Not really an adjunctive therapy... more like an alternative form of conventional treatment for post-radiation dry mouth.

I had to do the leg work on this, but it paid off. Although not generally available, I was able to show my MO published trial results and convince him to write a prescription:
Pilocarpine 1% solution by volume, 1 teaspoonful PO bid (swish/spit after 2 minutes)

The advantage of the mouthwash version is that it is instant acting, reportedly long lasting, and has none of the side-effects of the oral (pill) version. The studies I found online had partipant results claiming 12-36 hours relief from just one use of the mouthwash solution. My results were not as good (~ 6hrs), but enough so that I have been able to cut my oral Pilocarpine use down to one 5mg pill/day, and sleep through the night (no more frequent urination and phlegm buildup because of the oral Pilocarpine).

There are a few downsides to the mouthwash though.
1) You'll need to find a compounding pharmacy that will work with you to come up with a palatable formulation. A standard pharmacy can't fill the Rx.
2) Liquid Pilocarpine has a short shelf life, so you won't be able to purchase more than a 45-60 day supply at a time.
3) It's expensive...and most insurance doesn't cover it (yet). Shop around, as price varies considerably.

I hope this helps someone... it did me!

-Bob

Bob

I'm very interested in what you have found with Philocarpine mouthwash. Would you send out a pointer to the research you mentioned?

thanks

marilyn

Yes, I'd like a reference to the published trial results too since I might be able to convince my ENT to help me get this if I have the data in hand......

Interesting !

Good catch Bob

What is PO bid?

PO BID = by mouth twice a day

Hello Bob,

I am writing regarding your post about the mouthwash version of Pilocarpine (Salagen). My husband Ken still has no saliva after 4 yrs. Oral Salagen does not seem to help and we have tried many other products. Nothing works. I saw a pharmacist today who said he could mix the Pilocarpine solution but he said he needs to know what else is mixed with the solution? You said 1% solution by volume-with what is it mixed?

Hope you see this post and can help.

Thanks.
Linda K.

Hello BOb,

Thank you for your reply regarding the Pilocarpine solution. My husband drinks water 24/7 and chewing gum helps at times. After 4 yrs. he still gets a lot of phlegm. We did try a new product called Caphosol but expensive. It did help get him through the night without having to gargle.

He has never tried Mucinex but he is on a lot of medication so we have to be sure it does not interfere with any of his meds.

I may have my pharmacist call the pharmacy you mentioned. At least he can give it a try.

Thanks for your help.

Linda K.