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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Best Substitute For Atropine In Case Of ALS Bulbar Onset?

My husband has ALS Bulbar Onset. He has been taking Atropine for excess saliva, but his pharmacy has declined to refill his prescription, saying that the FDA has not approved it for this use. Would Glycopyrrolate be an appropriate substitute for this? Or what would be an appropriate substitute for the Atropine drops?
Wed, 12 Feb 2014
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Internal Medicine Specialist 's  Response
Hi,
Atropine is not totally safe and hence it is kept away from routine uses by FDA. you can use glycopyrolate 1 mg 1-2 times a day which will help in hypersalivation. Beware of side effects like palpitations and urinary problems.
However, it is much safer than atropine and is a recommended drug for neurological diseases that produce hypersalivation.
Hope this helps.
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What Is The Best Substitute For Atropine In Case Of ALS Bulbar Onset?

Hi, Atropine is not totally safe and hence it is kept away from routine uses by FDA. you can use glycopyrolate 1 mg 1-2 times a day which will help in hypersalivation. Beware of side effects like palpitations and urinary problems. However, it is much safer than atropine and is a recommended drug for neurological diseases that produce hypersalivation. Hope this helps.