Table 3.
Medications reported to induce xerostomia, salivary gland hypofunction, or sialorrhea with moderate level of evidence
| Drug name and function | ATC code | Mechanism and site of action | Number of citations for: | Sources per level of evidence (n) | Total publications (n) | References | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Oral ‘dryness’ | Sialorrhea | |||||||||||
| Xerostomia | SGH | Subjective | Objective | A2 | B2 | A3 | B3 | |||||
| Amisulpride (atypical anti-psychotic) | N05AL05 | Antagonist to dopamine and 5-HT | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 2 | [157, 203 a] |
| Asenapine (atypical anti-psychotic) | N05AH05 | Antagonist to dopamine, 5-HT, histamine (H1) and α(1,2) adrenergic receptors | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | [115, 204] |
| Atenolol (anti-hypertensive/anti-arrhythmic) | C07AB03 | β1-Adrenergic antagonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [205] |
| Azelastine (anti-allergic) | R01AC03, | Histamine (H1) antagonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [206] |
| Cetirizine (anti-allergic) | R06AE07 | Histamine (H1) antagonist | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | [206, 207] |
| Clobazam (anxiolytic/anti-convulsant) | N05BA09 | Benzodiazepine—enhances the GABA effect on its receptors | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 1 | [208] |
| Darifenacin (urological—reduces bladder activity) | G04BD10 | Anti-muscarinic | 5 | 1 | 0 | 0 | 1 | 2 | 0 | 3 | 6 | [133–135, 137, 138, 171] |
| Desipramine (anti-depressant) | N06AA01 | Preferential NE-reuptake inhibitor | 2 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 2 | [91, 209 a] |
| Desloratadine (anti-allergic/anti-pruritic) | R06AX27 | Histamine (H1)-antagonist, anti-muscarinic | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | [210, 211] |
| Desvenlafaxine (anti-depressant) | N06AX23 | 5-HT and NE reuptake inhibitor | 5 | 0 | 0 | 0 | 0 | 3 | 0 | 2 | 5 | [52, 212–215] |
| Dexfenfluramine (appetite suppressant) | A08AA04 | Releases 5-HT | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | [216, 217] |
| Dexmedetomidine (hypnotic sedative) | N05CM18 | α2-Adrenergic agonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [218] |
| Didanosine (anti-viral—HIV-1 therapy) | J05AF02 | Nucleoside analog reverse transcriptase inhibitor | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [219] |
| Dihydrocodeine (opioid-analgesic) | N02AA08 | Weak agonist for the μ-opioid receptor | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [220] |
| Dosulepin (anti-depressant) | N06AA16 | Non-selective 5-HT/NE reuptake inhibitor, anti-muscarinic, anti-histamine (H1) | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [221] |
| Doxepin (anti-depressant) | N06AA12 | Non-selective 5-HT/NE reuptake inhibitor, anti-muscarinic, anti-histamine (H1), α1-adrenergic receptor antagonist | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [92] |
| Ebastine (anti-allergic/anti-pruritus) | R06AX22 | Histamine (H1) antagonist | 2 | 0 | 0 | 0 | 0 | 3 | 0 | 0 | 3 | [222–224] |
| Enalapril (anti-hypertensive) | C09AA02 | ACE inhibitor | 2 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 1 | [205] |
| Eszopiclone (hypnotic-sedative) | N05CF04 | Enhances the GABA effect on its receptors | 3 | 0 | 0 | 0 | 0 | 1 | 0 | 2 | 3 | [225–227] |
| Etravirine (anti-viral—HIV-1 therapy) | J05AG04 | Non-nucleoside reverse transcriptase inhibitor | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Fentanyl (opioid-analgesic) | N01AH01, N02AB03 | Strong µ-opioid receptor agonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [218] |
| Fesoterodine (urological - reduces bladder activity) | G04BD11 | Anti-muscarinic | 4 | 0 | 0 | 0 | 0 | 3 | 0 | 1 | 4 | [181, 183, 228–230] |
| Haloperidol (anti-psychotic) | N05AD01 | Antagonist to dopamine, 5-HT, histamine (H1), muscarinic and α(1,2)adrenergic receptors | 2 | 0 | 1 | 0 | 0 | 2 | 0 | 0 | 2 | [24, 119] |
| Hyoscyamine (anti-peristaltic/spasmolytic) | A03BA03 | Anti-muscarinic | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [231] |
| Isradipine (anti-hypertensive) | C08CA03 | Calcium channel blocker—arterial vasodilator effects | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [205] |
| Lamivudine (anti-viral—HIV, hepatitis B) | J05AF05 | Nucleoside analog reverse transcriptase inhibitor | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Levocetirizine (anti-allergic) | R06AE09 | Histamine (H1) receptor antagonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [232] |
| Lisinopril (anti-hypertensive) | C09AA03 | ACE inhibitor | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [233] |
| Lurasidone (anti-psychotic) | N05AE05 | 5-HT/dopamine antagonist, α2-adrenerg receptor antagonist, partial 5-HT(7)-agonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [234] |
| Maraviroc (anti-viral) | J05AX09 | Prevents HIV from entering the cells | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Methyldopa (anti-hypertensive) | C02AB01 | False transmitter; synthesis of the less potent α-methyl-NE instead of NE | 2 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 2 | [50, 53] |
| Metoprolol (anti-hypertensive/anti-arrhythmic) | C07AB02 | β1-Adrenergic receptor antagonist | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 2 | [14, 235] |
| Mexiletine (anti-arrhythmic) | C01BB02 | Sodium channel blocker | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [236] |
| Morphine (opioid-analgesic) | N02AA01 | Strong agonist on the µ-receptor | 2 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 2 | [237, 238] |
| Naltrexone (treatment of alcoholism) | N07BB04 | Opioid receptor antagonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [239] |
| Nevirapine (anti-viral—HIV-1) | J05AG01 | Non-nucleoside reverse transcriptase inhibitor | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Nicotine (for smoking cessation) | N07BA01 | Agonist to nicotinic receptors | 2 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 2 | [240, 241] |
| Orlistat (anti-obesity) | A08AB01 | Inhibits lipase, that breaks down dietary triglycerides | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [169] |
| Pregabalin (anti-convulsant by non-GABAergic mechanisms) | N03AX16 | Reduces transmitter release | 3 | 0 | 0 | 0 | 0 | 1 | 0 | 2 | 3 | [242–244] |
| Raltegravir (anti-viral—HIV-1) | J05AX08 | Prevents the integration of virus DNA into host chromosomes | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Saquinavir (anti-viral) | J05AE01 | HIV protease inhibitor | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | [219] |
| Sertindole (anti-psychotic) | N05AE03 | Antagonist to dopamine, 5-HT and α1-adrenergic receptors | 2 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | [245, 246] |
| Sodium valproate (anti-convulsant) | N03AG01 | Reduces the excitability of nerves by inhibiting the inflow of sodium ions | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [114] |
| Tapentadol (opioid-analgesic) | N02AX06 | Weak µ-opioid antagonist, and neuronal NE-reuptake inhibitor | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [247] |
| Terazosin (urological—decreases urinary flow obstruction/anti- hypertensive) | G04CA03 | α1-Adrenergic receptor antagonist | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [248] |
| Tizanidine (anti-muscle-spasticity) | M03BX02 | Releases GABA from spinal cord inhibitory interneurons, in addition weak α2-adrenergic agonist | 2 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 | [28, 249] |
| Tolvaptan (diuretic) | C03XA01 | Vasopressin V2 receptor antagonist preventing the action of the anti-diuretic hormone (ADH) | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [250] |
| Tramadol (opioid-analgesic) | N02AX02 | Weak µ-opioid receptor agonist and NE/ 5-HT reuptake inhibitor | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [237] |
| Trospium (urological—reduces bladder activity) | G04BD09 | Muscarinic receptor antagonist | 4 | 0 | 0 | 0 | 0 | 2 | 0 | 2 | 4 | [128, 132, 133, 137] |
| Zopiclone (hypnotic) | N05CF01 | Non-benzodiazepine—enhances the GABA effect on its receptors | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | [251] |
5-HT 5-hydroxytryptamine (serotonin), ACE angiotensin-converting enzyme, ATC Anatomical Therapeutic Chemical, GABA gamma-aminobutyric acid, NE norepinephrine, SGH salivary gland hypofunction
aAnimal study