The Medical Letter on Drugs and Therapeutics
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ISSUE
1355
In Brief: Glycopyrrolate Oral Solution for Sialorrhea
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 Select a term to see related articles  2011   Anticholinergics   Cerebral palsy   Clozapine   Cuvposa   Drooling   Glycopyrrolate   In brief   Parkinson's disease   Pediatrics   Robinul   Schizophrenia   Sialorrhea 

Glycopyrrolate (Robinul, and others), a synthetic muscarinic receptor antagonist, has been used off-label for many years for treatment of excessive drooling in patients with Parkinson’s disease, in patients taking clozapine for schizophrenia, and in developmentally disabled children.1-3 It has now been approved by the FDA as Cuvposa (Shionogi) for use specifically in children 3-16 years old with severe chronic drooling due to a neurologic condition, such as cerebral palsy. It is being marketed as an oral solution, which will permit more precise weight-based dosing than was possible with the oral tablets used in the past. As with other anticholinergic drugs, dry mouth, constipation, flushing and nasal congestion can occur. Since glycopyrrolate decreases secretion not only of saliva, but also of sweat, overheating due to high ambient temperatures or excessive exercise could be dangerous for patients who take it.

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