The product is the first pharmacologic treatment for dry mouth. Pilocarpine, which has been used for over a century to treat glaucoma, was first isolated from the leaves of the South American plants Pilocarpus jaborandi and Pilocarpus microphyllus in 1875. An estimated 40,000 cancers of the head and neck are diagnosed each year in the United States, and most of the patients undergo radiation therapy. The radiation can cause permanent damage to the salivary glands, with a major effect on the patient's quality of life. Indirect effects can include nutritional deficiencies, weight loss, and altered social habits.
Pilocarpine is a cholinergic parasympathomimetic agent with a broad range of pharmacologic effects.
It increases secretion by the exocrine glands and can affect the sweat, salivary, lacrimal, gastric, pancreatic, and intestinal glands and the mucosal cells of the respiratory tract. The most common side effect with Salagen treatment has been moderate sweating. Other side effects have included nausea, runny nose, chills, flushing, urinary frequency, dizziness, and fatigue. Patients with cardiovascular disease should receive pilocarpine only under close supervision. Concomitant administration of beta-adrenergic antagonists could result in conduction disturbances.