3/5/2018 Artificial saliva: Drug information - UpToDate

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Artificial saliva: Drug information

Copyright 1978-2018 Lexicomp, Inc. All rights reserved.

(For additional information see "Artificial saliva: Patient drug information")

For abbreviations and symbols that may be used in Lexicomp (show table)

Brand Names: US Aquoral; Biotene Dry Mouth Gentle [OTC]; Biotene Moisturizing Mouth Spray
[OTC]; Biotene Oral Balance [OTC]; BocaSal; Caphosol; Entertainer's Secret [OTC]; Moi-Stir [OTC]; Mouth
Kote [OTC]; NeutraSal; Numoisyn; Oasis; SalivaMAX; SalivaSure [OTC]; Salivate Rx

Pharmacologic Category Gastrointestinal Agent, Miscellaneous

Dosing: Adult
Mucositis (due to high-dose chemotherapy or radiation therapy): Oral:

Caphosol, NeutraSal: Swish and spit 4 to 10 doses daily (use for the duration of chemo- or radiation
therapy).

SalivaMax, SalivateRx: Swish and spit 2 to 10 doses daily

Xerostomia: Oral: Use as needed, or product-specific dosing:

Aquoral: Two sprays 3 to 4 times daily

Biotene Dry Mouth Gentle oral rinse: Swish and spit 15 mL up to 3 times daily

Biotene Oral Balance gel: Apply one-half inch length onto tongue and spread evenly; repeat as often
as needed

Caphosol, NeutraSal, SalivaMax, SalivateRx: Swish and spit 2 to 10 doses daily.

Entertainer's Secret: Spray as often as needed.

Mouth Kote spray: Spray 3 to 5 times, swish for 8 to 10 seconds, then spit or swallow; use as often
as needed.

Numoisyn liquid: Use 2 mL as needed.

Numoisyn lozenges: Dissolve 1 lozenge slowly; maximum 16 lozenges/day.

Oasis mouthwash: Rinse mouth with ~30 mL twice daily or as needed; do not swallow.

Oasis spray: 1 to 2 sprays as needed; maximum 60 sprays/day.

SalivaSure: Dissolve 1 lozenge slowly as needed; for severe symptoms, 1 lozenge per hour is
recommended.

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Dosing: Pediatric Xerostomia: Oral: Children ≥12 years of age and Adolescents: Biotene Dry Mouth
Gentle oral rinse: Refer to adult dosing.

Dosing: Geriatric Refer to adult dosing.

Dosing: Renal Impairment There are no dosage adjustments provided in the manufacturer's
labeling.

Dosing: Hepatic Impairment There are no dosage adjustments provided in the manufacturer's
labeling.

Dosage Forms Excipient information presented when available (limited, particularly for generics);
consult specific product labeling. [DSC] = Discontinued product

Gel, oral:

Biotene Oral Balance: Glycerin, water, sorbitol, xylitol, carbomer, hydroxyethylcellulose, sodium
hydroxide (42 g) [alcohol-free, sugar-free]

Liquid, oral:

Biotene Dry Mouth Gentle: Water, glycerin, xylitol, sorbitol, propylene glycol, poloxamer 407,
potassium sorbate, hydroxyethylcellulose, sodium phosphate, cetylpyridinium chloride, disodium
phosphate (473 mL) [alcohol-free; mild mint flavor]

Numoisyn: Water, sorbitol, linseed extract, Chondrus crispus, methylparaben, sodium benzoate,
potassium sorbate, dipotassium phosphate, propylparaben (300 mL)

Lozenge, oral:

Numoisyn: Sorbitol 0.3 g/lozenge, polyethylene glycol, malic acid, sodium citrate, calcium phosphate
dibasic, hydrogenated cottonseed oil, citric acid, magnesium stearate, silicon dioxide (100s)

SalivaSure: Xylitol, citric acid, apple acid, sodium citrate dihydrate, sodium carboxymethylcellulose,
dibasic calcium phosphate, silica colloidal, magnesium stearate, stearic acid (90s)

Powder, for reconstitution, oral:

BocaSal: Calcium chloride, sodium bicarbonate, sodium chloride, and sodium phosphates (30s)

NeutraSal: Calcium chloride, sodium bicarbonate, sodium chloride, and sodium phosphates (30s,
120s)

SalivaMAX: Calcium chloride, sodium bicarbonate, sodium chloride, and sodium phosphates (30s,
120s)

Salivate Rx: Calcium chloride, sodium bicarbonate, sodium chloride, and sodium phosphates (30s)

Solution, oral:

Caphosol: Dibasic sodium phosphate 0.032%, monobasic sodium phosphate 0.009%, calcium
chloride 0.052%, sodium chloride 0.569%, purified water (30 mL) [packaged in two 15 mL ampuls
when mixed together provide one 30 mL dose]

Entertainer's Secret: Sodium carboxymethylcellulose, aloe vera gel, glycerin (60 mL) [ethanol free;
honey-apple flavor]

Solution, oral [mouthwash/gargle]:

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Oasis: Water, glycerin, sorbitol, poloxamer 338, PEG-60, hydrogenated castor oil, copovidone,
sodium benzoate, carboxymethylcellulose (473 mL) [ethanol free, sugar free; mild mint flavor]

Solution, oral [spray]:

Aquoral: Oxidized glycerol triesters and silicon dioxide (5.6 mL, 40 mL [DSC]) [contains aspartame;
citrus flavor]

Biotene Moisturizing Mouth Spray: Water, polyglycitol, propylene glycol, sunflower oil, xylitol, milk
protein extract, potassium sorbate, acesulfame K, potassium thiocyanate, lysozyme, lactoferrin,
lactoperoxidase (45 mL)

Moi-Stir: Water, sorbitol, sodium carboxymethylcellulose, methylparaben, propylparaben, potassium

chloride, dibasic sodium phosphate, calcium chloride, magnesium chloride, sodium chloride (120
mL)

Mouth Kote: Water, xylitol, sorbitol, yerba santa, citric acid, ascorbic acid, sodium saccharin, sodium
benzoate (5 mL, 60 mL, 240 mL) [ethanol free, sugar free; lemon-lime flavor]

Oasis: Glycerin, cetylpyridinium, copovidone (30 mL) [ethanol free, sugar free; contains sodium
benzoate; delivers ~150 sprays, mild mint flavor]

Generic Equivalent Available (US) No

Administration
Biotene Dry Mouth Gentle oral rinse: Rinse for 30 seconds.

Biotene Oral Balance gel: Apply on tongue and spread evenly.

Biotene spray: Spray directly into mouth; spray is safe to swallow.

Caphosol: Swish mixed solution thoroughly with 1/2 of mixture (15 mL) for 1 minute and spit; repeat.
Avoid eating or drinking for at least 15 minutes after use.

Entertainer's Secret: Tilt head back and spray into throat or nostril while inhaling sharply.

Mouth Kote spray: Spray into mouth and swirl for 8 to 10 seconds; spray may be swallowed or spit out.

NeutraSal, SalivaMax, SalivateRx: For each dose, swish 1/2 the prepared solution around the mouth for
at least 1 minute and spit out; repeat with the remaining solution. Avoid eating or drinking for at least 15
minutes (NeutraSal) or 30 minutes (SalivaMax, SalivateRx) after use.

Numoisyn liquid: Rinse in mouth before swallowing.

Numoisyn lozenges: Dissolve slowly in mouth; move lozenge around mouth for optimal effect.

Oasis mouthwash: Rinse for 30 seconds.

Oasis spray: Spray into mouth holding bottle upright; do not rinse.

SalivaSure lozenges: Allow lozenge to move around and slowly dissolve in mouth.

Use
Mucositis (due to high-dose chemotherapy or radiation therapy): Adjunct to standard oral care in
relief of symptoms associated with chemotherapy or radiation therapy-induced mucositis

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Xerostomia: Relief of dry mouth and throat in xerostomia or hyposalivation

Adverse Reactions Frequency not defined.

Central nervous system: Speech disturbance

Gastrointestinal: Dysgeusia, dysphagia, gastrointestinal disease (minor)

Contraindications Hypersensitivity to saliva substitute or any component of the formulation; fructose

intolerance (Numoisyn lozenges only)

Metabolism/Transport Effects None known.

Drug Interactions

(For additional information: Launch drug interactions program)

There are no known significant interactions.

Dietary Considerations
Caphosol: Contains sodium 75 mg/30 mL dose

Moi-Stir: Contains sodium: 6.47 mEq/120 mL, potassium: 1.93 mEq/120 mL, magnesium: 0.128 mEq/120 mL

Mechanism of Action Protein or electrolyte mixtures which restore/replace saliva, lubricate, moisten,
clean, and/or provide a coating on oral mucosa

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REFERENCES

1. Biotene Dry Mouth Gentle oral rinse [prescribing information]. Warren, NJ: GlaxoSmithKline; no date.
2. Furness S, Worthington HV, Bryan G, et al, “Interventions for the Management of Dry Mouth: Topical Therapies,”
Cochrane Database Syst Rev, 2011, (12):CD008934. [PubMed 22161442]

3. Narhi TO, Meurman JH, and Ainamo A, “Xerostomia and Hyposalivation: Causes, Consequences and Treatment in the
Elderly,” Drugs Aging, 1999, 15(2):103-16. [PubMed 10495070]

4. Papas AS, Clark RE, Martuscelli G, et al, “A Prospective, Randomized Trial for the Prevention of Mucositis in Patients
Undergoing Hematopoietic Stem Cell Transplantation,” Bone Marrow Transplant, 2003, 31(8): 705-12. [PubMed
12692611]

5. SalivaMax (calcium phosphate) [prescribing information]. Stafford, TX: Forward Science; November 2016.
6. SalivateRx Artificial Saliva (calcium phosphate) [prescribing information]. Stafford, TX: Forward Science Technologies
LLC; April 2016.

7. Scully C and Epstein JB, “ Oral Health Care for the Cancer Patient,” Oral Oncology, 1996, 32(5): 281-92. [PubMed
8944831]

8. Sweeney MP and Bagg J, “The Mouth and Palliative Care,” Am J Palliat Care, 2000, 17(2):118-24. [PubMed 11406956]

Topic 8793 Version 60.0

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