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module menu icon Anticholinergics and dry mouth

Anticholinergic and antimuscarinic drugs such as atropine, hyoscine, oxybutynin, or ipratropium affect oesophageal smooth muscle function and coordination as well as causing xerostomia. Other drug classes causing dry mouth as a common side-effect include:6,11,17,18,19,20,21

  • antihistamines, and especially sedating antihistamines such as chlorphenamine, diphenhydramine or promethazine
  • decongestants, eg pseudoephedrine, oxymetazoline
  • diuretics, eg furosemide, bumetanide, thiazides
  • angiotensin converting enzyme (ACE) inhibitors, eg captopril, lisinopril
  • antiarrhythmics, eg beta blockers, disopyramide
  • anti-emetics, eg metoclopramide, ondansetron
  • tricyclic antidepressants by blockading cholinergic receptors, eg amitriptyline, clomipramine, nortriptyline
  • selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and atypical antidepressants
  • bronchodilators – orally inhaled beta-2 agonists, anticholinergics and corticosteroids
  • alpha-receptor blockers.

Chronic cough due to ACE inhibitors may increase the risk of aspiration pneumonia. However, there is some evidence that ACE inhibitors may improve swallowing function, although this is probably insufficient to reduce pneumonia risk in elderly stoke patients.6,22

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