Afinitor Mouth Sore Prevention and Treatment

ShetlandPony

I decided to start this topic to make sure those taking Afinitor know about a fairly recent development, especially as it seems there are some patients whose medical oncologists are not yet on board.

Mouth Sore Prevention: Ask your doctor for a prescription for alcohol-free 0.5 mg/5 mL dexamethasone oral solution. Swish and spit three or four times per day, starting the day you begin taking Afinitor.

In 2016 it was reported that in the SWISH trial (NCT02069093), in which MBC patients taking Afinitor and Aromasin used this mouth rinse, there was a marked decrease of grade 1, 2, and 3 stomatitis. Additionally, there was a significant increase in patients who reported no cases of stomatitis. The abstract from the SWISH trial concludes that "Prophylactic use of 0.5 mg/5 mL dexamethasone oral solution...should be considered a new standard of care..."

The trial did specify alcohol-free, so I suggest asking your local pharmacies what brand they get, and checking to see if it is an alcohol-free one. And sugar-free, too. (This solution is often prescribed to be swallowed for other conditions, but we are using it as a mouth rinse.)

Below are some links with more information about the SWISH trial.

http://www.onclive.com/onclive-tv/dr-rugo-on-swish...

http://www.ascopost.com/issues/august-10-2016/use-...

Also, for better mouth health, my oncology nurse recommends Biotene rinse. (I prefer the one called Biotene Dry Mouth Gentle Oral Rinse, with the green label, because it is the one without parabens.)

Mouth Sore Treatment: If you do get a mouth sore, here are some suggestions from the nurses at my cancer center. Rinse several times per day with a solution of 1/4 teaspoon baking soda, 1/8 teaspoon of salt, and 8 ounces warm water. Use topical vitamin E. Get enough protein. Ask for a prescription for Magic Mouthwash, which contains Benadryl (the antihistamine diphenhydramine), Maalox (an antacid containing aluminium hydroxide and magnesium hydroxide), and lidocaine (a numbing agent). I would keep up with the dexa rinse, too.

Groovywilma

Thank you for such detailed information! I am not on Afinitor at this time, but I'm sure these recommendations will be extremely helpful for mouth sore prevention in general. I appreciate the specific info! Thank you!