Side Effects of pilocarpine: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Main Research Findings

Pilocarpine is a medication used to treat dry mouth and dry eyes associated with Sjögren’s syndrome. 9 Pilocarpine has been shown to stimulate saliva secretion. 9 However, pilocarpine can cause side effects, especially in the elderly. 25

Pilocarpine is also reported as a side effect of topiramate, a medication used to treat epilepsy. 13 Topiramate can rarely cause increased eye pressure, which can lead to glaucoma. 13

Pilocarpine is also used to induce seizures in mice. 10 In mice, pilocarpine can induce oxidative stress, which can cause damage to nerve cells. 10

Pilocarpine is also used in rats to induce seizures, behavioral disorders, hippocampal neuronal death, oxidative stress, and inflammation. 16 Topiramate has been shown to suppress pilocarpine-induced seizures, and to reduce behavioral disorders, neuronal death, oxidative stress, and inflammation. 16

Pilocarpine is also used in rats to induce seizures in the lithium/pilocarpine model. 15 A standardized extract of Centella asiatica has been shown to suppress lithium/pilocarpine-induced seizures. 15 Centella asiatica extract showed anticonvulsant effects in rats without affecting biochemical and haematological parameters. 15

Reasons for side effects

Pilocarpine is a drug that stimulates the parasympathetic nervous system. The parasympathetic nervous system controls many bodily functions, including salivation, slowing of the heart rate, and increasing digestion. When pilocarpine stimulates the parasympathetic nervous system, these functions can become overactive, causing side effects. 25

Common side effects

Sweating

Pilocarpine has been reported to cause increased sweating. 25 Sweating is caused by pilocarpine stimulating the parasympathetic nervous system. 25

Lacrimation

Pilocarpine has been reported to cause increased tearing. 25 Tearing is caused by pilocarpine stimulating the parasympathetic nervous system. 25

Gastrointestinal symptoms

Pilocarpine may cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea. 25 These symptoms are caused by pilocarpine stimulating the parasympathetic nervous system. 25

Tachycardia

Pilocarpine may cause tachycardia. 4 Tachycardia is caused by pilocarpine stimulating the parasympathetic nervous system. 4

Other side effects

Pilocarpine may also cause other side effects, including headache, dizziness, muscle cramps, vision problems, and hypersensitivity. 25

Measures against side effects

Reducing side effects

To reduce the side effects of pilocarpine, it is important to start with a low dose and gradually increase the dose. 25 Also, adjusting the time of administration of pilocarpine or using it in combination with other medications can reduce side effects. 25

Preventing side effects

To prevent side effects of pilocarpine, it is important to talk to your doctor before taking pilocarpine. 25 If you are pregnant or breastfeeding, you should talk to your doctor before taking pilocarpine. 25 Also, you should tell your doctor about any past illnesses or medications you are taking before taking pilocarpine. 25

Comparison between studies

Commonalities between studies

All studies show that pilocarpine can increase saliva secretion. 9 7 25 21 23 5 12 2 1

Differences between studies

The effects and side effects of pilocarpine varied between studies. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13 These differences can be explained by the animal species used in the study, the research methods, the dosage, and other factors. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13

Real-life Application Precautions

Pilocarpine is an effective drug for treating dry mouth and dry eyes, but it is important to be aware of the risk of side effects. 9 25 Before taking pilocarpine, it is important to talk to your doctor to assess the risks and benefits of side effects. 9 25 You should also talk to your doctor immediately if you experience side effects while taking pilocarpine. 9 25

Current Limitations of Research

There is still not enough research on the effects and side effects of pilocarpine. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13 In particular, there is a lack of data on the long-term effects and safety of pilocarpine. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13

Future Research Directions

More research is needed to better understand the effects and side effects of pilocarpine. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13 In particular, research on the long-term effects and safety of pilocarpine is needed. 9 16 15 10 24 4 7 14 20 25 21 18 19 22 6 3 11 2 1 5 12 8 17 13

Conclusion

Pilocarpine is an effective drug for treating dry mouth and dry eyes, but it is important to be aware of the risk of side effects. 9 25 Before taking pilocarpine, it is important to talk to your doctor to assess the risks and benefits of side effects. 9 25 You should also talk to your doctor immediately if you experience side effects while taking pilocarpine. 9 25

Literature analysis of 25 papers
Positive Content
22
Neutral Content
0
Negative Content
3
Article Type
3
0
0
2
25
2.

Oral pilocarpine for the treatment of dry eye in patients with Sjögren's syndrome.

Author: FelbergSergio, DantasPaulo Elias Correa, SatoElcio Hideo

Dry eye relief
Side effects

This placebo-controlled crossover study evaluated the efficacy of oral pilocarpine (20 mg daily) for treating dry eye in patients with Sjögren's Syndrome. While the treatment was associated with a high frequency of side effects, it significantly improved quality of life, ocular discomfort, and tear film quality.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Design and validation of neuronal exocytosis blocking peptides as potential novel antiperspirants.

Author: ButronLaura, Nikolaeva-KolevaMagdalena, SempereAna, RiveroVerónica, Fernandez-BallesterGregorio, EspinosaAna, VergassolaMatteo, MastrocolaElena, ZucchiSara, RagniLorella, Fernández-CarvajalAsia, ManganoGiorgina, Ferrer-MontielAntonio, DevesaIsabel

Antihyperhidrosis candidate

This study developed novel peptides that target neuronal acetylcholine exocytosis, potentially reducing excessive sweating. The most potent peptide, SPSR38-4.1, significantly decreased pilocarpine-induced sweating in a mouse model, suggesting its potential as a new antihyperhidrosis candidate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Efficacy of cevimeline vs. pilocarpine in the secretion of saliva: a pilot study.

Author: BrimhallJae, JhaveriMalhar A, YepesJuan F

Increased saliva secretion
Similar side effects

Both cevimeline and pilocarpine increased the secretion of saliva in patients with xerostomia, with a slightly higher increment in saliva with pilocarpine.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Buccal drug delivery technologies for patient-centred treatment of radiation-induced xerostomia (dry mouth).

Author: MalallahOsamah S, GarciaCristina M Aller, ProctorGordon B, ForbesBen, RoyallPaul G

Dry mouth treatment
Gastrointestinal distress
Lacrimation
Sweating

This review examines the technologies for the local delivery of saliva-stimulating agents, including oral disintegrating tablets, oral disintegrating films, medicated chewing gums, and implantable drug delivery devices.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Parasympathomimetic drugs for dry mouth due to radiotherapy.

Author: SpivakovskySylvia, SpivakovskyYael

Xerostomia treatment
High discontinuation rate
Side effects

Pilocarpine is a medication used to treat dry mouth. This study reviewed the evidence for using pilocarpine to treat radiation-induced salivary dysfunction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

8.

Slc10A4 - what do we know about the function of this "secret ligand carrier" protein?

Author: BorgesKarin

Neurological disorders treatment
Side effects

This commentary discusses the possible functions of Slc10a4, a solute carrier protein, in regards to its role in neurological disorders.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

9.

Pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in Sjögren syndrome: a double-blind randomized controlled trial.

Author: CifuentesM, Del Barrio-DíazP, Vera-KelletC

Lacrimal flow enhancement
Salivary flow enhancement
Nausea
Sialorrhoea

Pilocarpine was more effective than artificial saliva in enhancing salivary and lacrimal secretion in patients with Sjögren syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Sex-related Differences in Glial Fibrillary Acidic Protein-positive GABA Regulate Neuropathology Following Pilocarpine-induced Status Epilepticus.

Author: HongGeum Pyo, KimMi-Hye, KimHee Jung

Glial activation
Neuronal death

Male mice were found to be more susceptible to status epilepticus (SE) than female mice, exhibiting more extensive neuronal death, glial activation, and inflammatory cytokine release. These differences may be related to sex-specific differences in astrocytic GABA transporter expression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Randomized, Placebo- and Active-Controlled Crossover Study of the Safety and Efficacy of THVD-102, a Fixed-dose Combination of Oxybutynin and Pilocarpine, in Subjects With Primary Focal Hyperhidrosis.

Author: PariserDavid M, KrishnarajaJanakan, TremblayThomas M, RubisonR Michael, LoveTed W, McGrawBenjamin F

Hyperhidrosis treatment
Dry mouth

THVD-102, a fixed-dose combination of oxybutynin and pilocarpine, shows potential for treating primary focal hyperhidrosis while minimizing dry mouth side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

TOPIRAMATE-INDUCED BILATERAL ANGLE-CLOSURE GLAUCOMA. A CASE REPORT.

Author: MageraL, Baxant, StudenýP

Angle-closure glaucoma

This case report describes a rare instance of secondary angle-closure glaucoma induced by Topamax (topiramate), highlighting the importance of recognizing this potential side effect, particularly in cases of bilateral glaucoma.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Insights into the mechanism by which atropine inhibits myopia: evidence against cholinergic hyperactivity and modulation of dopamine release.

Author: ThomsonKate, KellyTamsin, KaroutaCindy, MorganIan, AshbyRegan

Myopia inhibition

This study investigated whether cholinergic agonists accelerate ocular growth rates in chickens. The study found that cholinergic agonists did accelerate ocular growth, supporting the hypothesis that cholinergic hyperactivity may play a role in myopic growth.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

The standardized extract of Centella asiatica L. Urb attenuates the convulsant effect induced by lithium/pilocarpine without affecting biochemical and haematological parameters in rats.

Author: Rivadeneyra-DomínguezEduardo, Zamora-BelloIsaac, Castañeda-MoralesJuan Manuel, Díaz-VallejoJoel Jahaziel, Rosales-SánchezÓscar, Rodríguez-LandaJuan Francisco

Anticonvulsant effect
Antioxidant activity
Neuroprotective effect
Haematological alterations
Hepatotoxicity
Nephrotoxicity

This study evaluated the effect of a standardized extract of Centella asiatica on biochemical and haematological parameters in rats subjected to lithium/pilocarpine-induced seizures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Memantine decreases neuronal degeneration in young rats submitted to LiCl-pilocarpine-induced status epilepticus.

Author: ZenkiKamila Cagliari, KalinineEduardo, ZimmerEduardo R, Dos SantosThainá Garbino, MussuliniBen Hur Marins, PortelaLuis Valmor Cruz, de OliveiraDiogo Lösch

Neuroprotection
SE-induced neuronal death

This study investigated the effects of memantine, a low-affinity N-methyl-d-aspartate receptor (NMDAR) channel blocker, on seizure severity and neuronal cell death in young rats with status epilepticus (SE). Memantine was neuroprotective against SE-induced neuronal death, and this neuroprotection was time- and region-dependent.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Neuroprotection after status epilepticus by targeting protein interactions with postsynaptic density protein 95.

Author: DykstraCrystal M, RatnamMelanie, GurdJames W

Neuroprotection
Reduced cell loss

A new drug, Tat-NR2B9c, was developed to protect neurons from damage caused by status epilepticus (SE). In a rat model of SE, Tat-NR2B9c was able to significantly reduce neuronal death in the hippocampus, particularly in the CA1 and CA4 regions. This suggests that Tat-NR2B9c may have therapeutic potential for treating SE.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Management of xerostomia and salivary gland hypofunction.

Author: RamSaravanan, KumarSatish, NavazeshMahvash

Xerostomia management
Increased candidiasis
Increased caries
Increased periodontitis

Oral health care providers need to be aware of the etiologies and clinical manifestations of salivary gland hypofunction to identify patients and prevent complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation.

Author: FaragArwa M, HollidayCraig, CimminoJoseph, RoomianTamar, PapasAthena

Higher adherence
Improved SS
More side effects

Cevimeline (CEV) and pilocarpine (PILO) were comparable in effectiveness for hyposalivation, but PILO was associated with more side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management.

Author: BarbeAnna Greta

Dry mouth treatment
Bronchoconstriction
Emesis
Nausea

Medication-induced xerostomia (dry mouth) is a common issue for older patients. This article discusses various treatment options including medication changes, multidisciplinary approaches, topical agents, and innovative methods like electrostimulation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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