

Bioadherent oral gel that provides rapid and durable oral pain relief.
Oral mucositis - Directions for use: Pour the entire contents of the single-dose packet into a glass and add 40 ml or 3 tablespoonfuls of water. Stir mixture well and use at once. Rinse around the mouth for at least one minute or as long as possible to coat tongue, palate, throat, inside of cheeks and all oral tissue thoroughly. Gargle and spit out. If swallowed accidentally, no adverse effects are anticipated. 
Use
at least 3 times a day or as needed. Do not eat or drink for at least one hour following treatment. In the unlikely event that water is not available, the product may be used undiluted. If the desired pain relief is not achieved when diluted, you may try diluting with less water or undiluted.  

[Supplied: Gelclair Dose Pack: 21 single-dose, 15 ml packets.] 
lidocaine viscous Xylocaine ®
2% topical solution
Indications: production of topical anesthesia of irritated or inflamed mucous membranes of the mouth and pharynx. It is also useful in reducing the gag reflex when taking oral x-rays or dental impressions. 
Dosage
: the maximum recommended single dose for healthy patients should be such that the dose does not exceed 4.5 mg/kg of body weight and does not in any case exceed a total of 300mg. Symtomatic treatment of irritated or inflammed mucous membranes of the mouth and pharynx: Usual adult dose: 15 ml undiluted.   Mouth: swish around then spit out. Pharynx: gargle then may swallow.  Do not give at smaller intervals than every 3 hours.  Max 8 doses/day. 
Supplied
: 2% topical solution (20 mg/ml)
BMX Cocktail (Benadryl + Lidocaine viscous + Maalox) BMX cocktail (Benadryl : Maalox : Lidocaine) (1:1:1) // Lidocaine: 6.7 mg/ml ; Benadryl: 0.83 mg/ml. SHAKE WELL BEFORE USING. Note: the most significant drug-induced adverse reactions are attributable to lidocaine. The lowest dosage that results in effective anesthesia should be used to avoid high plasma concentrations. Indications: Topical anesthesia of irritated or inflamed mucous membranes. Commonly used for radiation mucositis or chemotherapy-induced stomatitis. The mixture may be swallowed, however, if the inflammation is limited to the oral cavity the mixture should be swished around the mouth then expectorated. 
Dosing
: (Guidelines based on maximum single dose of lidocaine 4.5 mg/kg- not to exceed 300 mg/dose. Max of 8 doses/day). 
Patient weight (45kg): 5 to 30 ml q3-6h prn (max 8 doses/day). 
Patient weight (50 to 55kg): 5 to 35 ml q3-6h as needed (max 8 doses/day). 
Patient weight (60kg): 5 to 40 ml q3-6h as needed (max 8 doses/day). 
Patient weight (65kg and above): 5 to 45 ml q3-6h as needed (max 8 doses/day).
Xerostomia (Dry Mouth)           [Top]
Pilocarpine
Salagen ®
Cholinergic agonist.  
Xerostomia
:  following head and neck cancer: 5 mg orally 3 times per day. Titration up to 10 mg 3 times/day may be considered for patients who have not responded adequately. Do not exceed 2 tablets per dose
Sjogren's syndrome: 5 mg 4 times/day

Supplied: 5 mg tablet. 

Artificial saliva
Moi-Stir ®
Salivart ®
Saliva Substitute

Xerostomia:  Use orally as needed.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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