Which drug is available orally as a capsule for xerostomia associated with Sjogren's syndrome?

• A. Cevimeline hydrochloride
• B. Bethanechol
• C. Pilocarpine
• D. Atropine

Answer: (A)

In Sjögren's syndrome, dry mouth comes from autoimmune damage to the salivary glands, so the treatment goal is to stimulate salivary secretion using a cholinergic (muscarinic) agonist. Cevimeline hydrochloride is a muscarinic agonist that specifically increases activity in exocrine glands, including the salivary glands, and it is formulated as an oral capsule, making it convenient for chronic oral therapy in this condition.

Pilocarpine also helps dry mouth by stimulating muscarinic receptors, but it is available as tablets rather than capsules, so it doesn’t meet the capsule requirement. Bethanechol is another muscarinic agonist, but it’s not the preferred option for Sjögren’s xerostomia due to its broader effects and limited use for this indication. Atropine, being an antimuscarinic, would reduce saliva and worsen dryness.

Thus, the capsule-form cevimeline hydrochloride is the suitable choice for an oral capsule formulation to treat xerostomia in Sjögren’s syndrome.