Doxycycline + maalox oral rinse?

[Charcoales]

Got an rx for doxycycline +diphenhydamine + nystatin + maalox suspension. Swish and spit. I know they aren't swallowing it, but wouldn't the maalox still chelate the doxycyline and make it useless or is there something I'm missing here?

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[ejx91]

The chelation only affects absorption.

 

[TMP-SMX]

Curious what the topical doxycycline is supposed to do in the mouth unless there's periodontal disease

 

[Charcoales]

I looked up magic mouthwash recipes and none had doxycycline + maalox together, they either had doxycycline or maalox but never together... hmm.

Proof:
Google "pharmacist letter magic mouthwash" click first link. You'll see they never mix maalox and a tetracycline together.

There are plenty of tetracycline + lidocaine + banophen

Or maalox + lidocaine + banophen

But never tetracycline + maalox + banophen/lidocaine

 

[Dred Pirate]

I have seen a lot with tetracycline "back in the day" when I was in school - I can't remember if it had maaloz- but I don't think so

 

[CetiAlphaFive]

Got an rx for doxycycline +diphenhydamine + nystatin + maalox suspension. Swish and spit. I know they aren't swallowing it, but wouldn't the maalox still chelate the doxycyline and make it useless or is there something I'm missing here?

I get these from 100 year old dentists sometimes.

Educate the dentist on why that combination is pointless, and also point out that doxycycline isn't as cheap as it used to be .

I'd ask them what, specifically, they want the doxy to do.

The one that actually did give me an explanation said he had a "poster" from the 90s with a list of magic mouthwash formulations

 

[croquemonsieur]

I'd just speak to the patient and let them decide what they want. We dispense tons of meds that don't have much of an effect/benefit, so this really isn't very different

 

[Charcoales]

I'd just speak to the patient and let them decide what they want. We dispense tons of meds that don't have much of an effect/benefit, so this really isn't very different

I would maybe do this but only if pt swore it wasn't for any kind of infection, since if the dr was putting the doxy in there to treat an infection, and the abx wasn't doing anything... seems unethical to let it go.

 

[croquemonsieur]

I would maybe do this but only if pt swore it wasn't for any kind of infection, since if the dr was putting the doxy in there to treat an infection, and the abx wasn't doing anything... seems unethical to let it go.

Serious infections aren't typically treated with intermittent 30-second applications of topical antibiotics so you're good

 

[CetiAlphaFive]

Serious infections aren't typically treated with intermittent 30-second applications of topical antibiotics so you're good

Does your state not require that prescriptions be for a legitimate medical purpose?

 

[zelman]

Does your state not require that prescriptions be for a legitimate medical purpose?

Placebos work.

 

[owlegrad]

I would maybe do this but only if pt swore it wasn't for any kind of infection, since if the dr was putting the doxy in there to treat an infection, and the abx wasn't doing anything... seems unethical to let it go.

Do you think the dr put it in there for the flavor? What other reason is there to put doxy in?

 

[Charcoales]

Do you think the dr put it in there for the flavor? What other reason is there to put doxy in?

Has other uses in the dental field. Has a different dosage than normal, see "Periostat".

"This product is used in patients with gum disease (periodontitis) after a certain dental procedure (scaling and root planing). It helps to improve tooth attachment and reduce gum pockets."

"THE DOSAGE OF PERIOSTAT® (doxycycline hyclate) DIFFERS FROM THAT OF DOXYCYCLINE USED TO TREAT INFECTIONS."

 

[Saddleshoes]

I am a dentist...

I'm guessing your RX writer was a dentist. I can tell you that my fellow dentists are idiots when it comes to pharmacy matters.
I'm also guessing they had a patient with Acute Necrotizing Ulcerative Gingivitis (ANUG) with possible concurrent Candia infection too.