Oral glycopyrrolate alleviates drooling in a patient with tongue cancer

Although sialorrhea and and drooling are uncommon symptoms in cancer patients, they can cause considerable discomfort, inconvenience and social embarrassment, ln this article we describe a patient with tongue cancer who was successfully treated with oral glycopyrrolate 0.4 mg 3 times daily. Glycopyrrolate is a quaternary ammonium compound. In contrast to the recommended treatment with scopolamine, glycopyrrolate is virtually without side effects to the central nervous system because it penetrates the blood-brain barrier poorly. Glycopyrrolate has a slow and erratic absorption from the gastrointestinal system, but even low plasma levels are associated with a distinct and long-lasting antisialogic effect. J Pain Symptom Manage 1999:18:300-302. (C) U.S. Cancer Pain Relief Committee, 1999.