PILOCARPINE
Background and Date of Approval
The U.S. FDA approved pilocarpine on 12 April 1996 for treatment of dry eye and dry mouth in patients.
Uses
Pilocarpine is used to treat dryness in the mouth once after the radiotherapy of head or neck cancer. Additionally, It is given to treat the dryness in the mouth and eyes when you have been diagnosed with the medical condition called Sjogren's syndrome.
How is it administered?
Swallow the tablet with water during or directly after meals. Do not crush, bite, or chew. Your physician will decide the accurate frequency and duration of this treatment by monitoring your progress.
Side Effects
The most common side effects of Pilocarpine are flu-like symptoms, weakness, chills, runny nose, sweating, headache, frequent urination, diarrhea, constipation, dizziness, indigestion, stomach pain, nausea, vomiting, watering of the mouth, watery eyes, abnormal or blurred vision, red and swollen eyes, painful eyes. Serious side effects while taking Pilocarpine include allergic reactions, including rash and itching, fast heartbeat, and high blood pressure.
Warnings
Do not take this medicine if you are allergic to Pilocarpine or the other ingredients of this medicine or if you have any medical condition such as uncontrolled asthma, heart (heart failure / irregular pulse), liver disorder, or kidney (renal insufficiency, or stone) disorder, acute inflammation of the iris, or any chronic disease. Before starting the treatment, tell your doctor if you have any lung-related problems (chronic pulmonary disease, chronic bronchitis), bile duct problems, stomach or intestinal problems, cognitive or mental problems, or eye problems.
Precautions
Your doctor might check your eye before beginning the treatment; inform your doctor if you have yet to have an eye check-up recently. Inform your healthcare professional if you have any liver disorder (cirrhosis) because your doctor will begin your treatment with a low dose and increase the dose based on the response. Before starting the treatment, inform your doctor if you are trying to get pregnant or already pregnant. It is advised to use effective contraception to avoid unwanted pregnancy during treatment.
Word of Advice
Do not discontinue Pilocarpine without your doctor's instruction. If therapeutic benefit is not evident, your physician may elect to stop treatment. Your doctor will modify the dosage according to treatment response. This medicine may impair fertility in both men and women; discuss fertility concerns with your doctor. Use reliable contraception to prevent pregnancy. Before initiating treatment, inform your doctor of all other medicines you are taking. Should you experience any adverse effects, contact your doctor without delay.
References
Norgine Pharmaceuticals Limited, Electronic Medicines Compendium (EMC), [Revised on Sep 2020] [Accessed on 29th April 2023], https://www.medicines.org.uk/emc/files/pil.1370.pdf KD Tripathi, Cholinergic Transmission and Cholinergic Drugs, Essentials of Medical Pharmacology, 8th Edition, 2019, 110-123. S.H. Ralston, I.B. McInnes, Rheumatology and bone disease, Davidson's Principles and Practice of Medicine, 22nd Edition, 2014, 1057-1135. G.G. Dark, A.R. Abdul Razak, Oncology, Davidson's Principles & Practice of Medicine, 22nd Edition, 2014, 259-282.
Frequently Asked Questions
Why is it mandatory to use contraception while on the treatment with Pilocarpine?
It is mandatory to use contraception because the medication may trigger the vaginal secretions. This may lead to an increased risk of pregnancy and the spread of STIs (sexually transmitted infections).
Why is it recommended not to get pregnant during Pilocarpine treatment?
Pregnant women who consume Pilocarpine can cause harm to their unborn babies. Hence it is not recommended to take this medication; notify your doctor if you are pregnant or planning to get pregnant.
Can Pilocarpine be taken with other medications?
Pilocarpine may interact with other medications, including antidepressants, antihistamines, and blood pressure medications. It is mandatory to tell your doctor about all medications, supplements, and herbal remedies you are taking before starting treatment with Pilocarpine.
How should Pilocarpine be stored?
Pilocarpine should be stored at room temperature, away from heat and moisture. It should be kept far away from the reach of pets and children.
How long should I use Pilocarpine?
Pilocarpine is an oral tablet to use in long-term administration. Your physician determines frequency and duration.