Individual generic drug information

pilocarpine

Reference monograph

Part of registered formulation

PILOCARPINE NITRATE

Reference record: Pilocarpine
Source: BNF 80 (2020–2021)
Printed source pages: 1296, 1297
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Pilocarpine only.

Indications And Dose

Xerostomia following irradiation for head and neck cancer ▶BY MOUTH ▶Adult: 5 mg 3 times a day for 4 weeks, then increased if tolerated to up to 30 mg daily in divided doses if required, dose to be taken with or immediately after meals (last dose always with evening meal), maximum therapeutic effect normally within 4–8 weeks; discontinue if no improvement after 2–3 months Dry mouth and dry eyes in Sjögren’s syndrome ▶BY MOUTH ▶Adult: 5 mg 4 times a day; increased if tolerated to up to 30 mg daily in divided doses if required, dose to be taken with meals and at bedtime, discontinue if no improvement after 2–3 months

Source page 1296

Contra Indications

Acute iritis. uncontrolled asthma (increased bronchial secretions and increased airways resistance). uncontrolled cardiorenal disease. uncontrolled chronic obstructive pulmonary disease (increased bronchial secretions and increased airways resistance)

Source page 1297

Cautions

Asthma (avoid if uncontrolled). biliary-tract disease. cardiovascular disease (avoid if uncontrolled). cholelithiasis. chronic obstructive pulmonary disease (avoid if uncontrolled). cognitive disturbances. maintain adequate ﬂuid intake to avoid dehydration associated with excessive sweating. peptic ulceration. psychiatric disturbances. risk of increased renal colic. risk of increased urethral smooth muscle tone. susceptibility to angle-closure glaucoma

Source page 1297

Safety

Extracted information for Pilocarpine only.

Interactions

→Appendix 1: pilocarpine

Source page 1297

Side Effects

▶Common or very common Asthenia. conjunctivitis. constipation. diarrhoea. dizziness. excessive tearing. eye pain. ﬂushing. gastrointestinal discomfort. headache. hyperhidrosis. hypersalivation. hypersensitivity. hypertension. increased risk of infection. nausea. palpitations. skin reactions. urinary disorders. vision disorders. vomiting ▶Uncommon Gastrointestinal disorders ▶Frequency not known Affective disorder. agitation. arrhythmias. atrioventricular block. chills. confusion. hallucination. hypotension. memory loss. psychiatric disorder. respiratory distress. shock. tremor

Source page 1297

Pregnancy

Avoid—smooth muscle stimulant; toxicity in animal studies.

Source page 1297

Breast Feeding

Manufacturer advises avoid—present in milk in animal studies.

Source page 1297

Hepatic Impairment

Manufacturer advises caution in moderate to severe cirrhosis. Dose adjustments Manufacturer advises initial dose reduction in moderate to severe cirrhosis.

Source page 1297

Renal Impairment

Manufacturer advises caution with tablets.

Source page 1297

Dose and formulations

Extracted information for Pilocarpine only.

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral solution Tablet CAUTIONARY AND ADVISORY LABELS 21, 27 ▶Salagen (Norgine Pharmaceuticals Ltd) Pilocarpine hydrochloride 5 mg Salagen 5mg tablets | 84 tablet P £41.14 DT = £41.14 Oral hygiene Mouthwashes and other preparations for oropharyngeal use Lozenges and sprays There is no convincing evidence that antiseptic lozenges and sprays have a beneﬁcial action and they sometimes irritate and cause sore tongue and sore lips. Some of these preparations also contain local anaesthetics which relieve pain but may cause sensitisation. Mouthwashes, gargles, and dentifrices Superﬁcial infections of the mouth are often helped by warm mouthwashes which have a mechanical cleansing effect and cause some local hyperaemia. However, to be effective, they must be used frequently and vigorously. A warm saline mouthwash is ideal and can be prepared either by dissolving half a teaspoonful of salt in a glassful of warm water or by diluting compound sodium chloride mouthwash p. 1277 with an equal volume of warm water. Mouthwashes containing an oxidising agent, such as hydrogen peroxide p. 1276, may be useful in the treatment of acute ulcerative gingivitis (Vincent’s infection) since the organisms involved are anaerobes. It also has a mechanical cleansing effect arising from frothing when in contact with oral debris. Chlorhexidine below is an effective antiseptic which has the advantage of inhibiting plaque formation on the teeth. It does not, however, completely control plaque deposition and is not a substitute for effective toothbrushing. Moreover, chlorhexidine preparations do not penetrate signiﬁcantly into stagnation areas and are therefore of little value in the Ear, nose and oropharynx control of dental caries or of periodontal disease once pocketing has developed. Chlorhexidine mouthwash is used in the treatment of denture stomatitis. It is also used in the prevention of oral candidiasis in immunocompromised patients. Chlorhexidine mouthwash reduces the incidence of alveolar osteitis following tooth extraction. Chlorhexidine mouthwash should not be used for the prevention of endocarditis in patients undergoing dental procedures. Chlorhexidine can be used as a mouthwash, spray or gel for secondary infection in mucosal ulceration and for controlling gingivitis, as an adjunct to other oral hygiene measures. These preparations may also be used instead of toothbrushing where there is a painful periodontal condition (e.g. primary herpetic stomatitis) or if the patient has a haemorrhagic disorder, or is disabled. Chlorhexidine preparations are of little value in the control of acute necrotising ulcerative gingivitis. With prolonged use, chlorhexidine causes reversible brown staining of teeth and tongue. Chlorhexidine may be incompatible with some ingredients in toothpaste, causing an unpleasant taste in the mouth; rinse the mouth thoroughly with water between using toothpaste and chlorhexidine-containing products. There is no convincing evidence that gargles are effective in adults. ANTISEPTICS AND DISINFECTANTS

Source page 1297

Clinical care

Extracted information for Pilocarpine only.

Patient And Carer Advice

Driving and skilled tasks Blurred vision may affect performance of skilled tasks (e.g. driving) particularly at night or in reduced lighting.

Source page 1297

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

5 mg 3 times a day for 4 weeks, then increased if

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1296

Adults

First line only; read the complete Indications and dose section above.

5 mg 4 times a day; increased if tolerated to up

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1296

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

pilocarpine

Reference monograph

Part of registered formulation

PILOCARPINE NITRATE

Reference record: Pilocarpine
Source: BNF 80 (2020–2021)
Printed source pages: 1296, 1297
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Pilocarpine only.

Indications And Dose

Source page 1296

Contra Indications

Source page 1297

Cautions

Source page 1297

Safety

Extracted information for Pilocarpine only.

Interactions

→Appendix 1: pilocarpine

Source page 1297

Side Effects

Source page 1297

Pregnancy

Avoid—smooth muscle stimulant; toxicity in animal studies.

Source page 1297

Breast Feeding

Manufacturer advises avoid—present in milk in animal studies.

Source page 1297

Hepatic Impairment

Manufacturer advises caution in moderate to severe cirrhosis. Dose adjustments Manufacturer advises initial dose reduction in moderate to severe cirrhosis.

Source page 1297

Renal Impairment

Manufacturer advises caution with tablets.

Source page 1297

Dose and formulations

Extracted information for Pilocarpine only.

Medicinal Forms

Source page 1297

Clinical care

Extracted information for Pilocarpine only.

Patient And Carer Advice

Driving and skilled tasks Blurred vision may affect performance of skilled tasks (e.g. driving) particularly at night or in reduced lighting.

Source page 1297

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

5 mg 3 times a day for 4 weeks, then increased if

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1296

Adults

First line only; read the complete Indications and dose section above.

5 mg 4 times a day; increased if tolerated to up

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1296

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.