pilocarpine hydrochloride

Posted on April 28th, 2009 by

Class: Supportive care

Generic Name: Pilocarpine hydrochloride (PIE-loe-kar-peen HIE-druh-KLOR-ide)
Trade Name: Salagen®

For which conditions is this drug approved? Pilocarpine is FDA approved for the treatment of dry mouth caused by radiation therapy in patients with head and neck cancer.  It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Pilocarpine belongs to a class of drugs called cholinergic agonists. Pilocarpine stimulates the salivary glands to produce more saliva, thus relieving dry mouth.

How is pilocarpine typically given (administered)? Pilocarpine is taken orally, in the form of a tablet and the dose depends on several factors, including the condition being treated, the response to treatment and the overall health of the patient.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with pilocarpine.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.  Patients will be assessed on the extent of dry mouth. Patients may also have their lung and heart functions monitored.

What are the common (occur in 30% or more of patients) side effects of treatment with pilocarpine?

• Sweating

What are the less common (occur in 10% to 29% of patients) side effects of treatment with pilocarpine?

• Nausea
• Chills
• Runny nose
• Dizziness
• Weakness
• Reddening of the face or neck
• Diarrhea
• Urinary frequency
• Headache

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Patients taking pilocarpine should exercise caution with driving vehicles or operating heavy machinery, as treatment may cause dizziness or blurry vision.
• If an oral dose is missed, do not double up on doses.  Patients should contact their doctor in this event.
• Keep tablets out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.

When should patients notify their physician?

• Difficulty breathing, wheezing
• Chest pain
• Noticeable changes in heart rate or rhythm
• Dizziness or blurry vision
• Increased tears
• Headache
• Yellowing of skin or eyes
• Right upper quadrant pain
• Severe abdominal pain
• Swelling of the ankles, feet, hands or face
• Mental confusion, abnormal thinking
• Persistent or extreme diarrhea
• Persistent or extreme nausea or vomiting
• Urinating more than usual

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

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Tags: Drug Dictionary, P, Supportive

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