In this study, we examined the effectiveness and adverse events of pilocarpine hydrochloride (pilocarpine) gargle in the treatment of xerostomia in Sjogren's syndrome (SS). Dryness of the mouth, salivary flow rate, adverse events associated with oral administration or gargle method were compared before and after 4 weeks of administration in the eight SS patients enrolled in this study. Dryness of the mouth in seven patients was significantly improved by oral administration. Gargling also improved dryness of mouth but did not reach statistical significance. The salivary flow rate based on the gum test was significantly increased with the gargle method as well as with oral administration. The salivary flow rate by the Saxon test also increased with both oral administration and gargling but did not reach statistical significance. Increased rate of salivary flow was equally observed in both methods. An adverse event associated with oral administration was sweating, and one patient could not continue the study due to uncomfortable sweating and palpitation. In contrast, the gargle method induced slight sweating alone in six of seven patients. These results indicate that the gargle method, compared with oral administration improves xerostomia with equivalent efficacy without inducing excessive sweating.
