Several types of medications, such as antifungals and nonsteroidal anti-inflammatory drugs (NSAIDs), may cause bad breath, according to a review published recently in the International Dental Journal.
Understanding how these drugs contribute to bad breath may help clinicians diagnose and manage the condition more effectively, the authors wrote.
“Halitosis can be due to consuming some specific medications, and its origin can be intra-oral or extra-oral,” wrote the authors, led by Mina Iranitalab of the University of Toronto (Int Dent J, January 9, 2026, 109332).
The review analyzed literature published between January 2015 and December 2024 using electronic database searches. Relevant articles were screened, and data were collected, categorized, and reported as intraoral or extraoral causes of halitosis. The review identified several medications linked to extraoral halitosis, including ranitidine, cysteamine, antifungals, peppermint oil, aspirin and other NSAIDs, PX-12, silybin, disulfiram, suplatast tosilate, dimethyl sulfoxide, levocarnitine, nitrates, nitrites, and iodine-containing drugs, they wrote.
Ranitidine, designed to reduce gastric acid secretion, was reported to cause extraoral halitosis in approximately 1 out of 110 patients who were taking 150 mg daily. Additionally, cysteamine, used to treat cystinosis and Huntington’s disease, and several antifungals were associated with halitosis, often through gastrointestinal side effects.
Peppermint oil, prescribed for irritable bowel syndrome, was linked to halitosis in one clinical trial, though later studies did not consistently confirm this finding. Aspirin and other NSAIDs were found to contribute to halitosis through heartburn-related mechanisms, while tumor inhibitors such as PX-12 and silybin showed dose-dependent associations with halitosis, they wrote.
Other medications, including disulfiram, suplatast tosilate, dimethyl sulfoxide, and levocarnitine, were reported to cause halitosis due to the production and exhalation of odorous metabolites. In contrast, intraoral halitosis was primarily linked to oral conditions such as tongue coating, periodontal disease, poor oral hygiene, and medications that cause xerostomia or medication-related osteonecrosis of the jaw.
However, the study had limitations. Further research is needed to properly evaluate halitosis as a drug-related side effect, as few studies have monitored it independently, the authors added.
“Prior knowledge of medications that are more likely to cause these conditions can help clinicians diagnose and manage the underlying causes of halitosis more effectively,” they concluded.
