Pilocarpus jaborandi · PhytoNexus

01 Identity and provenance

Accepted binomial: Pilocarpus jaborandi
Common names: Jaborandi
Family (APG IV): Rutaceae
Part used: Leaf
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Kapourani A et al. Pharmaceuticals 2022;15:762 | Tulane PharmWiki, pilocarpine clinical profile | VERIFIED 2026 (batch 4) - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources. Interactions labelled CLINICAL vs THEORETICAL. Marketed-formulation column intentionally blank. | HOST FACTOR

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Imidazole alkaloids	Pilocarpine Leaf	Pilocarpine IS the marketed drug (Salagen, Isopto Carpine) - plant-derived, not an analogue. Cevimeline is a synthetic M3 agonist alternative.

The analogue column is what makes the interaction reasoning tractable: where a constituent has a marketed structural counterpart, the counterpart's interaction profile is the starting hypothesis for the plant.

Looking up structures and physicochemical properties from PubChem…

03 Stated application

Reported activity: WELL-ESTABLISHED, FDA-APPROVED USES: xerostomia in Sjogren syndrome and after head-and-neck radiotherapy (oral, 5 mg up to four times daily); glaucoma and presbyopia (ophthalmic, via miosis and ciliary contraction opening the trabecular meshwork). One of the few entries in this database with a genuine modern indication.
Reported adverse effects: CONTRAINDICATED in uncontrolled asthma and COPD (bronchospasm and increased bronchial secretion), peptic ulcer, arrhythmia, coronary disease, angle-closure glaucoma (ophthalmic preparation), hyperthyroidism, urinary obstruction, orthostatic hypotension. Common: sweating (the commonest effect), flushing, nausea, increased urinary frequency, GI cramping, rhinitis, dizziness. Impaired night vision - counsel patients. Bradycardia. Excessive dosing precipitates cholinergic crisis; allowable daily dose 30 mg. Systemic adverse effects frequently limit oral use.

04 Interaction matrix

Source column, verbatim: CLINICAL: beta-blockers (additive cardiac effects, caution advised); other cholinergic agents (additive, risk of cholinergic crisis); anticholinergics antagonise the effect. Contraindicated with drug-induced xerostomia where the causative drug is being continued.
Normalised onto 2 canonical drug classes below.

Curated from the reviewed source

Drug class	Severity	Mechanism type	Provenance	Expected effect
Anticholinergics Autonomic	3Major	PD-additive	curated A	Anticholinergic toxidrome: dry mouth, urinary retention, blurred vision, …	why ▾
Class mechanism. Tropane alkaloids (atropine, hyoscine, hyoscyamine) are competitive muscarinic antagonists; added to prescribed anticholinergics, antihistamines or tricyclics the burden summates. Expected Anticholinergic toxidrome: dry mouth, urinary retention, blurred vision, tachycardia, delirium, hyperthermia. Management Calculate total anticholinergic burden. Avoid in older adults, prostatism and narrow-angle glaucoma. Onset rapid Evidence A - human data with a cited source Matched on “anticholinergics” Find evidence for this pair Map this mechanism
Antihypertensives Cardiovascular	2Moderate	PD-additive	curated A	Orthostatic hypotension, dizziness, syncope and falls; or loss of blood-p…	why ▾
Class mechanism. Vasodilator, diuretic, ACE-inhibitory and calcium-antagonist activity in botanical extracts adds to prescribed blood-pressure lowering. A minority (ephedrine-, glycyrrhizin- and caffeine-bearing) act in the opposite direction and antagonise control. Expected Orthostatic hypotension, dizziness, syncope and falls; or loss of blood-pressure control with pressor botanicals. Management Home BP log for 2 weeks after any change. Warn about postural symptoms; review in the elderly and in those on multiple agents. Onset rapid Evidence A - human data with a cited source Matched on “beta blockers” Find evidence for this pair Map this mechanism

Predicted from constituent chemistry

These edges are not clinical findings. Each one is a rule inference: a constituent class in this plant is known to act on a target that the drug class also acts on. They are shown because a blank cell reads as “safe”, and for a Tier 1 entry a blank cell only means “not yet looked at”. Treat them as a literature-search agenda, not as a warning.

Drug class	Severity	Mechanism type	Provenance	Expected effect
Narrow-therapeutic-index CYP3A4 substrates Pharmacokinetic	4Contraindicated	PK-CYP3A4	predicted D	Toxic accumulation or subtherapeutic failure of the co-prescribed drug, s…	why ▾
Chemistry of this pair. Alkaloidal bases have pH-dependent absorption and commonly interact with hepatic CYP isoenzymes and efflux transporters. Class mechanism. Furanocoumarins, bergamottin, piperine, glabridin and berberine inhibit CYP3A4; hyperforin, andrographolide and several diterpenes induce it through PXR. Because CYP3A4 handles roughly half of marketed drugs, the affected list is broad and the direction is product-specific. Expected Toxic accumulation or subtherapeutic failure of the co-prescribed drug, sometimes fatal for antiarrhythmics, immunosuppressants and oncology agents. Management Screen the full regimen for 3A4 substrates. Where the substrate has a narrow index, avoid rather than monitor. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antacids, PPIs and H2 blockers Gastrointestinal	2Moderate	PK-absorption	predicted D	Reduced or erratic absorption of alkaloids; heartburn and reflux from pre…	why ▾
Chemistry of this pair. Alkaloidal bases have pH-dependent absorption and commonly interact with hepatic CYP isoenzymes and efflux transporters. Class mechanism. Gastric pH elevation alters the dissolution and ionisation of alkaloidal and enteric-coated botanical products; menthol- and peppermint-oil products lose their enteric protection at high pH and can be released prematurely. Expected Reduced or erratic absorption of alkaloids; heartburn and reflux from premature release of volatile-oil preparations. Management Separate administration by 2 hours. Avoid non-enteric peppermint oil in reflux disease. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

contraindication - asthma/COPD, cardiac disease, peptic ulcer. G

06 Confusable material

No same-genus or shared-common-name entry in the corpus.

07 Mechanism map

Chemistry sorts to the left, pharmacology to the right. Dashed edges are predicted. Drag nodes, scroll to zoom, export at 3× for a figure.

species

chemical class

marker compound

drug class

expected effect

hazard

08 Open literature

Abstract-scoped query built from this binomial, its common names and its marker compounds, run live against Europe PMC, PubMed and OpenAlex, then ranked locally against an evidence hierarchy.

Checking openFDA spontaneous reports…

09 Isomechanistic neighbours

Species whose interaction profile overlaps this one, ranked by shared severity weight rather than by count — a shared contraindication counts for more than a shared minor signal. Practical use: these are the plants you should not stack with this one, because the mechanisms summate.

Species	Family	Shared classes	Jaccard
Physostigma venenosum Calabar Bean	Fabaceae	4	0.50
Veratrum album White Hellebore	Melanthiaceae	4	1.00
Bacopa monnieri Brahmi	Plantaginaceae	3	0.50
Atropa belladonna Belladonna	Solanaceae	3	0.50
Hyoscyamus niger Henbane	Solanaceae	3	0.50
Areca catechu Areca Nut	Arecaceae	3	0.60

10 References and notes

Source column: StatPearls NBK556128 (Pilocarpine)

StatPearls NBK556128 (Pilocarpine)

manual

BibTeX for all 1 records

@article{anon,
  title = {StatPearls NBK556128 (Pilocarpine)},
}

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