ORAL CANCER AND DRY MOUTH

Prescription Products and Dry Mouth


Prescription drugs are part of the powerful set of tools our medical professionals have at their disposal with which they can use to try and help you to overcome your medical conditions. But, powerful tools must be used with caution. Doctors will be able to tell you which prescription products to try and which ones to avoid, as it is a part of their professional training. It takes a very long time, and a great deal of work to become a doctor, involving years of study.

One of the after effects of treatment for oral cancer is dry mouth or xerostomia. Often we want to reach for the most potent tool first, as we believe that they have the most effect. But as a precautionary measure, we have in place certain rules which cause us to involve someone with education and experience in the matter. So we must communicate with our medical advisors on how the prescription drugs are working for us, and tell them if the side effects are so great as to cause additional problems.

As we all know, certain drugs can only be used with the permission of your doctor, and there is good reason for this. With powerful tools come great responsibilities. We must share that responsibility with our medical advisors. So, if you elect to use the most powerful tools, then you should also accept some responsibility. Please keep in communication with your doctor or nurse if there are additional problems.

It is also important to know that there may be better alternatives to the problem of dry mouth for cancer patients and post cancer patients. Some of these are over the counter drugs. Some of these are simple things you can do to moisten your mouth, such as sipping on water, or using a lozenge. It may be that you will want to try several of these things.

Pilocarpine (Salagen) for Dry Mouth / Xerostomia

One of the two most popular prescription drugs for Dry Mouth is Pilcarpine also known by its commercial name Salagen among others. Pilcarpine is used to treat both glaucoma and dry mouth. This prescription medicine works my mimicking a chemical that occurs naturally in your brain. This natural chemical controls the production of sweat and saliva in your body. So it can stimulate the secretion of large amounts of saliva and sweat. It does more than one thing at a time, which can be at the root of some side effects, take heed. Because it has more than one specific effect on your body, it is used to treat dry mouth (xerostomia) in Sjogren's syndrome, to treat dry mouth as an after effect of radiation therapy for head and neck cancer, and also to treat certain eye conditions. That is to say this drug causes the salivary glands to make saliva and the lacrimal glands in the eye to make tears to lubricate the eyes. So keep in mind that it may do something to your eyes as well.

One concern is that it can take two or three months of taking this medicine in accordance with the advice of your doctor before dry mouth or eye symptoms are relieved. Your doctor will likely tell you to stop taking this medicine if there is no improvement in your condition after a few months.

In the mean time, perhaps an over the counter or self help remedy may be tried.

Below lets list a few of the things which a doctor will need to keep in mind while considering prescribing pilocapine to you. Also keep in mind that some drugs which you are now taking, or certain drugs which you may start taking while using pilocarpine may interact with this medicine.

Do not use pilocarpine if you are allergic to any ingredient in this drug. Also, if you have an eye condition such as glaucoma, a bad eye infection, inflammation in your eyes, or uncontrolled asthma then do not use.

Before using pilocarpine, ask yourself if you have any of the following medical conditions or if any of the following apply to you.


If any of the side effects in this list start to happen to you, then please check again with your doctor or health advisor quickly. These may indicate that your dosage should be cut back. The human body is normally a very well tuned machine, as you ought to know but medications may change this fact.


There are other side effects, which are not as pronounced, and which are considered to be manageable with the help of your doctor. Your heal care professional may be able to help you with these, or perhaps you body will get used to the medication and they will subside. Or you will learn to tolerate them.



Cevimeline (Evoxac) for Dry Mouth / Xerostomia

Another popular prescription drug for the treatment of dry mouth due to oral cancer treatment or other causes is Cevimeline, otherwise called Ecoxac among others. This drug works by activating certain receptors in the part of the nervous system which controls involuntary action. One of these involuntary actions is that of producing saliva. In other words it stimulates certain nerves to increase the amount of saliva you produce, making it easier and more comfortable to speak and to swallow. This drug also has a list of considerations involved with it. Please take care.

Before you start taking this drug, your doctor will evaluate your situation and consider some of the following possible issues. First he or she will consider if you may be allergic to the medicine or anything in the medicine. Then he or she will consider if you have any of the following types of medical conditions.


Secondly, your medical advisor will consider any of certain classes of drugs which you may already be using.


You and the medical professional whom you are employing to your benefit will both be responsible for your ongoing treatment. So, if any of these symptoms occur to you, it may indicate an overdose. Please seek emergency help as soon as you can.


Normally the body is a well regulated and very finely tuned machine. But, medications can alter this balance. If the following less severe symptoms occur to you, then you may talk to your health care professionals about it. They may be able to alter the dosage, or offer other advice or options. You may also learn to tolerate them as you battle your dry mouth symptoms.

More common symptoms


Dry Mouth prescription medication Less common symptoms

  • tightness in chest
  • skin problems
  • shortness of breath
  • rapid weight gains
  • swelling, pain, or redness of the joints
  • pain in the jaw or in the side of the face
  • swelling and pain in the eyes or eyelids
  • muscle stiffness, pain or aches
  • mental or mood changes
  • migraine headaches
  • appetite loss
  • leg cramps
  • itching
  • hiccups
  • heartburn
  • fever
  • feeling of warmth in the arms, neck, face, or perhaps chest
  • diarrhea
  • decreased felling of touch
  • a mucus producing cough
  • chills
  • change in vision
  • joint or bone pain
  • bloody nose
  • bloating or swelling of face, hands, feet or lower legs
  • belching
  • abdominal pain

Other options for dry mouth problems

In addition to the use of these powerful drugs, you may consider OTC, Over the Counter drugs which may have fewer side effects. Or, you may also try self help measures such as drinking sips of water, juice or another beverage. Also included would be munching on ice chips, or using a lozenge. Why not try some of these self help options? They don't cost much and might help. We encourage you to work with your doctor or health professional when tacking medical conditions due to a dry mouth as a complication arising from oral cancer treatments. We also invite you to read further on our website.


Salagen and Evoxac for Dry Mouth / Xerostromia

Here is a conclusion on the topic from Dr. Jerry Gin.

The two most commonly prescribed products for dry mouth are pilocarpine (Salagen) and cevimeline (Evoxac). Both products work on the signals to exocrine glands (e.g., salivary gland) to cause increase in gland secretion. Pilocarpine is a cholinergic parasympathomimetic agent and cevimeline isacholinergic agonist. If a person's salivary gland function has been lost or severely compromised, stimulation may not produce the desired amount of saliva from these drugs. Both drugs are not specific for the salivary gland so other glands will be stimulated. This can cause unwanted side effects and thus the drugs should not be taken if patients have certain conditions.These drugs are not recommended if the patient has asthma, eye problems such as narrow-angle glaucoma and inflammation of the iris, and problems involving the heart, lung, and kidneys. Some of the problems may be mitigated based on dosage. Overdosing can cause problems such as blurring vision, chest pain, chills, diarrhea, warm to fever, dizziness, flushing, headache, effect on heart rate, mental confusion, nausea, pounding in ears, shaking, shortness of breath, sweating, tearing of eyes, indigestion.

Jerry Gin, Ph.D. , is a biochemist, specializing in health care. He has many years of working experience in laboratory medicine, pharmaceuticals, diagnostics, dentistry, and ophthalmology.



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