Systemic pilocarpine for treatment of xerostomia.
BACKGROUND
Xerostomia is the feeling of dryness in the mouth, usually owing to hypofunctioning of the salivary glands. Causes of xerostomia include medications, the effects of radiation therapy on the salivary glands during the treatment of head and neck cancer or thyroid cancer, and autoimmune diseases such as Sjögren's syndrome. The primary treatment to reduce xerostomia is oral pilocarpine.


OBJECTIVE
This review discusses the randomized trials available on the efficacy and tolerability of oral pilocarpine for the treatment of xerostomia.


METHODS
The randomized trials of pilocarpine for xerostomia available in the medical literature are reviewed.


CONCLUSIONS
Pilocarpine has some efficacy in the treatment of xerostomia from radiation therapy, graft-versus-host disease and Sjögren's syndrome. It has limited activity for the prevention of xerostomia during radiation therapy. It may have increased efficacy in combination with newer forms of radiation therapy.
Berk
Lawrence
L
Moffitt Cancer Center at Tampa General Hospital, Moffitt Cancer Center, Radiation Oncology, 2 Columbia Dr, Tampa, FL 33606, USA. lawrence.berk@moffitt.org
D000284:Administration, Oral; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D018721:Muscarinic Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D010862:Pilocarpine / Q000009:adverse effects / Q000627:therapeutic use*; D011832:Radiation Injuries / Q000188:drug therapy / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D012469:Salivary Glands / Q000503:physiopathology / Q000528:radiation effects; D012859:Sjogren's Syndrome / Q000503:physiopathology; D013964:Thyroid Neoplasms / Q000532:radiotherapy; D014987:Xerostomia / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
D018721:Muscarinic Agonists; D010862:Pilocarpine