Abstract
Pilocarpine hydrochloride (Salagen®) is currently indicated for the treatment of xerostomia caused by Sjögren syndrome (SS). However, administration of this drug is frequently discontinued because of adverse effects. In this study, we examined the compliance and clinical efficacy of the gradually-increasing administration of pilocarpine. Twenty-six SS patients (2 men, 25 women, mean age 64 years, range 40-85) received 7.5mg pilocarpine per day for the first 4 weeks, and then 15mg pilocarpine per day for further 8 weeks. Nineteen patients (73.1%) completed administration for total 12 weeks, and 7 patients failed it (3 patients stopped administration until the 4th week, and 4 patients after the 4th week). When calculated with 23 patients whose daily dose increased to 15mg, the completion rate was 82.6%. Saxon test and questionnaires revealed an increase in saliva-flow rate in 88.9% of 19 patients and improvements of subjective and objective symptoms in over 50%. The results suggested that 15mg of pilocarpine was well tolerated in patients who underwent the gradually-increasing administration.
