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Muscarinic Agonist — Dry Mouth / Sjögren's

Pilocarpine

Brand names: Salagen, Pilocarpine HCl

Pilocarpine is a cholinergic agent used systemically to treat dry mouth (xerostomia), including that following head and neck radiotherapy or due to Sjogren's syndrome.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a muscarinic receptor agonist that stimulates exocrine secretion, increasing saliva production from residual functioning salivary gland tissue.

Prescribing in practice

  • It is contraindicated in uncontrolled asthma and in acute or narrow-angle glaucoma owing to its cholinergic effects.
  • Common cholinergic adverse effects include sweating, nausea, urinary frequency and rhinitis.
  • Caution is needed in patients with cardiovascular disease, chronic bronchitis or other conditions sensitive to increased cholinergic tone.

Monitoring

Monitor for the response of dry-mouth symptoms and for cholinergic adverse effects such as excessive sweating or palpitations.

Counselling the patient

  • Increased sweating is a common effect, so maintain an adequate fluid intake.
  • Tell us if you experience wheezing, blurred vision or a fast heartbeat.
  • Take it as directed and report any troublesome side effects.

Evidence & guidelines

Use is established for radiotherapy-induced and Sjogren's-related xerostomia; refer to the SPC for contraindications and cautions.

Reference: Fox et al. (1996) NEJM Pilocarpine for Sjögren's; BSAC/BSR Sjögren's Syndrome Guidelines 2017; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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