Pilocarpine is a naturally occurring alkaloid and cholinergic agonist that primarily stimulates muscarinic receptors, leading to increased secretion from exocrine glands and contraction of smooth muscles. It is widely used in the management of glaucoma to reduce intraocular pressure by enhancing aqueous humor outflow and in xerostomia (dry mouth), especially in patients who have undergone radiation therapy for head and neck cancers or have Sjögren’s syndrome. Pilocarpine was first isolated from the leaves of the Pilocarpus jaborandi plant in the late 19th century, and its medicinal properties were gradually explored in the early 20th century, particularly for ophthalmic and salivary applications. Its introduction represented a significant advance in ophthalmology and supportive care, providing a targeted means to stimulate parasympathetic activity therapeutically. Over time, pilocarpine has remained a cornerstone in the treatment of ocular and salivary disorders due to its efficacy, predictable pharmacologic profile, and relatively safe use.
