Dosing & Uses
Dosage Forms & Strengths
tablet
- 5mg
- 7.5mg
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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
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
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.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
Images
Patient Handout
Formulary
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