The US Food and Drug Administration approved Cuvposa (glycopyrrolate) oral solution to treat chronic severe drooling caused by neurologic disorders in children ages three years to 16 years.

Drooling is normal in infants. But a significant proportion of the developmentally disabled population experiences drooling caused primarily by neuromuscular dysfunction that makes it hard to swallow. Cuvposa reduces drooling by lowering the volume of saliva produced.

Glycopyrrolate was approved decades ago to treat peptic ulcers and reduce salivation in patients under anesthesia. Until now, glycopyrrolate has been used on an off-label basis to treat drooling in the developmentally disabled population, but in a different dosage form than the approved product. A drug is said to be used off-label when a physician prescribes its use in a different way than described in the US FDA-approved drug label.

In 2001, the US FDA held an advisory committee meeting to discuss how best to develop products for drooling with ethically and scientifically sound trials in children who have neurological disorders. Utilizing the advice provided, the US FDA has been able to move forward in addressing the needs of this population.

“Cuvposa provides an important therapy for controlling salivation in patients with neurologic disease,” said John Jenkins, director of the Office of New Drugs in the US FDA’s Center for Drug Evaluation and Research. “US FDA approval not only ensures that the product meets modern standards for safety, effectiveness, quality and labelling; but, also results in a more suitable dose form for this patient population.”

The US FDA drug approval process provides a review of product-specific information that is critical to ensuring the safety and efficacy of a finished drug product. For instance, the applicant must demonstrate that its manufacturing processes can reliably produce drug products of expected identity, strength, quality, and purity. US FDA's review of the applicant's labelling ensures that health care professionals and patients have the information necessary to understand a drug product's risks and its safe and effective use.

When used off label, oral tablets of glycopyrrolate had to be crushed to treat drooling in children with neurological disorders. Cuvposa is a flavoured oral solution that is easier to administer and provides the optimal dose for each patient.

In clinical trials of Cuvposa glycopyrrolate oral solution, 78 per cent of the children on the drug reached clinical improvement in drooling compared with 19 per cent of those given an inactive substance (placebo).

Common adverse reactions reported with glycopyrrolate are dry mouth, constipation, flushing, and urinary retention.

Cuvposa (glycopyrrolate) Oral Solution is marketed by Shionogi Pharma Inc of Osaka, Japan.