Pilocarpine

Pilocarpine is a prescription used for treating the symptoms of dry mouth caused due to radiation or Sjogren’s syndrome.

Pilocarpine is available under the following different brand names: Pilocarpine PO, Salagen

Adult dosage

Tablet

• 5mg
• 7.5mg

Radiation-induced Xerostomia

Adult dosage

• 5 mg orally every 8 hours; may titrate up to 10 mg orally every 8 hours; not to exceed 30 mg/day
• Xerostomia Associated with Sjogren's Syndrome

Adult dosage

• 5 mg orally every 6 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Pilocarpine include:

• temporary irritation/burning/stinging of the eye,
• temporary blurred vision,
• poor vision in dim light,
• headache, or
• brow ache.

Serious side effects of the Pilocarpine include:

• eye pain,
• flushing,
• diarrhea,
• nausea,
• stomach/abdominal pain or cramps,
• increased saliva,
• unusual sweating, or
• vision changes.

Rare side effects of the Pilocarpine include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Pilocarpine has severe interactions with no other drugs.
• Pilocarpine has serious interactions with the following drugs:
  • lonafarnib
• Pilocarpine has moderate interactions with at least 77 other drugs.
• Pilocarpine has minor interactions with at least 24 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Uncontrolled asthma, anterior eye inflammation, any time miosis is undesirable (eg, narrow-angle glaucoma, acute iritis)
• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Pilocarpine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Pilocarpine?”

Cautions

• Patients with significant cardiovascular disease may be unable to compensate for transient changes in hemodynamics or rhythm induced by therapy; pulmonary edema has been reported as a complication of pilocarpine toxicity from high ocular doses given for acute angle-closure glaucoma; pilocarpine should be administered with caution in and under the close medical supervision of patients with significant cardiovascular disease
• Therapy has been reported to increase airway resistance, bronchial smooth muscle tone, and bronchial secretions; therapy should be administered with caution to and under close medical supervision in patients with controlled asthma, chronic bronchitis, or chronic obstructive pulmonary disease requiring pharmacotherapy
• Pilocarpine toxicity is characterized by an exaggeration of parasympathomimetic effects, which may include: headache, visual disturbance, lacrimation, sweating, respiratory distress, gastrointestinal spasm, nausea, vomiting, diarrhea, atrioventricular block, tachycardia, bradycardia, hypotension, hypertension, shock, mental confusion, cardiac arrhythmia, and tremors
• Dose-related cardiovascular pharmacologic effects of pilocarpine include hypotension, hypertension, bradycardia, and tachycardia
• The drug should be administered with caution to patients with known or suspected cholelithiasis or biliary tract disease; contractions of the gallbladder or biliary smooth muscle could precipitate complications including cholecystitis, cholangitis, and biliary obstruction
• Pilocarpine may increase ureteral smooth muscle tone and could theoretically precipitate renal colic (or "ureteral reflux"), particularly in patients with nephrolithiasis
• Cholinergic agonists may have dose-related central nervous system effects; this should be considered when treating patients with underlying cognitive or psychiatric disturbances

Pregnancy and Lactation

• Use with caution if the benefits outweigh the  risks during pregnancy
• Lactation
  • Unknown if the drug is distributed into breast milk; use caution