pilocarpine (Rx)

Brand and Other Names:Pilocarpine PO, Salagen
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 7.5mg

Radiation-induced Xerostomia

5 mg PO q8hr; may titrate up to 10 mg PO q8hr; not to exceed 30 mg/day

Xerostomia Associated with SjÖgren's Syndrome

5 mg PO q6hr

Hepatic Impairment

Mild impairment (Child-Pugh score of 5-6): Dose reduction not necessary

Moderate impairment (Child-Pugh score of 7-9): 5 mg PO BID followed by adjustment based on therapeutic response and tolerability

Severe impairment (Child-Pugh score of 10-15): Not recommended

Safety & efficacy not established

Next:

Interactions

Interaction Checker

and pilocarpine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (1)

              • lonafarnib

                pilocarpine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              Monitor Closely (77)

              • aclidinium

                pilocarpine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • amifampridine

                amifampridine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • amitriptyline

                pilocarpine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • amoxapine

                pilocarpine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • anticholinergic/sedative combos

                pilocarpine increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atogepant

                pilocarpine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • atracurium

                pilocarpine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atropine

                pilocarpine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atropine IV/IM

                pilocarpine increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • avapritinib

                pilocarpine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                pilocarpine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • belladonna alkaloids

                pilocarpine increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • belladonna and opium

                pilocarpine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bethanechol

                bethanechol and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • carbachol

                carbachol and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • cevimeline

                cevimeline and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • cisatracurium

                pilocarpine increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • clomipramine

                pilocarpine increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cyclizine

                pilocarpine increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cyclobenzaprine

                pilocarpine increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • darifenacin

                pilocarpine increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dicyclomine

                pilocarpine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diphenhydramine

                pilocarpine increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • donepezil

                donepezil and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • dosulepin

                pilocarpine increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • doxepin

                pilocarpine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • echothiophate iodide

                echothiophate iodide and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • fesoterodine

                pilocarpine increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • finerenone

                pilocarpine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • flavoxate

                pilocarpine increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • flibanserin

                pilocarpine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • galantamine

                galantamine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • glycopyrrolate

                pilocarpine increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glycopyrrolate inhaled

                pilocarpine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • henbane

                pilocarpine increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • homatropine

                pilocarpine increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • huperzine A

                huperzine A and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • hyoscyamine

                pilocarpine increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hyoscyamine spray

                pilocarpine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • imipramine

                pilocarpine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ipratropium

                pilocarpine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • isavuconazonium sulfate

                pilocarpine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ivacaftor

                pilocarpine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

              • lemborexant

                pilocarpine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • lofepramine

                pilocarpine increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lomitapide

                pilocarpine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

              • maprotiline

                pilocarpine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • meclizine

                pilocarpine increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methscopolamine

                pilocarpine increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • midazolam intranasal

                pilocarpine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

              • neostigmine

                neostigmine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • nortriptyline

                pilocarpine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • onabotulinumtoxinA

                pilocarpine increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • orphenadrine

                pilocarpine increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxybutynin

                pilocarpine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxybutynin topical

                pilocarpine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • oxybutynin transdermal

                pilocarpine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pancuronium

                pilocarpine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • physostigmine

                physostigmine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • pralidoxime

                pilocarpine increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • propantheline

                pilocarpine increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • protriptyline

                pilocarpine increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pyridostigmine

                pilocarpine and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • rapacuronium

                pilocarpine increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • rivastigmine

                pilocarpine and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                rivastigmine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • rocuronium

                pilocarpine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • scopolamine

                pilocarpine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • solifenacin

                pilocarpine increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • succinylcholine

                pilocarpine and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.

              • tazemetostat

                pilocarpine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tinidazole

                pilocarpine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tiotropium

                pilocarpine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tolterodine

                pilocarpine increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trimipramine

                pilocarpine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trospium chloride

                pilocarpine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • umeclidinium bromide

                pilocarpine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.

              • vecuronium

                pilocarpine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              Minor (23)

              • acebutolol

                pilocarpine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • atenolol

                pilocarpine increases effects of atenolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • betaxolol

                pilocarpine increases effects of betaxolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • bisoprolol

                pilocarpine increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • carvedilol

                pilocarpine increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.

              • celiprolol

                pilocarpine increases effects of celiprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • desipramine

                pilocarpine increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              • donepezil

                donepezil increases effects of pilocarpine by pharmacodynamic synergism. Minor/Significance Unknown.

              • esmolol

                pilocarpine increases effects of esmolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • galantamine

                galantamine increases effects of pilocarpine by pharmacodynamic synergism. Minor/Significance Unknown.

              • labetalol

                pilocarpine increases effects of labetalol by pharmacodynamic synergism. Minor/Significance Unknown.

              • metoprolol

                pilocarpine increases effects of metoprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • nadolol

                pilocarpine increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • nebivolol

                pilocarpine increases effects of nebivolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • pantothenic acid

                pantothenic acid, pilocarpine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.

              • penbutolol

                pilocarpine increases effects of penbutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • pindolol

                pilocarpine increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • procainamide

                procainamide decreases effects of pilocarpine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • propranolol

                pilocarpine increases effects of propranolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • ruxolitinib

                pilocarpine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • sotalol

                pilocarpine increases effects of sotalol by pharmacodynamic synergism. Minor/Significance Unknown.

              • timolol

                pilocarpine increases effects of timolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • trazodone

                pilocarpine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              Previous
              Next:

              Adverse Effects

              >10%

              Sweating (29%)

              Headache (11%)

              Flushing (8-13%)

              Dizziness (5-12%)

              Chills (3-15%)

              Nausea (6-15%)

              Urinary frequency (9-12%)

              Rhinitis (5-14%)

              Diaphoresis (29-68%)

              1-10%

              Pain (4%)

              Asthenia (>3%)

              Dyspepsia (7%)

              Vomiting (3-4%)

              Hypertension (3%)

              Lacrimation (6%)

              Amblyopia (4%)

              Frequency Not Defined

              Confusion

              Hypotension

              Bradycardia

              Tachycardia

              Increased airway resistance

              Diarrhea

              Bladder tightness

              Decreased visual acuity

              Previous
              Next:

              Warnings

              Contraindications

              Uncontrolled asthma, anterior eye inflammation, any time miosis in undesirable (eg, narrow-angle glaucoma, acute iritis)

              Hypersensitivity

              Cautions

              Patients with significant cardiovascular disease may be unable to compensate for transient changes in hemodynamics or rhythm induced by therapy; pulmonary edema has been reported as a complication of pilocarpine toxicity from high ocular doses given for acute angle-closure glaucoma; pilocarpine should be administered with caution in and under close medical supervision of patients with significant cardiovascular disease

              Therapy has been reported to increase airway resistance, bronchial

              smooth muscle tone, and bronchial secretions; therapy should be administered with caution to and under close medical supervision in patients with controlled asthma, chronic

              bronchitis, or chronic obstructive pulmonary disease requiring pharmacotherapy

              Pilocarpine toxicity is characterized by exaggeration of parasympathomimetic

              effects, which may include: headache, visual disturbance, lacrimation, sweating, respiratory distress, gastrointestinal spasm, nausea, vomiting, diarrhea, atrioventricular block, tachycardia,

              bradycardia, hypotension, hypertension, shock, mental confusion, cardiac arrhythmia, and tremors

              Dose-related cardiovascular pharmacologic effects of pilocarpine include hypotension, hypertension, bradycardia, and tachycardia

              Drug should be administered with caution to patients with known or suspected cholelithiasis or biliary tract disease; contractions of gallbladder or biliary smooth muscle could precipitate

              complications including cholecystitis, cholangitis, and biliary obstruction

              Pilocarpine may increase ureteral smooth muscle tone and could theoretically precipitate renal colic (or "ureteral reflux"), particularly in patients with nephrolithiasis

              Cholinergic agonists may have dose-related central nervous system effects; this should be considered when treating patients with underlying cognitive or psychiatric disturbances

              Previous
              Next:

              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: unknown if drug is distributed into breast milk; use caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Cholinergic parasympathomimetic with predominant muscarinic action; increases secretion of exocrine glands (sweat, lacrimal, salivary, intestinal, pancreatic glands, and mucous cells of the respiratory tract may be stimulated

              Tone and mobility of gallbladder, biliary duct, and urinary tract may be increased

              Pharmacokinetics

              Half-Life: 0.76-1.35 hr

              Onset: 20 min (initial response for xerostomia)

              Duration: 3-5 hr (single dose), >10 hr (multiple dose)

              Peak plasma time: 0.85-1.25 hr

              Bioavailability: High fat meal decreases rate & extent of absorption

              Protein bound: None

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Salagen (pilocarpine) oral
              -
              7.5 mg tablet
              Salagen (pilocarpine) oral
              -
              5 mg tablet
              Salagen (pilocarpine) oral
              -
              7.5 mg tablet
              Isopto Carpine ophthalmic (eye)
              -
              1 % drops
              Isopto Carpine ophthalmic (eye)
              -
              4 % drops
              Isopto Carpine ophthalmic (eye)
              -
              2 % drops
              pilocarpine ophthalmic (eye)
              -
              4 % drops
              pilocarpine ophthalmic (eye)
              -
              1 % drops
              pilocarpine ophthalmic (eye)
              -
              2 % drops
              pilocarpine ophthalmic (eye)
              -
              4 % drops
              pilocarpine ophthalmic (eye)
              -
              2 % drops
              pilocarpine ophthalmic (eye)
              -
              1 % drops
              pilocarpine ophthalmic (eye)
              -
              2 % drops
              pilocarpine ophthalmic (eye)
              -
              1 % drops
              pilocarpine ophthalmic (eye)
              -
              4 % drops
              pilocarpine ophthalmic (eye)
              -
              4 % drops
              pilocarpine oral
              -
              5 mg tablet
              pilocarpine oral
              -
              5 mg tablet
              pilocarpine oral
              -
              5 mg tablet
              pilocarpine oral
              -
              5 mg tablet
              pilocarpine oral
              -
              7.5 mg tablet
              pilocarpine oral
              -
              7.5 mg tablet
              pilocarpine oral
              -
              7.5 mg tablet

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Select a drug:
              Patient Education
              pilocarpine oral

              PILOCARPINE - ORAL

              (PYE-loe-KAR-peen)

              COMMON BRAND NAME(S): Salagen

              USES: This medication is used to treat symptoms of dry mouth due to a certain immune disease (Sjogren's syndrome) or from saliva gland damage due to radiation treatments of the head/neck for cancer. Pilocarpine belongs to a class of drugs known as cholinergic agonists. It works by stimulating certain nerves to increase the amount of saliva you produce, making it easier and more comfortable to speak and swallow.

              HOW TO USE: Take this medication by mouth with or without food, usually 3-4 times daily, or as directed by your doctor.To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Dosage is based on your medical condition and response to treatment. If you have liver problems, your doctor may direct you to start taking this drug only twice daily. The usual maximum adult dose is 30 milligrams each day.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.You may continue to drink water or use saliva substitutes as needed for moisture in your mouth.You may start to feel some benefit in 1 to 2 weeks. However, it may take up to 3 months to feel the full benefit. Tell your doctor if your condition persists or worsens.

              SIDE EFFECTS: See also Precautions.Sweating, nausea, runny nose, chills, flushing, frequent urge to urinate, dizziness, weakness, diarrhea, and blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.This medication may cause an increase in tears. This can be helpful if you have dry eyes (such as with Sjogren's syndrome). Tell your doctor if runny eyes become a problem.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: slow/fast heartbeat, shakiness (tremor), fainting, lung problems (such as increased wheezing/cough/phlegm), mental/mood changes (such as confusion, agitation), severe stomach/abdominal pain.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, chronic bronchitis, chronic obstructive pulmonary disease-COPD), certain eye conditions (such as night blindness, acute iritis, narrow-angle glaucoma), heart disease (such as chest pain, heart failure, heart attack, slow heartbeat), low or high blood pressure, liver problems, gallbladder disease (such as gallstones), kidney stones, mental/mood disorders (such as depression, psychoses, thinking/understanding problems like dementia, Alzheimer's), stomach problems (such as chronic heartburn, ulcer).This drug may make you dizzy or cause vision problems, especially at night. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision, especially at night, until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).If pilocarpine makes you sweat heavily, drink plenty of fluids so that you do not become dehydrated. If you are unable to drink enough fluids, talk with your doctor right away.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness, diarrhea, and increased urge to urinate.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.

              DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Some products that may interact with this drug include: beta blockers (such as propranolol, metoprolol).Pilocarpine may cause drugs with "drying" effects (some antihistamines, anticholinergics such as certain drugs for asthma, over-active bladder, and Parkinson's) to work less well. Examples of affected drugs include chlorpheniramine, diphenhydramine, atropine, belladonna alkaloids, ipratropium, and tolterodine. These medications can also worsen dry mouth, causing pilocarpine to work less well. Consult your doctor or pharmacist for more information.Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could have a drying effect. Ask your pharmacist for more details.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: diarrhea that doesn't stop, heavy sweating, severe trouble breathing, severe wheezing, stomach cramps, vomiting, very slow/fast heartbeat, severe confusion.

              NOTES: Do not share this medication with others.Keep all regular medical and laboratory appointments so that your doctor can monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.