Take pilocarpine during a meal. Swallow the tablet with a large glass of water.
The tablets may reduce your ability to see clearly in poor lighting. Do not drive at night if you are affected.The most common side-effects include headache, sweating, flu-like symptoms and passing urine more frequently.
|Type of medicine||A cholinergic medicine|
|Used for||Dry mouth after radiotherapy; dry mouth and dry eyes in Sjögren's syndrome|
Pilocarpine is prescribed to relieve dry mouth (sometimes called xerostomia) brought on by radiotherapy to the head or neck.
Pilocarpine can also be used to relieve some of the symptoms of Sjögren's syndrome. Sjögren's syndrome can cause various symptoms, the most common being dry eyes and dry mouth. These symptoms are due to lack of secretions from glands in your body.
Pilocarpine tablets stimulate your glands to produce more saliva and tears.
Before taking pilocarpine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking pilocarpine it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have a heart condition or blood vessel disease.
- If you have a problem with the way your kidneys work, or a problem with the way your liver works.
- If you have asthma, COPD, or any other breathing problem.
- If you have a stomach ulcer, gallstones, or a problem with your bile duct.
- If you have an eye condition such as increased pressure in your eye (glaucoma), or inflammation of the iris of your eye (iritis).
- If you get confused easily.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take pilocarpine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about pilocarpine, and will also provide you with a full list of side-effects which you could experience from taking it.
- Your doctor will tell you how often to take the tablets - take them exactly as your doctor directs. As a guide, if you are taking them following radiotherapy, it is likely you will be prescribed one tablet three times daily to begin with. Take your doses during (or straight after) a meal, and make sure you take your last dose of the day with your evening meal. If you are taking pilocarpine because you have Sjögren's syndrome, the usual dose is one tablet four times daily. Take a tablet with each of your three main meals, and also one at bedtime. Although these are the usual starting doses for people taking pilocarpine, your doctor may increase your dose if it is appropriate for you.
- Every time you take a tablet, drink a large glass of water with it. This is to prevent you from becoming dehydrated, as pilocarpine can make you sweat more than usual.
- If you forget to take a dose, take it as soon as you remember unless your next dose is due. If it is nearly time for your next dose, don't take the forgotten dose but instead wait and take the next dose as normal. Do not take two doses together to make up for the missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If after taking pilocarpine for a couple of months you feel that your condition has not greatly improved, you should let your doctor know about this. Pilocarpine will not be effective if the glands in your mouth or eyes cannot be sufficiently stimulated to produce more saliva or tears.
- If you are due to have an operation or any dental treatment, please tell the person carrying out the treatment that you are taking pilocarpine.
- If you buy any medicines 'over the counter', check with a pharmacist that they are suitable for you to take alongside pilocarpine.
Can pilocarpine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with pilocarpine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any continue or become troublesome.
|Common and very common pilocarpine side-effects (some can affect more than 1 in 10 people)||What can I do if I experience this?|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Increased sweating and flushing||Take care not to become overheated during exercise or hot weather. Drink several large glasses of water every day|
|Blurred vision, eye irritation or pain, watery eyes||Do not drive or use tools or machines if you cannot see clearly (particularly at night or if you have difficulty seeing in poor lighting)|
|Diarrhoea, constipation, tummy ache (abdominal pain)||Try to eat a well-balanced diet. Drink plenty of water|
|Indigestion, feeling or being sick||Eat simple foods - avoid rich or spicy meals|
|Feeling dizzy or weak||Sit down for a few minutes until you feel better. Do not drive or use tools or machines while affected|
|Increased frequency of passing urine,|
high blood pressure, the sensation of having a 'thumping' heart (palpitations), flu-like symptoms, runny nose, allergic
reactions such as skin rash and itchiness
|If any of these become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store pilocarpine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Salagen® 5 mg Film Coated Tablets; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated December 2014.
- British National Formulary; 70th Edition (Sep 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall