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.
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