Pilocarpine
SALAGEN
Pronunciation: pye-loe-KAR-peen
“Saliva-generating Pile o’ carp”
Salagen is a sialogen
baby blue theme → muscarinic
What it isMuscarinic agonist; xerostomia in Sjogren disease and after radiation, and acute angle-closure glaucoma.
Why this oneIt stimulates residual salivary tissue, and topically it constricts the pupil to break an acute angle-closure attack.
What limits itSweating is the dose-limiting effect. Avoid in asthma and bradycardia; the eye drop causes brow ache and dim vision.
FDA-approved for
- glaucoma/dry mouth (~1994)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Xerostomia (head & neck cancer radiotherapy) | Adult | 5 mg TID | 15-30 mg/day (not to exceed 10 mg/dose) | 10 mg/dose |
| Dry mouth (Sjögren's syndrome) | Adult | 5 mg QID | 5 mg QID | 5 mg QID |
Renal Undefined
Hepatic Moderate impairment: start 5 mg BID; mild: no reduction; severe: not recommended
Instructions
- Titrate to therapeutic response and tolerability
- Head & neck cancer: up to 12 wk of uninterrupted therapy may be needed to assess response
Available strengths
- tab 5, 7.5 mg
- drops 0.4, 1, 1.25, 2, 4 %
- sol 4 mg/mL
Contraindications
- Uncontrolled asthma
- When miosis is undesirable (e.g., acute iritis, narrow-angle/angle-closure glaucoma)
Adverse reactions
- Sweating
- Nausea
- Rhinitis
- Chills
- Flushing
- Urinary frequency
- Dizziness
- Diarrhea
- Headache
Pregnancy No adequate studies; animal fetotoxicity (reduced fetal weight, stillbirths); use only if benefit justifies risk.
Lactation Undefined
Cost
Generic entry2004
NO BOXED WARNINGS
Principal riskSweating; bronchoconstriction in asthma
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Open Pilocarpine in the interactive console ↗
Memory aids: interaction avatars
