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The morphine group uses the mouthwash of 2% morphine solution (20 mg morphine sulfate diluted in 100 mL of water), 10 mL every three hours; six times a day. The morphine solution is prepared by the faculty of pharmacy under supervision of the Food and Drug Organization of the local Medical University.

The magic group uses a mouthwash contained a mixture of 240 mL magnesium aluminum hydroxide (Alborz Co., Iran), 25 mL 2% viscous lidocaine (SinaDaru Co., Iran), and 60 mL diphenhydramine (Emad Co., Iran), 10 mL every three hours; six times a day.

2% morphine solution

Magnesium aluminum hydroxide

2% viscous lidocaine

Simin Hemati, MD

Oral mucositis is a debilitating side effects of cancer treatment for which there is not much successful treatments at yet. The investigators are going to evaluate the effectiveness of topical morphine compared with a routine mouthwash in managing cancer treatment-induced mucositis. The investigators hypothesize that topical morphine is more effective and more satisfied by patients than the magic mouthwash in reducing severity of cancer treatment-induced oral mucositis.

Morphine Mouthwash for Management of Oral Mucositis in Patients With Head and Neck Cancer

Evaluating the Effectiveness of Topical Morphine Compared With a Routine Mouthwash in Managing Cancer Treatment-induced Mucositis in Patients With Head and Neck Cancer in Isfahan

Patients are visited by a radiation oncologist at baseline, 3rd day, and 6th day of the intervention. The WHO grading system of mucositis is administered for each patient in which, 0 indicates a healed mucositis and no signs or symptoms, 1 indicates mild soreness but not problem in eating, 2 indicates painful erythema, edema, or ulcers but able to eat, 3 indicates severe painful erythema, edema, or ulcers and having problem in eating, and 4 indicates if there is a requirement for parenteral or enteral support.

Patients also are asked about if pain/discomfort relived by mouthwash and if so for how long (\< 1 h, 1 to 2 h, \> 2 h). Their satisfaction with treatment is graded as satisfied, tolerable, and intolerable.

Isfahan University of Medical Sciences

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Morphine Mouthwash for Management of Oral Mucositis in Patients With Head and Neck Cancer	NCT01837446	Stomatitis	2% morphine sol... Magnesium alumi... 2% viscous lido... Diphenhydramine	18 Years -	Isfahan University of Medical Sciences
Morphine Mouthwash for Management of Oral Mucositis in Patients With Head and Neck Cancer	NCT01837446	Stomatitis	2% morphine sol... Magnesium alumi... 2% viscous lido... Diphenhydramine	18 Years -	Isfahan University of Medical Sciences
Morphine Mouthwash for Management of Oral Mucositis in Patients With Head and Neck Cancer	NCT01837446	Stomatitis	2% morphine sol... Magnesium alumi... 2% viscous lido... Diphenhydramine	18 Years -	Isfahan University of Medical Sciences

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