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Oral Pilocarpine for Treatment of Opioid-induced Oral Dryness in Healthy Adults

¹ Department of Hospital Dentistry and
⁴ Hospital Pharmacy, Malmö University Hospital, SE-205 02 Malmö, Sweden;
² Department of Oral Diagnostics and
³ Department of Cariology, Faculty of Odontology, Malmö University, SE-205 06 Malmö, Sweden; and
⁵ Department of Pharmacology, Göteborg University, Box 431, SE-405 30 Göteborg, Sweden;

^* corresponding author, bengt.gotrick{at}skane.se

Pilocarpine induces a profuse flow of saliva when administered orally, but effects on drug-induced oral dryness have not been examined. The aim of this trial was to investigate if pilocarpine increases production of saliva in individuals suffering from dry mouth due to treatment with opioids. Sixty-five individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol (50 mg t.d.s.) to induce oral dryness, and were thereafter assigned to one of three groups. Secretion rate of saliva was measured before and after tramadol, and after the oral administration of pilocarpine (5 mg), placebo, or no treatment. Baseline characteristics did not differ among the groups (mean ± SEM: 0.37 ± 0.06 mL/min), and tramadol lowered the secretion at the same level in all groups (0.15 ± 0.02 mL/min). Pilocarpine increased the flow above that observed with placebo (0.66 ± 0.19 vs. 0.15 ± 0.02 mL/min). Thus, pilocarpine re-establishes the flow of saliva in the state of tramadol-induced oral dryness.

KEY WORDS: pilocarpine • oral dryness • randomized controlled trial • drug-induced xerostomia

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