Sialorrhoea (Chronic Pathological Drooling)

Proveca gained its first product licence for Sialanar 320 micrograms/ml glycopyrronium (equivalent to 400 micrograms/ml glycopyrronium bromide) via the PUMA route on 15th September 2016. Sialanar is indicated for the symptomatic treatment of severe chronic pathological drooling in children aged 3 years and above with neurodisabilities.  

Saliva production and swallowing is an automatic act, however it is dependent on the ability to feel the build-up of saliva within the mouth and relies upon the normal movement of the tongue to collect it and transfer it to the back of the mouth for swallowing.  A child will typically produce 1-1.5 litres of saliva everyday with production predominantly occurring in three pairs of salivary glands, the submandibular, sublingual and parotid. (Fairhurst and Cockerill 2011).

The most common cause of sialorrhoea (chronic pathological drooling) is neuromuscular dysfunction, particularly cerebral palsy.  Acute sialorrhoea may be associated with inflammation, dental infections or infections of the oral cavity.  Some medication may also increase saliva production (hypersialia) for example clobazam, clonazepam and clozapine.