|Name of anticholinergic||Preparation||Dose||Specific characteristics and cautions|
|Hyoscine hydrobromide||Transdermal patch||0.5 mg patch per 72 hours||Associated with a skin reaction at the site of the patch. Frequently altering the patch site and using topically applied steroid may improve tolerance.28|
|Glycopyrronium||Tablet Oral solution (trialled in children)||1–2 mg three times daily||Glycopyrronium has a quaternary ammonium structure that renders it less permeable to the blood–brain barrier. Consequently, it is likely to be less associated with CNS side effects.30 39–41|
|Amitriptyline||Tablet||10–50 mg at bedtime||Amitriptyline has several other effects that may be exploited. These include sedative and antidepressant effects. However, the antidepressant dose is much higher than that typically used to treat sialorrhoea.42|
|Atropine||0.5% Eye drops||1–2 drops sublingually four to six times daily||Can be useful if related to meals as it can be administered when the problem occurs.43 44|
CNS, central nervous system.