Glycopyrronium for severe drooling in children

Drooling of saliva is common in children with physical, intellectual and learning disability, and with poor neuromuscular coordination and oral control.¹ It can cause skin breakdown, damage to clothes and equipment and psychosocial problems for the child and family. For many years, glycopyrronium has been prescribed off-label using the injection solution given orally or tablets crushed and suspended in water, or as unlicensed products that were imported or manufactured as pharmaceutical specials.^2,3 In January 2017, a glycopyrronium oral solution (Sialanar-Proveca Limited) became available in the UK as the first licensed product for the treatment of severe drooling (sialorrhoea) in children and adolescents aged 3 years and older with chronic neurological disorders.^4-6 Here, we consider the place of this new product in the management of severe drooling.