Commonly Requested Formulas for Patients with Mouth Ulcers or(Mucositis (Post Chemotherapy/Radiation

PCCA Formula # 12208 Dexamethasone 0.5 mg/5 mL Oral Rinse (MucoLox™) (FormulaPlus™ BUD Study)

PCCA Formula # 11132 Lidocaine HCl 2% Oral Rinse (MucoLox™)

PCCA Formula # 11133 Misoprostol 0.0024%/Diphenhydramine HCl 0.1%/ Lidocaine HCl 1% Oral Rinse (MucoLox™)

PCCA Formula # 11134 Misoprostol 0.0024%/Ketoconazole 1% Compound Oral Rinse (MucoLox™)
PCCA Formula # 11138 Dexamethasone 3.3 mcg/mL/Tetracycline HCl 13.5 mg/mL/Nystatin 16,667U/mL/Diphenhydramine HCl 1.25 mg/mL Mouthwash (MucoLox™)

PCCA Formula # 11120 Beta Glucan 0.5%/Dexpanthenol 1%/Vitamin E Acetate 2% Oral Rinse (MucoLox™)

PCCA Formula # 11431 Morphine Sulfate 2% Oral Rinse (MucoLox™)

PCCA Formula # 11143 Roentsch Mouthwash #5, Alternate (MucoLox™)

PCCA Formula # 1687 Oral Adhesive Paste

PCCA Formula # 0522 Tetracycline HCl 125 mg/Nystatin 60417 units/Diphenhydramine HCl 12.5 mg/Hydrocortisone 2.3 mg Base A Troche

PCCA Formula # 11144 Stanford Modified Mouthwash (MucoLox™)

PCCA Formula # 11145 Stanford Mouthwash (MucoLox™)

PCCA Formula # 0093 Polyox 301 Bandage See Patient Instructions for Use of Oral Mucosal Bandage,

PCCA Document 97763. The 30 mL Collapsible Bottle (PCCA #35-1283) is used for this dosage form.