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What is Pilocarpine?

Pilocarpine is a cholinergic medication, a drug that mimics the effects of the nerve cell-generated chemical, acetylcholine. As a messenger between nerve cells and between nerve cells and the organs they regulate, acetylcholine serves. In 1994, the FDA approved the oral formulation of pilocarpine for the treatment of dry mouth caused by radiation therapy for cancer of the head and neck, a treatment that damages the salivary glands and decreases their saliva production. An oral preparation for the management of Sjögren's syndrome, an autoimmune disease that damages the salivary and lacrimal glands, was approved in 1998.

Pilocarpine Uses

This medication is used to treat dry mouth symptoms due to a certain immune disease (Sjogren's syndrome) or damage caused to the saliva gland due to radiation treatment for cancer of the head/neck. Pilocarpine is a class of medications referred to as cholinergic agonists. It works to increase the amount of saliva you produce by stimulating certain nerves, making it easier and more comfortable to speak and swallow.

Pilocarpine Side effects:

Some of the common side effects of Pilocarpine are:

  • Sweating
  • Nausea
  • Runny nose
  • Diarrhea
  • Chills
  • Frequent urination
  • Dizziness
  • Weakness
  • Headache
  • Vomiting
  • Heartburn
  • Stomach pain
  • Swelling of arms, hands and lower legs

Some of the serious side effects of Pilocarpine are:

  • Change in the vision
  • Irregular heartbeat
  • Blurred vision
  • Mostly, the doctor will provide medicines looking at the benefit and their side effects. Many people who are using this medication won’t show any serious side effects. Consult with your doctor if you are having any of the above mentioned serious side effects.

    • Precautions

    Before taking Pilocarpine talk with your doctor if you are allergic to it or any other medications. The product may contain some inactive ingredients which can cause some serious allergic reactions or some other serious problems.
    Before using Pilocarpine talk with your doctor if you are having any medical history such as: breathing problems, glaucoma, night blindness, acute iritis, heart disease, low or high blood pressures, liver problems, gall bladder disease, kidney stones and stomach problems.

    How to take Pilocarpine?

    Pilocarpine comes in the form of a tablet which should be taken orally. When pilocarpine is used in people who have head and neck cancer and for the treatment of dry mouth caused by radiotherapy, pilocarpine is usually taken three times a day. If pilocarpine is used in people who have Sjogren's syndrome to relieve dry mouth, it is usually taken four times daily. Take pilocarpine daily at about the same time.
    Oral pilocarpine is commonly given three to four times a day. For radiation inducing xerostomia, the recommended dosage is 5 to 10 mg three times a day.
    The dosage for Sjögren's syndrome-associated xerostomia is 5 mg four times a day. The maximum impact occurs within around one hour, but if it is taken with food, it can occur later. The results are three to five hours in length.

    Missed Dose:

    If a dose is missing, take it as soon as you recall it. If the time for the next dose is close, skip the skipped dose. At your normal time, take your next dose. To catch up, do not double the dose.

    Overdose

    Overdose of a drug can be accidental. If you have taken more than the prescribed Pilocarpine tablets there is a chance of getting a harmful effect on your body’s functions. Overdose of a medicine can lead to some medical emergency.

    Warnings for some serious Health Conditions

    Pregnancy

    The efficacy of oral pilocarpine was not assessed during pregnancy. Before using pilocarpine during pregnancy, the doctor and patient need to consider the benefits and the unidentified danger to the foetus.

    For people with Diabetes

    Phenytoin tablets can increase blood sugar levels.

    Breastfeeding

    It is not clear if pilocarpine is secreted in quantities significant enough to affect a breastfeeding infant in human breast milk.

    Storage

    Direct contact with heat, air and light may damage your medicines. The exposure of medicine may cause some harmful effects. The medicine must be kept in a safe place and out of children’s reach. Mainly the drug should be kept at room temperature between 68ºF and 77ºF (20ºC and 25ºC).

    Pilocarpine Vs Atropine

    Pilocarpine

    Atropine
    Pilocarpine is a class of medications referred to as cholinergic agonists. It works to increase the amount of saliva you produce by stimulating certain nerves Atropine belongs to a class of medicines known as antimuscarinics or anticholinergics. Atropine occurs naturally and is extracted from the alkaloid plant belladonna.
    This medication is used to treat dry mouth symptoms due to a certain immune disease (Sjogren's syndrome) or damage caused to the saliva gland due to radiation treatment for cancer of the head/neck. Atropine is used before the eye examinations and can treat some types of eye conditions. This belongs to the class of drugs which is known as anticholinergics.
    Some of the common side effects of Pilocarpine are:
    • Sweating
    • Nausea
    • Runny nose
    • Diarrhea
    • Chills
    • Frequent urination
    		 Some of the common side effects of Pilocarpine are:
    • Drymouth
    • Blurred vision
    • Sensitivity to light
    • Lack of sweating
    • Dizziness

    Citations

    Effects of Pilocarpine, https://www.sciencedirect.com/science/article/abs/pii/0378517382901144
    Pilocarpine, https://link.springer.com/article/10.1007/BF02229072

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    Frequently Asked Questions

    What is the mechanism of action of Pilocarpine?

    In order to facilitate aqueous humour outflow, Pilocarpine contracts the ciliary muscle, causing increased tension on the scleral spur and opening the trabecular meshwork spaces.

    What is Pilocarpine used for?

    Pilocarpine is used in people with head and neck cancer to treat dry mouth caused by radiotherapy, and in people with Sjogren's syndrome to treat dry mouth (a condition that affects the immune system and causes dryness of certain parts of the body such as the eyes and mouth).

    How does Pilocarpine work on the eye?

    This medicine can also be used during some eye operations to counteract the effects of medications used to enlarge the pupil (e.g., during an eye exam). Pilocarpine medications work by forcing the pupil of the eye to shrink by reducing the amount of fluid inside the eye.

    How does Pilocarpine work for dry mouth?

    Pilocarpine is part of a class of medications referred to as cholinergic agonists. Pilocarpine tablet can increase the amount of saliva you produce by stimulating certain nerves, making it easier and more comfortable to speak and swallow.

    Can Pilocarpine raise blood pressure?

    Paradoxical effects on the cardiovascular system may be present with pilocarpine. Paradoxical is the anticipated effect of a muscarinic agonist, but Pilocarpine administration may produce hypertension after a brief episode of hypotension.

    When should I take Pilocarpine?

    Take your doses directly after a meal and be sure to take the last dose of the day with your evening meal. If you have Sjögren's syndrome, the usual dose if you are taking pilocarpine is one tablet 3-4 times a day.

    Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.