Background The most common side effects of chemotherapy or radiotherapy are linked to systemic toxicity and toxicity towards rapidly growing cells. In the latter category, oral mucosites, which are quite disabling for patients, occur in 15%–40% of patients treated with conventional chemotherapy, in 70%–90% in those treated with TCSE and in 80% of those who receive radiotherapy for neck or head cancers. Because of pain and difficulty in eating due to mucositis, 16%–32% of these patients require recurrent hospitalisation. Obviously, this side effect bears heavily on the budget of the Italian healthcare system.

Purpose To deal with these challenges, hospital pharmacists working with other health professionals have developed new formulations.

Material and methods After researching the latest information on Galenic formulations in large literature databases,¹ the hospital pharmacists evaluated currently available products and proposed new formulations. Once they prepared the formulations, they developed leaflets for each formulation to be given to the patient and caregiver. Treatments were provided for mucosites assigned a score from 0 to 3 on the WHO scale.

Results Of the formulations proposed, the hospital pharmacists adopted six solutions and one gel. Up to August 2017, the only one they produced was a formulation of lidocain and metilprednisolone. Subsequently, they added formulations of Ialuronate-Aloe (30% of the formulations provided) and Misoprostole-artificial saliva (11%), followed by Benzydamine and Supersatura (a solution containing sulphates and chlorides). In July 2018, Doxepin and Bicarbonate formulations were prepared, while the use of lidocain and metilprednisolone continued (36%).

Conclusion The new formulations were introduced to maintain and increase oral hygiene, limit the risk of infections, moisturise the oral cavity and relieve pain, all things that were not achievable with the previous formulations.

References and/or acknowledgements 1. https://www.mascc.org/assets/Guidelines-Tools/mascc%20isoo%20mucositis%20guidelines%20paper%206jun2014.pdf

2. http://www.salute.gov.it/portale/documentazione/p6_2_2_1.jsp?lingua=italiano&id=2139

3. http://www.cancernurse.eu/documents/EOCCGuidelinesv7.pdf

4. http://www.ukomic.co.uk/pdf/UK_OM_Guidelines.pdf

5. European Oncology Nursing Society(EONS), Oral Mucositis Guidelines, 2005.

6. http://www.palliativecareguidelines.scot.nhs.uk/media/42558/20170119-mouth-care.pdf

7. https://www.esmo.org/Guidelines/Supportive-and-Palliative-Care/Management-of-Oral-and-Gastrointestinal-Mucosal-Injury

8. International Journal of Pharmaceutical Compounding (IJPC).

No conflict of interest.