Last update Nov. 20, 2022

Pilocarpine

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Cholinergic parasympathetic drug with a predominant muscarinic action that stimulate secretion of exocrine glands. It has been indicated as a treatment of Sjögren’s xerostomy and xerophtalmy, and, after head and neck radiotherapy. Oral administration 3 to 4 times a day.

At the date of the last update, we found no published data on its excretion in breast milk.

Its pharmacokinetic data (low molecular weight and low percentage of plasma protein binding) makes it likely that significant amounts will pass into breast milk, although its high volume of distribution and short half-life would make it difficult.

The most common side effects are sweating, headache, polyuria, flu-like symptoms, chills, flushing, dizziness, tearing, abdominal pain, and hypersalivation.

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

Pilocarpine ophthalmic topical eye drops are compatible with breastfeeding.

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pilocarpine is also known as


Pilocarpine in other languages or writings:

Tradenames

Main tradenames from several countries containing Pilocarpine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Alta - Hig %
Molecular weight 208 daltons
Protein Binding 0 %
VD 2.1 l/Kg
Tmax 1.25 hours
0.76 - 1.35 hours

References

  1. JAMP. Pilocarpine. Drug Summary. 2020 Full text (in our servers)
  2. AEMPS. Pilocarpina. Ficha técnica. 2019 Full text (in our servers)
  3. Davies AN, Thompson J. Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy. Cochrane Database Syst Rev. 2015 Oct 5;(10):CD003782. Abstract Full text (link to original source)
  4. Wiseman LR, Faulds D. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs. 1995 Jan;49(1):143-55. Review. Abstract

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