Sjogren dry mouth guide

Dry mouth with Sjogren disease: a saliva medicine

For adults 18 and older whose Sjogren disease a clinician already diagnosed. A doctor reads your answers and may send pilocarpine tablets at the label dose. We do not order tests. The visit also gives comfort steps and dental advice.

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Start a $59 online review for Dry mouth with Sjogren disease.

Sjogren disease can leave you with a dry mouth. Your glands make less saliva. Pilocarpine is a tablet that helps them make more. It treats dry mouth only. It does not treat Sjogren disease. It does not treat dry eyes or sore joints. The FDA label lists this use, and we use the label dose. We use it in no other way. The visit also gives comfort steps and dental advice. This visit is for adults 18 or older whose Sjogren disease a clinician already diagnosed, and who saw a clinician in person about it in the last 12 months. We do not order tests. A clinician is a doctor, nurse practitioner, or physician assistant. You tell us the date of that visit.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

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Already in ongoing care with us for this? Check-ins are $39 (your first one is free).

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

A dry mouth from Sjogren disease
Trouble chewing or swallowing because the mouth is dry
Sjogren disease that a clinician already diagnosed

May fit online care

Adults 18 and older
You are 18 or older
A doctor, nurse practitioner, or physician assistant already told you that you have Sjogren disease
You saw a clinician in person about Sjogren disease in the last 12 months
A clinician or dentist already assessed the cause of your dry mouth
You want the doctor to consider a saliva medicine
You have none of the warning signs or medicine screens below

Look for another care setting

If more than one fits, follow the first one.
If you are taking pilocarpine tablets from us, stop them when any item below fits you. Do not wait for our reply.
Trouble breathing, or unable to swallow saliva (call 911 or go to the ER now).
Rapidly increasing swelling of the mouth, tongue, or neck (call 911 or go to the ER now).
Chest pain, fainting, or a very slow, very fast, or uneven heartbeat (call 911 or go to the ER now).
Wheezing, or swelling of the lips or face (call 911 or go to the ER now).
Sudden weakness or numbness on one side, a drooping face, trouble speaking, or sudden confusion (call 911 or go to the ER now).
Severe eye pain, or eye pain with a headache, nausea or vomiting, or halos around lights, or a change in sight that blinking does not fix: blurry, double, a dark spot, or gone (call 911 or go to the ER now).
You took many more tablets than the plan says, even if you feel fine. Do not drive yourself (call 911 or go to the ER now).
Eye pain that is more than dryness or burning, or bright light that hurts your eyes (go to the ER or urgent care today).
Trouble keeping up with fluids, or heavy sweating and you cannot drink enough (go to the ER or urgent care today).
Very bad belly pain, or pain in the side or back that comes in waves (go to the ER or urgent care today).
Yellow skin or eyes (go to the ER or urgent care today).
Vomiting or diarrhea that does not stop (go to the ER or urgent care today).
Painful swallowing (go to the ER or urgent care today).
A fever with swelling of the mouth or face (go to the ER or urgent care today).
A mouth sore lasting more than 2 weeks, or new white patches (go to the ER or urgent care today).
Unexplained weight loss (go to the ER or urgent care today).
New marked thirst with frequent urination (go to the ER or urgent care today).
Head or neck radiation, or active cancer treatment (go to the ER or urgent care today).
Dryness that is new and steadily getting worse (go to the ER or urgent care today).
New dry eyes or joint pain (go to the ER or urgent care today).
A new rash, hives, red or purple spots on the skin, or skin sores (go to the ER or urgent care today).
Dry eyes or sore joints that you already know about from Sjogren disease do not count. Only new ones count. Keep seeing your own doctors for your eyes and joints.
A clinician or dentist has not assessed the cause of your dry mouth, or you are not sure (go to the ER or urgent care today).
A fever of 100.4 F (38 C) or higher, or shaking chills (see a doctor in person today).
A painful, hot swelling of the cheek or under the jaw (see a doctor in person today).
New shortness of breath when you walk or do activity (see a doctor in person today).
New swelling in your legs or feet (see a doctor in person today).
Blood in your urine (see a doctor in person today).
Trouble swallowing food, even if it does not hurt (see a doctor in person within 7 days).
New swelling in a cheek, under the jaw, or in the neck, or a new lump (see a doctor in person within 7 days).
New numbness, tingling, or weakness (see a doctor in person within 7 days).
A dry cough that will not go away (see a doctor in person within 7 days).
You are under 18 (see your own doctor).
No clinician has told you that you have Sjogren disease, or you are not sure (no tablets from us, see your own doctor about a saliva medicine).
Your last in-person visit about Sjogren disease was more than 12 months ago, or you do not remember (no tablets from us, see your own doctor about a saliva medicine).
Asthma, chronic bronchitis, or COPD (no tablets from us, see your own doctor about a saliva medicine).
A heart or blood vessel problem, such as a heart attack, angina, a heart rhythm problem, a slow heartbeat, heart failure, a stroke or mini-stroke (TIA), or peripheral artery disease (poor blood flow in the legs) (no tablets from us, see your own doctor about a saliva medicine).
Glaucoma, iritis (swelling inside the eye), or a cataract or other lens change (no tablets from us, see your own doctor about a saliva medicine).
Gallstones, gallbladder disease, or bile duct disease (no tablets from us, see your own doctor about a saliva medicine).
Kidney stones (no tablets from us, see your own doctor about a saliva medicine).
Liver disease (no tablets from us, see your own doctor about a saliva medicine).
A heart or kidney doctor gave you a fluid limit (no tablets from us, see your own doctor about a saliva medicine).
You are allergic to pilocarpine (no tablets from us, see your own doctor about a saliva medicine).
You already take pilocarpine or cevimeline from another clinician (no tablets from us, see your own doctor about a saliva medicine).
You are pregnant, or you might be (no tablets from us, see your own doctor about a saliva medicine).
You are trying to have a baby, or you and your partner are trying to have a baby (no tablets from us, see your own doctor about a saliva medicine).
You are breastfeeding (no tablets from us, see your own doctor about a saliva medicine).
A beta blocker, such as metoprolol, atenolol, or propranolol (no tablets from us, see your own doctor about a saliva medicine).
A drying medicine, such as oxybutynin, tolterodine, glycopyrrolate, hyoscyamine, diphenhydramine, amitriptyline, or ipratropium (no tablets from us, see your own doctor about a saliva medicine).
A medicine that acts like pilocarpine, such as bethanechol, donepezil, pyridostigmine, or pilocarpine eye drops (no tablets from us, see your own doctor about a saliva medicine).
Tell us about all your medicines and supplements. Tell us if you have memory or mood problems. The doctor decides if the tablet is safe for you.

What to have ready

Who told you that you have Sjogren disease, and when
The date and place of your last in-person visit about it
Every medicine, vitamin, and supplement you take
What you have tried for dry mouth, and whether it helped
Any memory or mood problems

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

About Ankur Fadia, MD Verify Virginia medical license Verify West Virginia medical license Verify board certification

What does the tablet treat?

Pilocarpine tablets treat dry mouth in people with Sjogren disease. The tablet does not treat Sjogren disease, dry eyes, or sore joints. Keep seeing the clinicians who look after your eyes and joints.

Why is no test ordered?

We do not order tests. We use the diagnosis your clinician already made, the date of your last in-person visit about it, and your answers. The doctor reads them and may still send no tablet. If you need a test to know whether the tablet is safe for you, see your own doctor.

Does the tablet cause sweating?

It can. Sweating is the most common side effect. Flushing, chills, a runny nose, nausea, a headache, mild dizziness, and passing urine more often are common too. If you only have these side effects, keep taking the tablets, and message us if they bother you. Heavy sweating when you cannot drink enough needs the ER or urgent care today.

Can I drive at night?

The tablet can make it harder to see in the dark. Do not drive at night until you know how it affects you. Take care in dim light. If your sight changes in a way that blinking does not fix, including blurry sight, call 911 or go to the ER now.

What does the 6-week check mean?

The label says the studies showed the tablet works by 6 weeks of use. If your mouth is not clearly better after 6 weeks, message us. A little better is not enough. You get no more tablets unless your mouth is clearly better. The doctor decides the rest.

How many tablets do I get, and how do I get more?

The first supply is 120 tablets of 5 mg. That is 30 days. Take 1 tablet 4 times a day. Never take more than 1 tablet at a time. Never take more than 4 tablets in a day. You get a free check-in at about 2 weeks. It checks for side effects. It does not send more tablets. For more tablets, you do a check-in about every 30 days. The price of each check-in is shown before you pay. A check-in is a review. The doctor may send 30 more days of tablets, but only if every safety answer is clear. There are no automatic refills.

Do my known dry eyes or sore joints stop me from using this visit?

No. Dry eyes or sore joints that you already know about from Sjogren disease do not count. Only new ones count. Keep seeing your own doctors for your eyes and joints.

When should I get help right away?

Do not wait for our reply if a warning sign on this page starts. Our reply can take up to 6 hours. If more than one warning sign fits, follow the first one. If you are taking pilocarpine tablets from us, stop them. Do not drive yourself to the ER.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Cracked corners of the mouth Blepharitis Canker sores Dental infection Dizzy spells after BPPV Dry eye and eye allergies