A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI

Andy Wolff, Revan Kumar Joshi, Jörgen Ekström, Doron Aframian, Anne Marie Lynge Pedersen, Gordon Proctor, Nagamani Narayana, Alessandro Villa, Ying Wai Sia, Ardita Aliko, Richard McGowan, Alexander Ross Kerr, Siri Beier Jensen, Arjan Vissink, Colin Dawes

Research output: Contribution to journalReview article

39 Citations (Scopus)

Abstract

Background: Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. Objective: Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea. Data Sources: Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices. Limitations: While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search. Conclusions: We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.

Original languageEnglish (US)
JournalDrugs in R and D
Volume17
Issue number1
DOIs
StatePublished - Mar 1 2017

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Sialorrhea
Oral Medicine
Xerostomia
Salivary Glands
Education
Urogenital System
Digestive System
Information Storage and Retrieval
Cardiovascular System
Saliva
Respiratory System
Nervous System
Mouth
Quality of Life
Databases
Morbidity
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Pharmacology

Cite this

A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea : A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. / Wolff, Andy; Joshi, Revan Kumar; Ekström, Jörgen; Aframian, Doron; Pedersen, Anne Marie Lynge; Proctor, Gordon; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Aliko, Ardita; McGowan, Richard; Kerr, Alexander Ross; Jensen, Siri Beier; Vissink, Arjan; Dawes, Colin.

In: Drugs in R and D, Vol. 17, No. 1, 01.03.2017.

Research output: Contribution to journalReview article

Wolff, A, Joshi, RK, Ekström, J, Aframian, D, Pedersen, AML, Proctor, G, Narayana, N, Villa, A, Sia, YW, Aliko, A, McGowan, R, Kerr, AR, Jensen, SB, Vissink, A & Dawes, C 2017, 'A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI', Drugs in R and D, vol. 17, no. 1. https://doi.org/10.1007/s40268-016-0153-9
Wolff, Andy ; Joshi, Revan Kumar ; Ekström, Jörgen ; Aframian, Doron ; Pedersen, Anne Marie Lynge ; Proctor, Gordon ; Narayana, Nagamani ; Villa, Alessandro ; Sia, Ying Wai ; Aliko, Ardita ; McGowan, Richard ; Kerr, Alexander Ross ; Jensen, Siri Beier ; Vissink, Arjan ; Dawes, Colin. / A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea : A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. In: Drugs in R and D. 2017 ; Vol. 17, No. 1.
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AU - Joshi, Revan Kumar

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AU - Pedersen, Anne Marie Lynge

AU - Proctor, Gordon

AU - Narayana, Nagamani

AU - Villa, Alessandro

AU - Sia, Ying Wai

AU - Aliko, Ardita

AU - McGowan, Richard

AU - Kerr, Alexander Ross

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