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Pilocarpine Side Effects

In Summary

Commonly reported side effects of pilocarpine include: asthenia, dizziness, nausea, urinary frequency, headache, rhinitis, chills, diaphoresis, and flushing. Other side effects include: diarrhea, lacrimation, and vomiting. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pilocarpine: oral tablet

Along with its needed effects, pilocarpine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur while taking pilocarpine:

Symptoms of overdose
  • Chest pain
  • confusion
  • diarrhea (continuing or severe)
  • fainting
  • fast, slow, or irregular heartbeat (continuing or severe)
  • headache (continuing or severe)
  • nausea or vomiting (continuing or severe)
  • shortness of breath or troubled breathing
  • stomach cramps or pain
  • tiredness or weakness (continuing or severe)
  • trembling or shaking (continuing or severe)
  • trouble seeing (continuing or severe)

Some side effects of pilocarpine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Chills
  • cough
  • diarrhea
  • feeling of warmth or heat
  • fever
  • flushing or redness of skin especially on face and neck
  • increased need to urinate
  • indigestion
  • joint pain
  • muscle aches and pains
  • nausea
  • passing urine more often
  • runny nose
  • unusual tiredness or weakness
  • Sweating
Less common or rare
  • fast heartbeat
  • headache
  • holding more body water
  • swelling of face, fingers, ankles, or feet
  • trembling or shaking
  • trouble swallowing
  • trouble seeing
  • unusual weak feeling
  • voice change
  • vomiting

For Healthcare Professionals

Applies to pilocarpine: compounding crystal, compounding powder, oral tablet


Gastrointestinal side effects commonly reported have included nausea (6% to 15%), diarrhea (4% to 7%), dyspepsia (7%), abdominal pain (4%), and vomiting (4%). Anorexia, increased appetite, cholelithiasis, flatulence, gastritis, gastroenteritis, gastrointestinal disorder, and tongue disorder have been reported rarely.[Ref]


Respiratory side effects have included rhinitis (5% to 14%), sinusitis (4%), and pharyngitis (2%). Esophagitis, increased sputum, stridor, yawning, bronchitis, dyspnea, hiccup, laryngismus, laryngitis, and voice alteration have been reported infrequently.[Ref]


Endocrine side effects have included sweating (29% to 68%), lacrimation (6%), and increased salivation (3%).[Ref]


Cardiovascular side effects have included hypertension (3%), angina pectoris, arrhythmia, electrocardiogram abnormality, hypotension, myocardial infarction, tachycardia, bradycardia, palpitations, and syncope.[Ref]

Nervous system

Nervous system side effects commonly reported have included asthenia (6% to 12%) and dizziness (5% to 12%). Aphasia, confusion, abnormal dreams, hyperkinesia, hypesthesia, insomnia, myalgia, paresthesias, abnormal thinking, speech disorder, twitching, and tremor have been reported less frequently.[Ref]


Ocular side effects have included amblyopia, cataract, conjunctivitis, dry eyes, blurred vision, eye disorder, eye pain, eye hemorrhage, glaucoma, retinal disorder, and abnormal vision.[Ref]


Genitourinary side effects have included dysuria, metrorrhagia, urinary impairment, urinary incontinence, urinary tract infection, vaginitis, breast pain, mastitis, menorrhagia, ovarian disorder, pyuria, salpingitis, urethral pain, urinary urgency, vaginal hemorrhage, and vaginal moniliasis.[Ref]


Psychiatric side effects have included anxiety, confusion, depression, abnormal dreams, somnolence, emotional lability, insomnia, and nervousness.[Ref]


Hematologic side effects have included leukopenia, lymphadenopathy, hematuria, abnormal platelets, thrombocythemia, thrombocytopenia, thrombosis, and abnormal WBC.[Ref]


Metabolic side effects have included hypoglycemia.[Ref]


Dermatologic side effects have included seborrhea.[Ref]


Other infrequently reported side effects have included cyst, neck pain, neck rigidity, photosensitivity reaction, body odor, taste loss, taste perversion, voice alteration, tongue disorder, tooth disorder, increased cough, fever, and lab test abnormalities.[Ref]


1. "Product Information. Salagen Tablets (pilocarpine)." Boehringer-Ingelheim, Ridgefield, CT.

Some side effects of pilocarpine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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