pilocarpine (Rx)

Brand and Other Names:Pilocarpine PO, Salagen
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 7.5mg
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Radiation-induced Xerostomia

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

Hepatic Impairment

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

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Interactions

Interaction Checker

and pilocarpine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Sweating (29%)

            Headache (11%)

            Flushing (8-13%)

            Dizziness (5-12%)

            Chills (3-15%)

            Nausea (6-15%)

            Urinary frequency (9-12%)

            Rhinitis (5-14%)

            Diaphoresis (29-68%)

            1-10%

            Pain (4%)

            Asthenia (>3%)

            Dyspepsia (7%)

            Vomiting (3-4%)

            Hypertension (3%)

            Lacrimation (6%)

            Amblyopia (4%)

            Frequency Not Defined

            Confusion

            Hypotension

            Bradycardia

            Tachycardia

            Increased airway resistance

            Diarrhea

            Bladder tightness

            Decreased visual acuity

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            Warnings

            Contraindications

            Uncontrolled asthma, anterior eye inflammation, any time miosis in undesirable (eg, narrow-angle glaucoma, acute iritis)

            Hypersensitivity

            Severe hepatic impairment

            Cautions

            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

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown if drug is distributed into breast milk; use caution

            Pregnancy Categories

            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.

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            Pharmacology

            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

            Pharmacokinetics

            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

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            Formulary

            FormularyPatient Discounts

            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.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
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            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.

            Tier Description
            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.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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