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OTC Recommendation for Dry Mouth?

DR is a 68-year-old, Spanish-speaking male who presents to your consultation area accompanied by his son. DR’s son asks where the oral health products are located, as his dad saw a commercial on television for a product that relieves dry mouth.

Before pointing out the location, you decide to ask DR some questions. You learn DR’s dry mouth started several months ago and is accompanied by drowsiness in the morning, for which DR’s son asks you for an “energy booster” recommendation. DR reports drinking water throughout the day and having hard candies in the hopes of relieving his dry mouth; however, these interventions provide little relief.

Since DR confirms filling his prescriptions at your pharmacy, you review his medication profile, which includes: bupropion XL 150 mg PO daily; aspirin 81 mg PO daily; metformin 500 mg PO BID; lisinopril 2.5 mg daily; carvedilol 6.25 mg PO BID; rosuvastatin 10 mg PO daily; and amitriptyline 10 mg PO daily. Your records indicate that he has been filling all medications consistently on time for the past 6 months. His son shares that his dad “never misses a dose” [of his medication]; he also shares that his dad has a visiting nurse who fills his pillbox weekly. DR denies using OTC medications and CAM.

You confirm with DR that he has hypertension and take a moment to check his blood pressure, which is controlled at 105/67 mmHg. In addition, you learn that DR was diagnosed with diabetes 4 years ago. He reports a fasting blood glucose (today) of 106 and an A1c of 7%. DR reports taking bupropion XL and amitriptyline for his “down mood.” While discussing DR’s sleep habits, you learn that he takes amitriptyline at bedtime every night. He shares, “I sleep like a rock.”

Based on the above information, what recommendation(s) would you have for DR to relieve his dry mouth?

Marissa C. Salvo, PharmD
Assistant Clinical Professor
University of Connecticut School of Pharmacy
Storrs, Connecticut

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