GENERIC NAME: pilocarpine oral

BRAND NAME: Salagen

DRUG CLASS AND MECHANISM: 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 controls the production of fluid within the eye, and pilocarpine eye drops have been used to treat glaucoma for many years. 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 Sjogren's syndrome, an autoimmune disease that damages the salivary and lacrimal glands. Piloca pilocarpine was first isolated from the leaves of Pilocarpus microphyllus (also called jaborandi) in 1875.

GENERIC AVAILABLE: no

PRESCRIPTION: yes

PREPARATIONS: Tablets, 5mg; 7.5mg.

STORAGE: Tablets should be stored at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Oral pilocarpine is used to treat dry mouth caused by Sjogren's syndrome and radiation therapy to the head and neck.

DOSING: Oral pilocarpine usually is taken three or 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.

DRUG INTERACTIONS: Medications possessing anticholinergic effects or side effects should not be used with pilocarpine since they will counter pilocarpine's cholinergic effects. Such medications include atropine, e.g., Lomotil; some antihistamines, e.g., carbinoxamine (Cardec-DM, Rondec-D), clemastine (Tavist), diphenhydramine (Benadryl), promethazine (Phenergan), trimeprazine (Temaril); some phenothiazines, e.g., mesoridazine (Serentil), promazine (Sparine), thioridazine (Mellaril), triflupromazine (Vesprin)]; clozapine (Clozaril), cyclobenzaprine (Flexeril), disopyramide Norpace); some antidepressants, e.g., amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin; Zyban), clomipramine (Anafranil), doxepin (Sinequan), maprotiline (Ludiomil), and protriptyline (Vivactil).

PREGNANCY: 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.

NURSING MOTHERS: It is not known if pilocarpine is secreted in human breast milk in amounts large enough to affect the nursing infant.

SIDE EFFECTS: Excessive sweating (diaphoresis) is a frequent side effect of pilocarpine. Other side effects include chills, dizziness, excessive tearing, flushing, voice change, stuffy nose, tremor, increased need to urinate, visual disturbances, diarrhea, difficulty swallowing, abdominal pain, nausea, vomiting, and slow heart rate.
Last Editorial Review: 5/6/2004

From the Doctors at MedicineNet.com

Sjogren's Syndrome - Learn about Sjogren's syndrome, an autoimmune disease involving the abnormal production of extra antibodies that attack the glands and connective tissue. Primary Sjogren's syndrome only affects the glands, while secondary Sjogren's syndrome also involves the connective tissue. Symptoms may include dry eyes, dry mouth, rheumatoid arthritis, lupus, or scleroderma. Though there is no cure for Sjogren's syndrome, the symptoms may be treated by using lubricating eye ointments, drinking plenty of water, humidifying the air, and using glycerin swabs. Medications are also available to treat dry eye and dry mouth. Source:MedicineNet Retinal Detachment - Learn the signs, symptoms (floaters), statistics, causes, treatment (surgery) and risk factors (severe myopia, cataract surgery) of detached retinas. Source:MedicineNet Read 26 more pilocarpine related articles ... So Much to Do, So Little Sleep Head Injuries All Too Common in Summer Play Health Tip: The Word on Wisdom Teeth Health Tip: Make Exercise a Daily Habit New Source of Heart Stem Cells Found Health Highlights: June 23, 2008 Poorer Patients Have Poorer Survival After Cancer Diagnosis One Gene May Be Key to Myeloma Crocodile Babies Cry Out for Hatching Immune Molecule Key to Preventing Organ Rejection