Biotene toothpaste side effects

Biotene Mouthwash Side Effects

Generic Name: saliva substitutes topical

Medically reviewed by Last updated on Oct 31, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Pregnancy
  • Reviews
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Note: This document contains side effect information about saliva substitutes topical. Some of the dosage forms listed on this page may not apply to the brand name Biotene Mouthwash.

For the Consumer

Applies to saliva substitutes topical: mouth/throat aerosol solution

Other dosage forms:

  • mouth/throat gel, mouth/throat gum, mouth/throat liquid, mouth/throat lozenge, mouth/throat packet, mouth/throat solution

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Trouble swallowing.
  • Change in speech.
  • Change in taste.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at

For Healthcare Professionals

Applies to saliva substitutes topical: oral gel, oral lozenge, oral paste, oral powder for reconstitution, oral solution, oral spray, oral swab, oral tablet


Numoisyn Lozenge: Excessive consumption can cause minor digestive problems.

Numoisyn Liquid: Patients may experience difficulty in swallowing.


If small amounts of Caphosol or NeutraSal are swallowed accidentally, no adverse effects are anticipated.

Numoisyn Liquid: Patients may experience altered speech and changes in taste.

1. “Product Information. NeutraSal (saliva substitutes).” Invado Pharmaceuticals, Pomona,, NY.

2. “Product Information. Caphosol (saliva substitutes).” Cytogen Corporation, Princeton, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about Biotene Mouthwash (saliva substitutes topical)

  • During Pregnancy
  • Dosage Information
  • En Español
  • 3 Reviews
  • Drug class: mouth and throat products

Consumer resources

  • Biotene Mouthwash

Other brands: XyliMelts, NeutraSal, Aquoral, Biotene Oral Balance, … +9 more

Related treatment guides

  • Mucositis
  • Xerostomia

Mouthwash (Into the mouth)

Review Date: 7/4/2018
Reviewed By:

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Biotene Oral Balance

A saliva substitute is for use only in the mouth. Do not get it in your eyes.

Use your saliva substitute product exactly as directed on the label, or as prescribed by your doctor.

Saliva substitutes work inside your mouth and are not meant to be swallowed.

To use the oral rinse or other liquid saliva substitutes, swish a small amount in your mouth for 30 seconds, then spit out.

The oral powder must be mixed with about 1 ounce of water before using it. Stir the mixture and use it right away, even if you need to swish 2 or 3 times to get the full amount. Do not save the mixture for later use.

Shake the oral spray gently before each use and spray directly into your mouth and onto your tongue.

The tablet or lozenge can be held in the mouth for long periods of time, even while you are sleeping. Some tablets are pressed onto to your tooth or gums to help hold them in place.

Saliva substitute gel,paste, or swabs may be applied directly onto the gums, tongue, teeth, or sides of the mouth. Follow all instructions carefully.

How often you use a saliva substitute may depend on your condition or your medication schedule.

In most cases, saliva substitutes are used 3 to 5 times per day or whenever your mouth feels dry and uncomfortable. When used during chemotherapy or radiation, you may need to use saliva substitutes up to 10 times per day beginning on or before the day of your treatment. Follow all dosing instructions very carefully.

Do not allow a child to use this medicine without adult supervision.

Saliva substitutes may be only part of a complete treatment program that includes using other oral hygiene methods. Follow your doctor’s instructions very closely.

Store your saliva substitute as directed on the product label. Avoid moisture, heat, and light.

An overdose of a saliva substitute is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed large amounts of this product.

Since saliva substitutes are used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Copyright 1996-2020 Cerner Multum, Inc.

Latest Update: 11/9/2018, Version: 1.01

Biotene Dry Mouth Oral Rinse


This medication is used to treat dry mouth and throat. It is an artificial saliva that moistens and cleans the mouth. This allows you to be more comfortable when drinking, chewing and speaking. It also provides relief from mouth sores, also called mucositis, caused by radiation treatment or cancer chemotherapy.

how to use

Follow all directions on the product package for using this medication correctly. The dosage is based on your medical condition and response to treatment. To relieve dry mouth, use this medication as directed by your doctor by swishing your prescribed dose in your mouth and then spitting it out. Do not swallow this medication.If you are using the powder form of this medication, prepare the medication as directed by the product package.If you are using this medication during radiation treatment or cancer chemotherapy for mucositis, follow your doctor’s instructions carefully.Depending on your product, avoid eating or drinking for at least 15 to 30 minutes after using this product. Read the product instructions for more specific information.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.Tell your doctor if your condition persists or worsens.

side effects

Saliva substitutes can be used with no side effects. If you have any unusual side effects, tell your doctor or pharmacist promptly.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.


Before using saliva substitute, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history.This medication may contain sodium. Before using this medication, talk to your doctor if you are on a salt-restricted diet or if increased salt intake could worsen your condition (such as heart failure, high blood pressure).Tell your doctor if you are pregnant before using this product.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.


Overdose with this medication is unlikely even if swallowed. However, if someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.


Everyone may occasionally experience the unpleasant sensation of dry mouth (xerostomia), but some individuals endure the discomfort of dry mouth on a regular basis. Saliva has many essential health functions, including lubrication of the oral cavity, remineralization, protection against tooth decay, antimicrobial and buffering properties, assistance with swallowing and digestion, control of pH, and overall maintenance of the oral mucosa.1,2,4 If left untreated, xerostomia can cause discomfort and contribute to halitosis, dental caries, periodontal disease, and other oral health problems, such as candidiasis infection due to disturbance of the oral microflora resulting from decreased salivary flow.1,2
Xerostomia can be caused by a variety of factors, including adverse effects of certain medications and medical conditions (eg, Sjögren’s syndrome, poorly controlled diabetes, HIV/AIDS, uncontrolled hypertension, hepatitis C virus infection, lymphoma, hormonal changes due to menopause, radiation therapy, chemotherapy, nerve damage).1-5 Sjögren’s syndrome is considered to be a major cause of xerostomia in many individuals.1-5 Nonpharmacologic causes of xerostomia include the use of alcohol or tobacco, or the consumption of excessive caffeine or spicy foods.1 Examples of classes of pharmacologic agents frequently associated with causing or exacerbating xerostomia can be found in Table 1.1-5
Clinical Presentation
The severity of xerostomia varies among individuals. Common signs and symptoms are listed in Table 2.1-5
OTC Products for Managing Xerostomia
The goals of treating xerostomia include identifying the possible cause, relieving discomfort, and preventing complications such as dental caries and periodontal infections.1 A host of artificial saliva products are available to treat and prevent xerostomia, and they come in formulations such as rinses, sprays, toothpastes, gels, lozenges, and gum (Table 3). Artificial saliva products are formulated to mimic the chemical and physical properties of natural saliva; however, they do not contain the protective measures of natural saliva.1,2 Artificial saliva products typically contain carboxymethylcellulose and glycerin for viscosity, as well as calcium and phosphate ions.1,2 Some products contain fluoride and/or a flavoring agent/sweetener (ie, xylitol, sorbitol).1,2 Patients should be reminded that these products are classified as replacement products and not cures for xerostomia.1

Table 3: Examples of OTC Products for Xerostomia

· ACT Total Care Dry Mouth Lozenges

· Biotene Dry Mouth Toothpaste

· Biotene Oral Balance Dry Mouth Moisturizing Gel

· Biotene Mouth Spray for Dry Mouth

· Biotene PBF Oral Rinse

· Biotene Oral Rinse

· MedActive Oral Relief Gel for Dry Mouth

· MediActive Oral Relief Lozenges for Dry Mouth

· Orajel Dry Mouth Moisturizing Gel

· Oasis Moisturizing Mouthwash for Dry Mouth

· Oasis Moisturizing Mouth Spray for Dry Mouth

· Salese Dry Mouth Relief Moisturizing Lozenges

· Salivart Oral Moisturizer Spray

· SalivaSure Lozenges

· SmartMouth Dry Mouth Relief Mints

· Stoppers 4 Dry Mouth Spray

· TheraBreath Mouth Wetting Lozenges

· XyliMelts Discs for Dry Mouth

Pharmacists can be instrumental in identifying individuals at risk for developing xerostomia due to the use of certain classes of pharmacologic agents, medical conditions, and factors such as tobacco and alcohol use. Prior to recommending OTC products for preventing or managing xerostomia, pharmacists should ascertain whether self-treatment is appropriate and encourage patients to discuss xerostomia with their primary health care provider, especially if symptoms persist or worsen. During counseling, it is imperative that pharmacists remind patients about the importance of daily oral hygiene, including brushing and flossing at least twice a day to decrease or prevent dental caries and periodontal disease. Moreover, pharmacists can suggest various nonpharmacologic measures that may alleviate mild xerostomia; these measures include chewing gum with xylitol, using sugar-free hard candy to increase the flow of saliva, and avoiding caffeinated beverages, alcohol, and smoking. If symptoms persist or worsen despite self-treatment, patients should be advised to see their dentist for other treatment options. Additional resources are listed in Table 4.
Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.


This case was reported by a consumer and described the occurrence of dry heaves in a (b)(6) male patient who received glucose oxidase plus lactoperoxidase plus lysozyme (biotene dry mouth oral rinse) for an unknown drug indication. A physician or other health care professional has not verified this report. The patient’s past medical history included hospitalization. Concurrent medical conditions included dry mouth, high blood pressure, nocturnal awakening and sore roof of mouth. Consumer described his dry mouth as causing a thick slimy crud to build up in the corners of his mouth and it tastes terrible. Consumer reported that it makes his roof of his mouth sore and it’s like a thick scum that he can taste deep down in the back of his throat. Consumer said his dry mouth is so bad that he wakes up every 2 hours. Concurrent medications included unknown (unspecified medication), lisinopril, metoprolol succinate, amlodipine besylate, aspirin, omeprazole and hydralazine hydrochloride (hydralazine hc1). On an unknown date, the patient started glucose oxidase and lactoperoxidase plus lysozyme. At an unknown time after starting glucose oxidase plus lactoperoxidase plus lysozyme, the patient experienced accidental ingestion on two occasions. Patient does not remember swallowing a lot of it either time but the second time he swallowed biotene dry mouth oral rinse, he experienced dry heaves of five hours duration and he had a slight temperature. The patient also experienced feeling dazed, memory impairment, feeling as if in a fog and visual impairment. The patient was hospitalized for 5 days. Treatment with glucose oxidase plus lactoperoxidase plus lysozyme was discontinued. At the time of reporting, the events were resolved. The patient lodged a product complaint of the biotene not having a lasting effect for his dry mouth.

Dry Mouth

How Can I Manage Dry Mouth?

There are a number of strategies that can help reduce the discomfort and risks associated with dry mouth.

Before you begin treatment:

  • Ask your doctor about medications that may reduce or prevent dry mouth. Medications are available that can help to protect your salivary glands during treatment, such as amifostine (Ethyol). Other medications can help maintain or stimulate saliva production, such as pilocarpine (Salagen) or cevimeline (Evoxac). Incorporating these medications into your treatment regimen may be recommended to minimize the impact of radiation treatment on saliva production.
  • Get a complete oral and dental evaluation, and receive treatment for any active dental disease. Maintaining or restoring dental health and receiving preventative care are important parts of comprehensive care.
  • Prevention of dental damage with fluoride applied to the teeth by your dentist and daily applications with a mouth guard have been shown to be effective and important in prevention of dental damage.

During and After Treatment:

  • Maintain good daily oral hygiene, which may include using high strength prescription fluoride, remineralizing products, and antibacterial products.
  • See your dentist regularly (every 3 to 4 months). Dental care is more important than ever for head and neck cancer patients.
  • Use moisturizing, alcohol-free mouthwash, especially those specifically intended for dry mouth, such as Biotene or Oasis.
  • Use saliva substitutes, such as Lubricity, or mouth rinses containing complex polysaccharides, hyetellose, hyprolose, or carmellose.
  • Stay hydrated. Carry a water bottle whenever possible, and try to drink at least 64 ounces of fluids every day.
  • Suck on sugar-free hard candy (especially tart flavors) or chew sugar-free gum. Look for products containing xylitol.
  • When eating, moisten your foods with sauces, gravies, or dressings. Limit foods that are dry or hard to swallow, such as peanut butter, tough meats, and breads.
  • Avoid alcohol, and limit caffeine.
  • Apply wax- or lanolin-based lip balms with sunscreen. Avoid petrolatum and petrolatum-containing products.
  • Sleep with a humidifier in your room to alleviate nighttime discomfort.

As a cancer survivor:

  • Be sure your dentist is aware of your cancer and all cancer treatment you have received. He or she should communicate with your cancer team and seek the advice of experienced dental providers if complex dental/oral conditions arise.
  • Seek out oral care support groups who may have useful information.

As with any side effect of treatment, if it becomes troublesome, speak with your medical team about interventions that may help.

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