Robinul (glycopyrrolate) is an anticholinergic therapy approved by the U.S. Food and Drug Administration (FDA) to treat gastroesophageal reflux disease (GERD) also known as heartburn or acid reflux, and excessive saliva production. It was originally manufactured by the pharmaceutical company Shionogi ,but is now available from many companies.

Robinul can be used to treat drooling in patients with spinal muscle atrophy (SMA).

SMA and drooling

SMA is a genetic disease that causes progressive loss of the nerve cells, which control muscle movement.  This loss causes muscles to atrophy and become progressively weaker. Many SMA patients experience excessive saliva production caused by jaw spasms, overactive salivary glands, or spasming of the throat muscles that control swallowing.

Nerve cells send messages from the brain to tissues via electrical signals. To secrete saliva, nerve signals are sent from the brain to the gland cells. Nerve cells release a signaling molecule called acetylcholine, which binds to receptors on the gland cells. When the gland cells receive this message, they secrete saliva.

It is estimated that people normally secrete about half a liter to a liter and a half of saliva every day. If the salivary glands are overstimulated, as can be the case in SMA, much more saliva can be produced.

How Robinul can reduce drooling

Robinul can be injected into the bloodstream or taken orally. It binds to the same receptor as acetylcholine. Every receptor that is bound by Robinul is not available to bind acetylcholine. Robinul reduces nerve signaling to the salivary glands, which reduces the secretion of saliva.

Side effects of Robinul

Robinul’s side effects  can include coughing, runny nose, sore throat, headache, and constipation.

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