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Pilocarpine is a small molecule muscarinic acetylcholine receptor agonist primarily used to treat dry mouth (xerostomia) caused by radiotherapy in head and neck cancer or by Sjogren's syndrome. It is also used in ophthalmic formulations to treat glaucoma, ocular hypertension, and presbyopia. Pilocarpine acts mainly as an agonist at the muscarinic M3 receptor subtype found in exocrine glands (such as salivary glands) and smooth muscle cells of the eye. By stimulating these receptors, it increases secretion from exocrine glands (notably saliva), induces miosis (pupil constriction), contracts ciliary muscles for accommodation, and lowers intraocular pressure by enhancing aqueous humor outflow[1][3][6][8].
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