Pilocarpine for Xerostomia 

What is Pilocarpine? 

Pilocarpine is a medication that binds to cholinergic receptors causing an increase in the secretion of exocrine glands, including salivary glands. It comes in an oral (Salagen) and ophthalmic (Isopto Carpine) formulation being used to reduce ocular pressure in patients with open-angle glaucoma.  

What is Xerostomia? 

Xerostomia, or dry mouth, is a condition where the salivary glands are hypoactive. It is persistent and can cause dental problems if left untreated, such as difficulty eating/swallowing, tooth decay, altered taste, and oral infections. Xerostomia has a multitude of causes: Sjogren’s syndrome, medications (such as opioids, antihistamines). 

FAQs 

How often should I use this medication? 
Pilocarpine is dosed at 5 mg to be taken by mouth three to four times daily. 

What side effects can I expect? 
Nausea, headache, flushing, increased urinary frequency, excessive or unusual sweating 

Why do my symptoms seem to worsen overnight?
This is because our salivary output is in sync with our circadian rhythm – this means that we have less saliva being produced at night. In addition, this decline in salivary output can be exacerbated by breathing through the mouth. In addition to taking Pilocarpine, what else can I do to alleviate my dry mouth? Sugar-free chewing gum, sugar-free mints, and sugar-free candy can help stimulate saliva production. 

Created by: Megan Willingham, Pharm D Candidate 2022 

References 

Pilocarpine. Lexi-Drugs. Lexicomp, UpToDate, Inc,;2021. Updated November 16, 2021. Accessed December 3, 2021.  

Xerostomia (Dry Mouth). American Dental Association. Updated February 22, 2021. Accessed December 3, 2021.

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