Dosing & Uses
Dosage Forms & Strengths
capsule
- 30mg
Xerostomia
Indicated for xerostomia in patients with Sjogren's syndrome
30 mg PO q8hr
Safety and efficacy not established
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Adverse Effects
>10%
Sweating (18.7%)
Nausea (13.8%)
Rhinitis (11.2%)
Sinusitis (12%)
Upper respiratory infection (11%)
1-10%
Vomiting (4.6%)
Fatigue (3%)
Insomnia (2%)
Hot flashes (2%)
Abdominal pain (8%)
Excessive salivation (2%)
Urinary tract infection (6%)
Back pain (5%)
Arthralgia (4%)
Skeletal pain (3%)
Weakness (1%)
Coughing (6%)
Bronchitis (4%)
Frequency Not Defined
Dizziness
Tremor
Pharyngitis
Dyspepsia
Angina
Bronchospasm
Dehydration
Delirium
Esophagitis
Hematuria
Impotence
Warnings
Contraindications
Uncontrolled asthma, conditions in which miosis is undesirable (eg, narrow-angle glaucoma, acute iritis)
Hypersensitivity
Cautions
Use caution in controlled asthma, chronic bronchitis, COPD, history of nephrolithiasis
Excessive sweating may lead to dehydration
May cause decreased visual acuity
Use caution in patients with history of biliary stones
Use caution in patients with cardiovascular disease
Pregnancy & Lactation
Pregnancy Category: C
Lactation: unknown whether distributed into breast milk, avoid or do not nurse
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.Pharmacology
Mechanism of Action
Muscarinic receptor agonist (quinuclidine derivative of acetylcholine), exhibits high binding affinity for muscarinic M3 receptors on lacrimal & salivary gland epithelium: increases salivation
Absorption
Bioavailability: Rapid absorption, food decrease rate of absorption
Peak Plasma Time: 1.5-2 hr
Distribution
Protein Bound: <20%
Vd: 6 L/kg
Metabolism
Metabolized by CYP3A4 and CYP2D6
Metabolites: Cis- & trans-sulfoxide (inactive), glucuronic acid conjugate (inactive), N-Oxide (inactive)
Elimination
Half-Life: ~5 hr
Excretion: Urine 97%; feces 0.5%
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Patient Handout
Formulary
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