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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Margit on March 2, 2001, at 22:22:49
Is it safe to take Salaven with a tricyclic AD, in my case Nortriptyline? My doc didn't know. I called the manufacturer and they didn't know. Does anybody have any experience with combining these two meds? I have an extremly dry mouth from the AD to the point that I have cracks in my tongue. My doc gave me a brochure on Salaven, a product that produces more saliva. Since he wasn't sure I asked my pdoc, but he didn't know either. I'd appriciate any response.
Posted by downer on March 2, 2001, at 22:53:44
In reply to Salaven and a tricyclic?, posted by Margit on March 2, 2001, at 22:22:49
My doc just gave me Salagen to go with imipramine so I guess it is ok. Apparently, whatever causes the dry mouth, when fixed, augments the tricyclic to work better (at least that is what he said). Hope that helps.
Posted by SalArmy4me on March 3, 2001, at 3:41:12
In reply to Salaven and a tricyclic?, posted by Margit on March 2, 2001, at 22:22:49
I took Salagen when I was on Parnate, and I switched to Urecholine later because I needed more cholinergic effects in order to remedy urinary retention--as well as dry mouth. But Salagen should be safe to take with a tricyclic. If in doubt, check the Drug-Checker on www.drkoop.com
> Is it safe to take Salaven with a tricyclic AD, in my case Nortriptyline? My doc didn't know. I called the manufacturer and they didn't know. Does anybody have any experience with combining these two meds? I have an extremly dry mouth from the AD to the point that I have cracks in my tongue. My doc gave me a brochure on Salaven, a product that produces more saliva. Since he wasn't sure I asked my pdoc, but he didn't know either. I'd appriciate any response.
Posted by Sunnely on March 3, 2001, at 10:10:20
In reply to Salaven and a tricyclic?, posted by Margit on March 2, 2001, at 22:22:49
Traditionally, a cholinomimetic agent called bethanechol (Urecholine) has been used as an antidote to anticholinergic side efects including dry mouth. In one study, an oral regimen of Urecholine increases salivary flow and was superior to placebo in relieving dry mouth, urinary, retention, constipation, blurred, vision, and thirst.
Pilocarpine is a natural cholinomimetic alkaloid that has been available for many years in an ophthalmic solution for the treatment of open-angle glaucoma.
Pilocarpine (Salagen, Minims) has been approved by the FDA for oral treatment of chronic dry mouth (xerostomia), which can result from salivary gland hypofunction (low activity) resulting from radiotherapy for cancer of the head and neck. Salagen has also been found effective in anticholinergic side effects (e.g., dry mouth) brought on by psychotropic medications.
With regard to Salagen's use in psychotropic-induced xerostomia, in a two large, multiceter, random-assignment, double-blind, 12-week trials, improvement in xerostomia occurred in 42% to 54% of patients Salagen, compared to 25% to 27% of placebo-treated paitents (Medical Letter 1994;36:73). The supplemental use of hard candy, sprays, and gum decreased during treatment Salagen. The side effects observed were those of cholinergic excess and included sweating, nausea, nasal stuffiness, chills, flushing, urinary frequency, dizziness, asthenia, and visual disturbances.
Salagen, when used as directed, is a generally safe treatment for psychotropic-induced xerostomia. Of course, you should first consult with your doctor and pharmacist to make sure you don't have any medical contraindications and potentially harmful drug-drug interaction regarding its use. Needless to say, patients should always follow regular dental hygiene and visits to their dentist. Physicians should inquire their patients who are on psychotropics about oral hygiene and take dry mouth seriously.
For many patients, the use of sugar-free candies and frequent sips of water can allow satisfactory management of xerostomia. For others, dry mouth can lead to dental caries, infections, and difficulty eating and talking. Unfortunately, even nortriptyline (Pamelor), which is less anticholinergic than many tricyclics, can cause clinically bothersome anticholinergic side effects (including dry mouth) in many patients.
Source: Pilocarpine for anticholinergic side effects. Biological Therapies in Psychiatry Newsletter, AJ Gelenberg, MD (ed.), February 1995.
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> Is it safe to take Salaven with a tricyclic AD, in my case Nortriptyline? My doc didn't know. I called the manufacturer and they didn't know. Does anybody have any experience with combining these two meds? I have an extremly dry mouth from the AD to the point that I have cracks in my tongue. My doc gave me a brochure on Salaven, a product that produces more saliva. Since he wasn't sure I asked my pdoc, but he didn't know either. I'd appriciate any response.
Posted by Margit on March 3, 2001, at 11:28:39
In reply to Salaven and a tricyclic?, posted by Margit on March 2, 2001, at 22:22:49
Thanks for all of your responses. They were very helpful. I was wondering though, since Salagen is a cholineric agent, would it help with constipation as well?
Posted by Margit on March 3, 2001, at 11:50:58
In reply to Re: Salaven and a tricyclic?, posted by downer on March 2, 2001, at 22:53:44
Have youtried it yet? And does it work? Just curious.
Posted by Margit on March 3, 2001, at 14:10:27
In reply to Re: Salaven and a tricyclic?, posted by downer on March 2, 2001, at 22:53:44
Have you tried the Salagen yet? And did it work? Just curious to know?
This is the end of the thread.
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