Pilocarpine is a drug used for treating dry mouth (xerostomia) that works by increasing the production of saliva. It may be prescribed in tablets to treat dry mouth systemically however a topical treatment is often preferred. A topical application in a troche may provide more immediate benefits.  Pilocarpine is on the World Health Organizations’ List of Essential Medicines.  It is exclusively derived from the plant genus pilocarpus, which is native to South America.

Pilocarpine is a cholinergic agonist that increases secretion by the exocrine glands. It has a variety of uses in stimulating cells throughout the body to produce sweat, saliva, mucous, tears, and more. It is sometimes used for treating glaucoma in the form of eye drops. However the most frequent reason pilocarpine is prescribed is for treating dry mouth. The commercially available version of this drug only comes in tablet form. Troches must be made by a compounding pharmacy.

Dry mouth can result from decreased saliva production or a change in saliva composition. It may be caused by the use of certain medications, dehydration, or malnutrition but sometimes dry mouth has no identifiable cause. Dry mouth is not limited to any particular group, although certain patients are more susceptible than others. Patients with Sjogren’s syndrome and patients undergoing radiation therapy often need a treatment for dry mouth. Sjogren’s is an autoimmune condition that affects salivary and tear glands. Pilocarpine is able to stimulate saliva production to relieve irritating dry mouth from this condition.