Usual Adult Dose for Xerostomia

Initial dose: 5 mg orally 3 times a day
Maintenance dose: 15 to 30 mg per day, given in divided doses

Comments:

• Doses should be adjusted based upon individual patient tolerance and response.
• The lowest effective dose should be used for maintenance.
• Single doses should not exceed 10 mg.
• At least 12 weeks of continued treatment may be necessary to assess whether treatment will produce a beneficial response.

Usual Adult Dose for Sjogren's Syndrome

5 mg orally 4 times a day

Comment: Efficacy was typically established by the sixth week of use.

Use: Treatment of dry mouth symptoms in patients with Sjogren's syndrome

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Mild liver dysfunction (Child-Pugh Score 5 to 6): No adjustment recommended.
Moderate liver dysfunction (Child-Pugh Score 6 to 10):

• Initial dose: 5 mg orally 2 times a day
• Maintenance dose: Doses may be adjusted, based on response and tolerability.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• Patients with uncontrolled asthma
• When miosis is undesirable (e.g., in acute iritis, in narrow-angle [angle-closure] glaucoma)

Dialysis

Data not available

Other Comments

Administration advice:

• Doses should be taken with water.

• Protect from light and moisture.

• Adverse events are dose-related, and occur more frequently with higher doses.

• Inform patients that this drug may cause depth perception impairment, dizziness, visual disturbances (especially at night), and they should avoid driving or operating machinery if these side effects occur.
• Inform patients that this drug may cause confusion, disorientation, drowsiness, and/or excessive hypotension, and they should avoid driving or operating machinery if these side effects occur.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.