Last updated: October 20, 2014

Trade Names: Salagen

Drug Class: Cholinergic agent

Preparations: 5- and 7.5 mg tablet

Dose: 5 mg three times daily; titrate to as high as 10 mg three times daily if needed

Indications: xerostomia, Sjögren’s syndrome

Mechanism of Action: Stimulates muscarinic receptors to increase saliva production

Contraindications: Hypersensitivity to pilocarpine, uncontrolled asthma, hepatic dysfunction

Precautions: Asthma, GI ulceration, cardiovascular disease, urinary tract obstruction, gall stones

Pregnancy Risk: C

Adverse Effects
Common: Sweating, flushing, dizziness, headache, nausea, rhinitis, urine frequency
Less common: Palpitation, rash, allergy, edema, bronchospasm

Drug Interactions
Beta-blockers: Increased risk of cardiac conduction disturbances
Parasympathomimetics: Additive effects
Anticholinergics (atropine, ipratropium): Antagonize effects

Patient Instructions: Expect increased sweating. It may take several weeks for response to occur.

Clinical Pharmacology: Half-life is 1 hour; duration of action 3–5 hours.

Cost: $$$

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