pilocarpine, Salagen: Drug Facts, Side Effects and Dosing
What is pilocarpine? What are the uses for pilocarpine?
Pilocarpine is a cholinergic drug, that is, a drug that mimics the effects of the chemical, acetylcholine which is produced by nerve cells. Acetylcholine serves as a messenger between nerve cells and between nerve cells and the organs they control. For example, acetylcholine is responsible for causing the salivary glands to make saliva and the lacrimal glands to make tears to lubricate the eyes. In addition to its effects on the salivary and lacrimal glands, acetylcholine reduces the production of fluid within the eye. Pilocarpine eye drops have been used for many years to treat glaucoma, a condition in which pressure within the fluid of the eye is abnormally elevated and ultimately damages the eye and impares vision. In 1994, an oral formulation of pilocarpine was approved by the FDA for the treatment of dry mouth caused by radiation therapy for head and neck cancer, a treatment that damages the salivary glands and reduces their production of saliva. In 1998, the oral preparation was approved for the management of Sjögren's syndrome, an autoimmune disease that damages the salivary and lacrimal glands. Pilocarpine was first isolated from the leaves of Pilocarpus microphyllus (also called jaborandi) in 1875.
What brand names are available for pilocarpine?
Salagen
Is pilocarpine available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for pilocarpine?
Yes
What are the side effects of pilocarpine?
Excessive sweating (diaphoresis) is a frequent side effect of pilocarpine. Other side effects include:
- chills,
- dizziness,
- excessive tearing,
- flushing,
- voice change,
- stuffy nose,
- tremor,
- nervousness,
- increased need to urinate,
- visual disturbances,
- diarrhea,
- difficulty swallowing,
- abdominal pain,
- nausea,
- vomiting,
- slow or increased heart rate,
- and high or low blood pressure.
What is the dosage for pilocarpine?
Oral pilocarpine usually is taken three or four times daily. The recommended dose for radiation induced xerostomia is 5 to 10 mg three times daily.
The dose for xerostomia associated with Sjögren's syndrome is 5 mg four times daily. The maximum effect occurs in approximately one hour but may occur later if it is taken with food. The effects last three to five hours.
SLIDESHOW
Mouth Problems: TMJ, Canker Sores, Painful Gums and More See SlideshowWhich drugs or supplements interact with pilocarpine?
Medications that have anticholinergic effects should not be used with pilocarpine since they will counter pilocarpine's cholinergic effects. Such medications include atropine, for example, Lomotil; some antihistamines,for example, diphenhydramine (Benadryl), promethazine (Phenergan)], and trimeprazine (Temaril); some phenothiazines, for example, mesoridazine (Serentil), promazine (Sparine), thioridazine (Mellaril), and triflupromazine (Vesprin); some antidepressants, for example, amitriptyline (Elavil, Endep), amoxapine (Asendin), bupropion (Wellbutrin; Zyban), clomipramine (Anafranil), doxepin (Sinequan), maprotiline (Ludiomil), and protriptyline (Vivactil) as well as clozapine (Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace).
Is pilocarpine safe to take if I'm pregnant or breastfeeding?
The safety of oral pilocarpine during pregnancy has not been evaluated. The physician and patient need to weigh the benefits and the unknown risk to the fetus before using pilocarpine during pregnancy.
It is not known if pilocarpine is secreted in human breast milk in amounts large enough to affect the nursing infant.
What else should I know about pilocarpine?
What preparations of pilocarpine are available?
Tablets: 5 and 7.5 mg.
How should I keep pilocarpine stored?
Tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
Health News
Summary
Pilocarpine (Salagen) is a medication prescribed for the treatment of dry mouth caused by Sjogren's syndrome, and radiation to the neck and head. Review side effects, drug interactions, dosage, and pregnancy safety information prior to taking this medication.
Related Disease Conditions
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Sjogren's Syndrome
Sjögren's syndrome is an autoimmune disorder that causes symptoms that include dry eyes, dry mouth, fatigue, and joint and muscle pain. Read about Sjogren's syndrome diet, complications, treatment, diagnosis, medications, and symptoms.
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Dry Mouth
Dry mouth is a common side effect of many prescription and non-prescription drugs and certain medical conditions. Symptoms of dry mouth include a sticky, dry feeling in the mouth, frequent thirst, sores in the mouth; sores or split skin at the corners of the mouth, cracked lips, a dry feeling in the throat, a burning or tingling sensation in the mouth, and a dry, red, raw tongue.
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Glaucoma
Glaucoma is a common eye condition in which the fluid pressure inside the eye rises because of slowed fluid drainage from the eye. If untreated, glaucoma may damage the optic nerve and other parts of the eye, causing the loss of vision or even blindness.
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Retinal Detachment
Retinal detachment is the separation of the retina from its attachments to the underlying eye tissue. Symptoms of retinal detachment include flashing lights and floaters. Highly nearsighted young adults and those who've had cataract surgery are at higher risk for retinal detachment.
Treatment & Diagnosis
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
References
FDA Prescribing Information