Atropine for saliva

[Lizzie]

I’ve just received prescription for Atropine drops for excess saliva and drooling. On reading the info leaflet I feel quite concerned about taking it. There is no mention of any use other than as eye drops. The instructions on the box from the pharmacy say “put 2 drops under the tongue and swish and spit” mmmmm! Well I can neither swish or spit due to my failing tongue , lip and face muscles. It also says “do not swallow. If swallowed, go to A and E immediately “. It doesn’t exactly fill me with confidence .
Does anyone else out there have experience of Atropine for saliva control? Is there a different , less dodgy alternative?
Thanks for reading this.
Love, Lizzie

[Ellie]

Don't be alarmed Lizzie, atropine is used 'off licence' to reduce secretions. I didn't think it was a swish and spit instruction though, it usually goes under the tongue - I remember one man saying that he had a hard time keeping it in his mouth!

You might find think leaflet reassuring: https://www.palliativecareguidelines...il-2020-20.pdf

And yes, if you're not comfortable using atropine or if it doesn't work, there are alternative meds, hyoscine, glycopyrronium and amitriptyline.

Love Ellie.

[Lizzie]

That’s really helpful Ellie. Thankyou.
Love, Lizzie

[Lynne K]

I wouldn’t touch Amitriptyline with a barge pole. I tried a small dose many years ago (I think 10 mg at night) to aid sleeping when you have chronic pain. It did the jobs of getting me to sleep and a better sleep. But the after effects, heavy foggy head, sleepiness and inability to think clearly lasted until about 2pm the next day. We’re all different though. Lynne x

[matthew55]

After radiotherapy on my saliva glands I find 20mils of Carbocisteine and 13 mils Glycopyrronium Bromide 5 times in a day manages my saliva beautifully. 😟🤗😠😀xx

[Ellie]

matthew55 Sorry mate, I didn't know you have to take so much glycopyrronium after the RT - that high a dose could explain your nasal congestion and add to your fatigue 😥 It's not you going mad, well, maybe not 😘

[matthew55]

My nose has is clear and my coffee mixes help me with fatigue. I'm just odd. 😁xx

[denise]

Sounds like you're putting coffee up your nose Matthew 🤔 probably would clear it 😄

[pookies brook]

Hi All so has anyone used atropine drops whilst wearing a full face mask on a ventilator ? i suffer drooling when i am on the ventilator at night so my ventilation nurse prescribed Atropine drops but i also suffer from a build up of mucus in my throat and the nurse did say that the Atropine drops can stop the drooling but it may worsen the mucus !! so i don't want to try this if anyone else has had that happening i need to use the ventilator but the drooling is awful in the mask.

[Ellie]

pookies brook It's a dilemma, isn't it - cure one symptom and exacerbate another 😟

Managing secretions can be very challenging and any medicine which reduces saliva production, can have cause other secretions to thicken as they're not being diluted by saliva. Likewise, meds to thin secretions, can make saliva worse - what fun....

It's often down to dealing first with the issue causing you the most stress, reducing saliva in your case, then addressing the secondary issue if it happens. You might need a saline nebuliser, carbocisteine or pineapple juice to thin problematic mucus and/or tweak your dose of saliva meds to find a happy medium. It's all very well for medics to say, don't do x because it will do y, but they're not the one laying in bed at 1am with a mask full of saliva 😏 You can always give it a try.

My saliva pools in my mouth rather than in my mask, so I find myself trying to swallow constantly but my glycopyrronium meds stops most of the saliva. I have lots of water during the day and use a saline nebuliser, when necessary, to thin secretions.

Hope you find a Goldilocks solution - be prepared to try alternative meds and doses.

Love Ellie.