Skip to main content
SpringerLink
Log in

Manage drug-induced dry mouth with drug regimen changes, lifestyle interventions and topical or oral symptom-relieving products

  • Drug Reactions and Interactions
  • Published:
Drugs & Therapy Perspectives Aims and scope Submit manuscript

Abstract

Drug-induced dry mouth (i.e. xerostomia and hyposalivation) has negative effects on general and oral health, as well as on health-related quality of life, and can lead to potentially serious complications. Options for treatment include changing the regimen of the causative drug, lifestyle interventions (e.g. increasing fluid intake and improving dental care), topical symptom-relieving products (e.g. oral moisturizers, salivary substitutes and salivary stimulators) and/or oral drugs with cholinergic salivation-stimulating properties (e.g. cevimeline and pilocarpine).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barbe AG. Medication-induced xerostomia and hyposalivation in the elderly: culprits, complications, and management. Drugs Aging. 2018;35(10):877–85.

    Article  PubMed  Google Scholar 

  2. Sreebny L. Saliva in health and disease: an appraisal and update. Int Dent J. 2000;50(3):140–6.

    Article  CAS  PubMed  Google Scholar 

  3. Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc. 2003;134(1):61–9.

    Article  PubMed  Google Scholar 

  4. Dawes C. How much saliva is enough for avoidance of xerostomia? Caries Res. 2004;38(3):236–40.

    Article  CAS  PubMed  Google Scholar 

  5. van der Putten GJ, Brand HS, Schols JM, et al. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. Clin Oral Investig. 2011;15(2):185–92.

    Article  PubMed  Google Scholar 

  6. Gupta A, Epstein JB, Sroussi H. Hyposalivation in elderly patients. J Can Dent Assoc. 2006;72(9):841–6.

    PubMed  Google Scholar 

  7. Villa A, Wolff A, Aframian D, et al. World Workshop on Oral Medicine VI: a systematic review of medication-induced salivary gland dysfunction: prevalence, diagnosis, and treatment. Clin Oral Investig. 2015;19(7):1563–80.

    Article  PubMed  Google Scholar 

  8. Villa A, Abati S. Risk factors and symptoms associated with xerostomia: a cross-sectional study. Aust Dent J. 2011;56(3):290–5.

    Article  CAS  PubMed  Google Scholar 

  9. Pedersen AM, Bardow A, Jensen SB, et al. Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis. 2002;8(3):117–29.

    Article  CAS  PubMed  Google Scholar 

  10. Visvanathan V, Nix P. Managing the patient presenting with xerostomia: a review. Int J Clin Pract. 2010;64(3):404–7.

    Article  CAS  PubMed  Google Scholar 

  11. Han P, Suarez-Durall P, Mulligan R. Dry mouth: a critical topic for older adult patients. J Prosthodont Res. 2015;59(1):6–19.

    Article  PubMed  Google Scholar 

  12. Wolff A, Joshi RK, Ekström J, et al. A guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: a systematic review sponsored by the world workshop on oral medicine VI. Drugs R D. 2017;17(1):1–28.

    Article  CAS  PubMed  Google Scholar 

  13. Thomson WM, Chalmers JM, Spencer AJ, et al. The Xerostomia inventory: a multi-item approach to measuring dry mouth. Community Dent Health. 1999;16(1):12–7.

    CAS  PubMed  Google Scholar 

  14. Sreebny LM, Valdini A. Xerostomia: a neglected symptom. Arch Intern Med. 1987;147(7):1333–7.

    Article  CAS  PubMed  Google Scholar 

  15. Nederfors T. Xerostomia and hyposalivation. Adv Dent Res. 2000;14:48–56.

    Article  CAS  PubMed  Google Scholar 

  16. Kleiner SM. Water: an essential but overlooked nutrient. J Am Diet Assoc. 1999;99(2):200–6.

    Article  CAS  PubMed  Google Scholar 

  17. Wolff A, Fox PC, Porter S, et al. Established and novel approaches for the management of hyposalivation and xerostomia. Curr Pharm Des. 2012;18(34):5515–21.

    Article  CAS  PubMed  Google Scholar 

  18. Furness S, Worthington HV, Bryan G, et al. Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev. 2011;12:104.

    Google Scholar 

  19. van der Reijden WA, Vissink A, Veerman EC, et al. Treatment of oral dryness related complaints (xerostomia) in Sjogren’s syndrome. Ann Rheum Dis. 1999;58(8):465–74.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hahnel S, Behr M, Handel G, et al. Saliva substitutes for the treatment of radiation-induced xerostomia—a review. Support Care Cancer. 2009;17(11):1331–43.

    Article  PubMed  Google Scholar 

  21. Strietzel FP, Lafaurie GI, Mendoza GR, et al. Efficacy and safety of an intraoral electrostimulation device for xerostomia relief: a multicenter, randomized trial. Arthritis Rheum. 2011;63(1):180–90.

    Article  PubMed  Google Scholar 

  22. Alajbeg I, Falcao DP, Tran SD, et al. Intraoral electrostimulator for xerostomia relief: a long-term, multicenter, open-label, uncontrolled, clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):773–81.

    Article  PubMed  Google Scholar 

  23. Khosravani N, Birkhed D, Ekström J. The cholinesterase inhibitor physostigmine for the local treatment of dry mouth: a randomized study. Eur J Oral Sci. 2009;117(3):209–17.

    Article  CAS  PubMed  Google Scholar 

  24. Cevimeline hydrochloride 30 mg capsules: US prescribing information. Cranbury (NJ): Sun Pharmaceuticl Industries, Inc.; 2018.

  25. Committee for Proprietary Medicinal Products. Meeting report 24 to 25 April 2001. London: European Agency for the Evaluation of Medicinal Products; 2001.

    Google Scholar 

  26. Pilocarpine hydrochloride 5 and 7.5 mg film-coated tablets: US prescribing information. Amityville (NY): Amici Pharmaceuticals. 2018.

  27. Wiseman LR, Faulds D. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs. 1995;49(1):143–55.

    Article  CAS  PubMed  Google Scholar 

  28. Takakura AC, Moreira TS, Laitano SC, et al. Central muscarinic receptors signal pilocarpine-induced salivation. J Dent Res. 2003;82(12):993–7.

    Article  CAS  PubMed  Google Scholar 

  29. Schneyer CA, Hall HD. Autonomic pathways involved in a sympathetic-like action of pilocarpine on salivary composition. Proc Soc Exp Biol Med. 1966;121(1):96–100.

    Article  CAS  PubMed  Google Scholar 

  30. Salagen® (pilocarpine hydrochloride) 5 mg film-coated tablets: EU prescribing information. Amsterdam: Norgine B.V.; 2017.

  31. Barbe AG, Schmidt-Park Y, Hamacher S, et al. Efficacy of GUM® Hydral versus Biotène® Oralbalance mouthwashes plus gels on symptoms of medication-induced xerostomia: a randomized, double-blind, crossover study. Clin Oral Investig. 2018;22(1):169–80.

    Article  PubMed  Google Scholar 

  32. Braga MA, Tarzia O, Bergamaschi CC, et al. Comparison of the effects of pilocarpine and cevimeline on salivary flow. Int J Dent Hyg. 2009;7(2):126–30.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

    Consortia

    Adis Medical Writers

    Ethics declarations

    Conflict of interest

    The article was adapted from Drugs & Aging; 2018;35(10):877-85 by employees of Adis/Springer, who are responsible for the article content and declare no conflicts of interest.

    Funding

    The preparation of this review was not supported by any external funding.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Adis Medical Writers. Manage drug-induced dry mouth with drug regimen changes, lifestyle interventions and topical or oral symptom-relieving products. Drugs Ther Perspect 35, 226–229 (2019). https://doi.org/10.1007/s40267-019-00618-8

    Download citation

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s40267-019-00618-8

    Search

    Navigation