FormWeb • ONCOWASH

Huntsville Hospital

Approved Hospital Formulary

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Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

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ONCOWASH + Nystatin

ONCOWASH

Formulary Oncology Mouthwash Formulary

Drug Name	Form	Strength
ONCOWASH	SUSPENSION, ORAL	diphenhydramine elixir/viscous lidocaine 2%/Maalox
ONCOWASH + Nystatin	SUSPENSION, ORAL	diphenhydramine elixir/viscous lidocaine 2%/Maalox/Nystatin (240 mL)
ONCOWASH + Nystatin w/o Lidocaine	SUSPENSION, ORAL	diphenhydramine elixir/Maalox/Nystatin (180 mL)
ONCOWASH w/o Lidocaine	SUSPENSION, ORAL	diphenhydramine elixir/Maalox (120 mL)

Comments:

ONCOWASH contains a 1:1:1 formulation of: diphenhydrAMINE elixir 12.5 mg/5 mL (60 mL), viscous lidocaine 2% (60 mL), and MAALOX (60 mL).

FIRST Mouthwash BLM Compounding Kit may be utilized for standardized ONCOWASH formulation.

Variations to the standardized formulation are:

ONCOWASH + Nystatin (Adults): ONCOWASH + 500,000 units/5 mL nystatin oral suspension will be dispensed separately.

ONCOWASH + Nystatin (Pediatrics): 1:1:1:1 formulation: diphenhydrAMINE elixir 12.5 mg/5 mL (60 mL), viscous lidocaine 2% (60 mL), MAALOX (60 mL), and nystatin 100,000 units/mL (60 mL)
ONCOWASH + Nystatin without Lidocaine (Pediatrics*): 1:1:1 formulation of: diphenhydrAMINE elixir 12.5 mg/5 mL (60 mL), MAALOX (60 mL), and nystatin 100,000 units/mL (60 mL)
ONCOWASH without Lidocaine (Pediatrics*): 1:1 formulation of: diphenhydrAMINE elixir 12.5 mg/5 mL (60 mL) and MAALOX (60 mL)

*Recommended formulations in pediatric patients < 3 years old due to inability to swish & spit.

MAALOX component may contain simethicone.

Reviewed: 25 March 2015

Updated: 24 Sept 2019 (Formula Update), March 2022

Last updated: Mar. 21, 2022

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