Pilocarpine: uses, dosing, side effects & brands
Pilocarpine is a cholinergic receptor agonist sold in the U.S. under 6 brand and generic names, for head and neck neoplasms, xerostomia and angle-closure glaucoma. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Cholinergic Receptor Agonist
- Treats (across its forms)
- Head and Neck Neoplasms, Xerostomia and Angle-Closure Glaucoma
- Available as
- Drops · Insert, extended release · Tablet · Solution
- Sold as
- 6 products — Vuity, Ocusert Pilo-40 and Isopto Carpine, and others
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- about $0.38 per ml — not your price
How Salagen is dosed
From the FDA label for Salagen (application NDA020237). Other pilocarpine products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Regardless of the indication, the starting dose in patients with moderate hepatic impairment should be 5 mg twice daily, followed by adjustment based on therapeutic response and tolerability. Patients with mild hepatic insufficiency do not require dosage reductions. The use of pilocarpine in patients with severe hepatic insufficiency is not recommended. If needed, refer to the Hepatic Insufficiency subsection of the Precautions section of this label for definitions of mild, moderate and severe hepatic impairment. Head & Neck Cancer Patients: The recommended initial dose of Pilocarpine Hydrochloride Tablets is 5 mg taken three times a day. Dosage should be titrated according to therapeutic response and tolerance. The usual dosage range is up to 15-30 mg per day. (Not to exceed 10 mg per dose). Although early improvement may be realized, at least 12 weeks of uninterrupted therapy with Pilocarpine Hydrochloride Tablets may be necessary to assess whether a beneficial response will be achieved. The incidence of the most common adverse events increases with dose. The lowest dose that is tolerated and effective should be used for maintenance. Sjogren's Syndrome Patients: The recommended dose of Pilocarpine Hydrochloride Tablets is 5 mg taken four times a day. Efficacy was established by 6 weeks of use.
Everything below is the FDA label for Salagen (tablet). Pilocarpine is also sold as drops, insert, extended release and solution, and those are different medicines to take — follow the label for the one you were prescribed.
Salagen side effects
Head & Neck Cancer Patients: In controlled studies, 217 patients received pilocarpine, of whom 68% were men and 32% were women. Race distribution was 91% Caucasian, 8% Black, and 1% of other origin. Mean age was approximately 58 years. The majority of patients were between 50 and 64 years (51%), 33% were 65 years and older and 16% were younger than 50 years of age. The most frequent adverse experiences associated with pilocarpine hydrochloride tablets were a consequence of the expected pharmacologic effects of pilocarpine. Adverse Event Pilocarpine HCl Placebo 10 mg t.i.d. 5 mg t.i.d. (t.i.d.) (30 mg/day) (15 mg/day) N=121 N=141 N=152 Sweating 68% 29% 9% Nausea 15 6 4 Rhinitis 14 5 7 Diarrhea 7 4 5 Chills 15 3 <1 Flushing 13 8 3 Urinary Frequency 12 9 7 Dizziness 12 5 4 Asthenia 12 6 3 In addition, the following adverse events (≥3% incidence) were reported at dosages of 15-30 mg/day in the controlled clinical trials: Adverse Event Pilocarpine HCl Placebo 5-10 mg t.i.d. (t.i.d.) (15-30 mg/day) N=212 N=152 Headache 11% 8% Dyspepsia 7 5 Lacrimation 6 8 Edema 5 4 Abdominal Pain 4 4 Amblyopia 4 2 Vomiting 4 1 Pharyngitis 3 8 Hypertension 3 1 The following events were reported with treated head and neck cancer patients at incidences of 1% to 2% at dosages of 7.5 to 30 mg/day: abnormal vision, conjunctivitis, dysphagia, epistaxis, myalgias, pruritus, rash, sinusitis, tachycardia,…
Who shouldn’t take Salagen
Pilocarpine Hydrochloride Tablets are contraindicated in patients with uncontrolled asthma, known hypersensitivity to pilocarpine, and when miosis is undesirable, e.g., in acute iritis and in narrow-angle (angle closure) glaucoma.
Salagen drug interactions
Pilocarpine should be administered with caution to patients taking beta-adrenergic antagonists because of the possibility of conduction disturbances. Drugs with parasympathomimetic effects administered concurrently with pilocarpine would be expected to result in additive pharmacologic effects. Pilocarpine might antagonize the anticholinergic effects of drugs used concomitantly. These effects should be considered when anticholinergic properties may be contributing to the therapeutic effect of concomitant medication (e.g., atropine, inhaled ipratropium). While no formal drug interaction studies have been performed, the following concomitant drugs were used in at least 10% of patients in either or both Sjogren's efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone.
Every pilocarpine product we track (6)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Drops | Generic | $0 | View → | |
| 2 | 70/100 | Prescription | Insert | Generic | $0 | View → | |
| 3 | 68/100 | Prescription | Drops | Generic | $0 | View → | |
| 4 | Not yet rated | Prescription | Drops | Generic | $0 | View → | |
| 5 | Not yet rated | Prescription | Solution | Generic | $0 | View → | |
| 6 | Not yet rated | Prescription | Tablet | Generic | $0 | View → |
What pilocarpine pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
How long pilocarpine keeps
The date on a sealed pack is not the only one: some pilocarpine labels start a second clock once the product is opened or mixed, as short as 30 days.
Does pilocarpine expire? The in-use limits and storage rules from its labelsWhat people report to the FDA about pilocarpine
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 4,728 reports naming pilocarpine, and the FDA flagged 58% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- fatigue337 reports
- nausea304 reports
- headache281 reports
- dyspnoea254 reports
- diarrhoea240 reports
- arthralgia211 reports
- dizziness203 reports
- fall201 reports
Read these as a signal, not a rate. A report does not mean pilocarpine caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 27, 2026.
Related calculators
Frequently asked questions
What is Salagen?
Pilocarpine Hydrochloride Tablets contain pilocarpine hydrochloride, a cholinergic agonist for oral use. Pilocarpine hydrochloride is a hygroscopic, odorless, bitter tasting white crystal or powder which is soluble in water and alcohol and virtually insoluble in most non-polar solvents.
What kind of drug is pilocarpine?
The FDA classifies pilocarpine as a cholinergic receptor agonist. Cholinergic receptor agonists mimic acetylcholine and switch on its receptors, triggering the body's "rest and digest" responses. This boosts effects like saliva and tear flow, bladder and bowel emptying, and pupil constriction. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take pilocarpine with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run pilocarpine against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is pilocarpine sold under?
We track 6 pilocarpine-containing products in the U.S.: Vuity, Ocusert Pilo-40, Isopto Carpine, Pilocarpine Hydrochloride, Qlosi and Salagen. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does pilocarpine come in?
Across the brands we track, pilocarpine is currently marketed as drops, insert, extended release, tablet and solution, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic pilocarpine?
Yes. Our catalog lists 1 generic pilocarpine product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Pilocarpine: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/pilocarpine
- MLA
- “Pilocarpine: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/pilocarpine.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for pilocarpine on DailyMed (NIH) ↗.