Determination of the efficacy of topical oral pilocarpine for postirradiation xerostomia in patients with head and neck carcinoma.

Author(s): Hamlar DD, Schuller DE, Gahbauer RA, Buerki RA, Staubus AE, Hall J, Altman JS, Elzinga DJ, Martin MR

Affiliation(s): Department of Otolaryngology, Ohio State University Medical Center; Columbus, USA.

Publication date & source: 1996-08, Laryngoscope., 106(8):972-6.

Publication type: Clinical Trial; Randomized Controlled Trial

Pilocarpine hydrochloride suspended in a candy-like pastille was evaluated as a topical treatment for radiation-induced xerostomia in head and neck cancer patients. This local delivery system, which differs from systemically administered pilocarpine preparations, was developed to hopefully maximize the local response and minimize the systemic side effects. A prospective, randomized, double-blind, placebo-controlled trial was undertaken to determine objective and subjective efficacy in reversing the decrease in salivation. Forty previously irradiated patients received increasingly higher pilocarpine dosages in pastilles for 5 successive weeks. At each successive dose of pilocarpine, no significant increased salivation was noted. However, 25 (74%) of 34 patients reported that pilocarpine alleviated their subjective xerostomia. Topical pilocarpine administration has shown similar results to previous systemic delivery methods for radiation-induced xerostomia, but with improved patient tolerance.