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June 1991

Pilocarpine Treatment of Salivary Gland Hypofunction and Dry Mouth (Xerostomia)

Author Affiliations

From the Clinical Investigations and Patient Care Branch, National Institute of Dental Research, National Institutes of Health, Bethesda, Md (Drs Fox, Atkinson, Wolff, Valdez, Jackson, Delapenha, Shiroky, and Baum and Ms Macynski), and Columbia University School of Dental and Oral Surgery, New York, NY (Dr Kung). Dr Wolff is now with the Tel Aviv (Israel) University School of Dental Medicine; Dr Kung, Harvard School of Dental Medicine, Boston, Mass; Dr Jackson, National Heart, Lung, and Blood Institute, National Institutes of Health; and Dr Shiroky, Montreal (Quebec) General Hospital.

Arch Intern Med. 1991;151(6):1149-1152. doi:10.1001/archinte.1991.00400060085014

We studied the effects of pilocarpine hydrochloride, a parasympathomimetic agent, on major salivary gland output and subjective responses in 31 patients with salivary hypofunction. Pilocarpine hydrochloride (5-mg capsules, three times daily) was given for 5 months and a placebo was randomly assigned for 1 month in a double-blind fashion. Objective measurements of major salivary gland output, subjective impressions of oral moisture, treatment-related side effects, and a number of physiologic measures were assessed monthly. Pilocarpine significantly increased salivary output in 21 of the 31 patients. Subjective improvement in the feeling of oral dryness, speaking, chewing, and swallowing were reported by 27 individuals. Side effects, while common, generally were mild and tolerable. There were no significant alterations in cardiovascular or other physiologic measures. We conclude that pilocarpine is an effective and safe treatment for salivary gland hypofunction and xerostomia in selected patients. The increase in major gland output provides beneficial natural secretions and relief of oral dryness.

(Arch Intern Med. 1991;151:1149-1152)