Methylene Blue Mouthwash for Oral Mucositis Pain in Cancer: An Open-Label, Non-Randomized Study
Jordan Karow1, Regina M Mackey1, Emily Olson1
1Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Pain & Palliative Care Pharmacotherapy
|April 11, 2026
Summary
Mouthwash containing methylene blue (MB) provided short-term pain relief for oral mucositis (OM) in cancer patients, comparable to standard care. Further randomized trials are needed to confirm these findings for OM pain management.
Area of Science:
- Oncology
- Pain Management
- Oral Medicine
Background:
- Oral mucositis (OM) pain is a significant challenge in cancer treatment.
- Conventional treatments for OM pain are often inadequate.
- Methylene blue (MB) mouthwash is explored as a potential alternative.
Purpose of the Study:
- To compare the efficacy of MB mouthwash versus standard mouthwash in managing OM pain.
- To evaluate pain reduction in hospitalized patients with OM.
- To assess secondary outcomes like oral intake and opioid use.
Main Methods:
- Open-label, non-randomized clinical trial.
- Patients received either 0.05% MB or standard-of-care mouthwash.
- Oral rinses were performed every 8 hours for three days.
Main Results:
- Both MB and standard mouthwash significantly reduced pain scores.
- No statistically significant difference in pain reduction between the two groups.
- MB mouthwash demonstrated feasibility and tolerability.
Conclusions:
- MB mouthwash offers short-term pain relief for OM, similar to standard care.
- Findings support the need for larger, randomized controlled trials.
- MB mouthwash is a feasible and tolerable option for OM pain management.
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