Dosing & Uses
Dosage Forms & Strengths
5 mg PO q8hr; may titrate up to 10 mg PO q8hr; not to exceed 30 mg/day
Xerostomia Associated with SjÖgren's Syndrome
5 mg PO q6hr
Moderate impairment: 5 mg PO q2hr, then adjust dose according to treatment efficacy and patient's tolerability
Severe hepatic insufficiency (Child-Pugh score of 10-15): Contraindicated
Safety & efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Urinary frequency (9-12%)
Frequency Not Defined
Increased airway resistance
Decreased visual acuity
Uncontrolled asthma, anterior eye inflammation, any time miosis in undesirable (eg, narrow-angle glaucoma, acute iritis)
Severe hepatic impairment
Use caution in cardiovascular disease, cholelithiasis, biliary tract disease, COPD, chronic bronchitis, history of nephrolithiasis, concomitant use of beta adrenergic agonist, renal insufficiency, PUD, Parkinson's, hyperthyroidism, urinary tract obstruction
May require up to 12 wk to determine if head/neck cancer patients will respond
Pregnancy & Lactation
Pregnancy Category: C
Lactation: unknown if drug is distributed into breast milk; use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Cholinergic parasympathomimetic with predominant muscarinic action; increases secretion of exocrine glands (sweat, lacrimal, salivary, intestinal, pancreatic glands, and mucous cells of the respiratory tract may be stimulated
Tone and mobility of gallbladder, biliary duct, and urinary tract may be increased
Half-Life: 0.76-1.35 hr
Onset: 20 min (initial response for xerostomia)
Duration: 3-5 hr (single dose), >10 hr (multiple dose)
Peak plasma time: 0.85-1.25 hr
Bioavailability: High fat meal decreases rate & extent of absorption
Protein bound: None
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.