Drug & supplement interaction

Dimethylsulfoxide (dmso) + Pilocarpine

Pilocarpine brand names: Salagen, Pilocar, Vuity, Qlosi.

Moderate Interaction
The bottom line Moderate

Pilocarpine falls into 2 drug categories that Dimethylsulfoxide (dmso) can interact with; the most serious is rated moderate. Theoretically, DMSO might increase the risk of cholinergic adverse effects when taken with cholinergic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Dimethylsulfoxide (dmso) and Pilocarpine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Dimethylsulfoxide (dmso) interacts with whole categories of medication. Pilocarpine falls into 2 of those categories, so it can interact with Dimethylsulfoxide (dmso) in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CHOLINERGIC DRUGS

1 of 2

Why this applies to Pilocarpine

Pilocarpine falls under CHOLINERGIC DRUGS — the group Dimethylsulfoxide (dmso) interacts with.

Theoretically, DMSO might increase the risk of cholinergic adverse effects when taken with cholinergic drugs.
In vitro and animal research suggests that DMSO inhibits acetylcholinesterase activity.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here is the idea behind this pairing. Pilocarpine is a cholinergic drug, meaning it boosts the activity of acetylcholine, a chemical your body uses to make saliva and tears. DMSO, in lab and animal studies, seems to slow down acetylcholinesterase, the enzyme that normally clears acetylcholine away. So on paper, combining the two could pile on extra cholinergic activity and make pilocarpine's effects and side effects feel stronger.

In real life, that might look like more sweating, watery eyes, a runny nose, stomach cramps, nausea, or needing the bathroom more often. I want to be honest though: this is theoretical, based only on lab and animal data, not human cases. Still, since DMSO can also drive other substances through the skin, it is worth a quick chat with your pharmacist or doctor before using both.

References
  1. Jacob SW, Herschler R. Pharmacology of DMSO. Cryobiology 1986;23:14-27. PubMed
Moderate

TOPICAL DRUGS

2 of 2

Pilocarpine also falls under TOPICAL DRUGS.

Topical DMSO might increase the effects and adverse effects of topical drugs.
Evidence from animal studies and limited human studies suggests that DMSO may potentiate the action of numerous topical medications by increasing their absorption through the skin. This increase in absorption seems to depend on the concentration of DMSO and the molecular weight of the medication.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know about DMSO: when it's rubbed on the skin, it can act like a delivery truck, pushing other medicines you apply topically deeper and faster through the skin. So this interaction really matters if you're using pilocarpine in a form that touches the skin or eye alongside DMSO in the same area.

If DMSO drives more pilocarpine in, you could feel stronger cholinergic effects. Think sweating, watery eyes, a runny nose, more saliva than you want, stomach cramps, or a slower heartbeat. The concern is greatest with concentrated DMSO products, not tiny amounts. Note that the common Salagen and Qlosi tablets are swallowed, so this skin-absorption issue mostly applies to eye drops or topical uses. Before combining them, check with your pharmacist or doctor.

References
  1. Jacob SW, Herschler R. Pharmacology of DMSO. Cryobiology 1986;23:14-27. PubMed
  2. Capriotti K, Capriotti JA. Dimethyl sulfoxide: history, chemistry, and clinical utility in dermatology. J Clin Aesthet Dermatol. 2012;5(9):24-6.
  3. DOMOSO SOLUTION (90% Dimethyl Sulfoxide). Fort Dodge Animal Health, Fort Dodge, Iowa. Avaliable at: https://www.zoetisus.com/_locale-assets/mcm-portal-assets/products/pdf/domoso_solution_pi.pdf. Accessed 8/3/2020.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Dimethylsulfoxide (dmso) Also Interacts With Other Medications

Dimethylsulfoxide (dmso) has 338 moderate known drug interactions in our database — the Pilocarpine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Dimethylsulfoxide (dmso)

Covers the 2,830 medications we’ve checked against Dimethylsulfoxide (dmso). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pilocarpine

This page covers Dimethylsulfoxide (dmso) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pilocarpine page lists 40 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bacopa (moderate), Bael (moderate), Betel Nut (moderate) and Boxwood (moderate).

By severity: 1 major · 28 moderate · 11 minor.

From our pharmacist’s overview on the Pilocarpine page

“Pilocarpine stimulates the body's cholinergic system, whether as Salagen tablets for the dry mouth of Sjogren's or radiation treatment or as eye drops like Vuity, and its supplement list calls for real care. The one major-rated interaction among the 40 on file is activated charcoal, which soaks up the drug in the gut and can cut how mu…”

Reviewed by 2 · Jul 18, 2026

Open the Pilocarpine interaction page

How much people look this up

Where Dimethylsulfoxide (dmso) and Pilocarpine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Dimethylsulfoxide (dmso)
Top half

#659 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pilocarpine
Top half

#1,070 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Dimethylsulfoxide (dmso)

What is Dimethylsulfoxide (dmso)?

Dimethylsulfoxide (dmso)
  • Muscle and joint pain
  • Arthritis
  • Sprains and strains
  • Interstitial cystitis (bladder pain)
  • Skin penetration enhancer for other medicines

DMSO is a colorless liquid solvent that people apply to the skin for pain and inflammation, and it is FDA-approved (as a prescription) only for interstitial cystitis placed directly into the bladder. Most over-the-counter uses for pain and arthritis have limited or low-quality evidence, and DMSO can carry impurities or push other chemicals through your skin. Talk to your pharmacist or doctor before using it, and avoid industrial-grade products.

Read the full Dimethylsulfoxide (dmso) monograph & all interactions
Medication

About Pilocarpine

What Is Pilocarpine Used For?

Brand names: Salagen, Pilocar, Vuity, Qlosi

Pilocarpine eye drops are used to lower elevated pressure inside the eye in people with open-angle glaucoma or ocular hypertension, to manage acute angle-closure glaucoma, to prevent pressure spikes after laser eye surgery, and to cause pupil constriction (miosis) when needed. Vuity and Qlosi eye drops, as well as Pilocarpine Hydrochloride Ophthalmic solution, are specifically approved to treat presbyopia (age-related difficulty focusing up close) in adults.

Pilocarpine tablets — including Salagen and generic pilocarpine hydrochloride tablets — are used by mouth to relieve dry mouth caused by salivary gland damage from radiation therapy for head and neck cancer, or from Sjögren's syndrome (an autoimmune condition that reduces saliva and tear production).

See full Pilocarpine drug information
Keep checking

Other Drugs & Dimethylsulfoxide (dmso)

Browse every other medication we’ve checked against Dimethylsulfoxide (dmso) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
338Moderate
0Minor
2,491No known interaction
Moderate

338 interactions

Showing 60 of 338 moderate interactions — see all 338 on the Dimethylsulfoxide (dmso) page.

No interaction 2,491 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Dimethylsulfoxide (dmso) and Pilocarpine Together: Common Questions

Can you take Dimethylsulfoxide (dmso) with Pilocarpine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Dimethylsulfoxide (dmso) and Pilocarpine?
Pilocarpine belongs to more than one drug category, and Dimethylsulfoxide (dmso) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Dimethylsulfoxide (dmso) and Pilocarpine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.