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Cevimeline

    DEA Class;  Rx

    Common Brand Names; Evoxac

    • Salivary Stimulants

    Derivative of acetylcholine and thus functions as a cholinergic agonist; used for xerostomia secondary to Sjogren’s syndrome or radiation therapy; being investigated for Alzheimer’s disease.

    Indicated for xerostomia in patients with Sjogren’s syndrome

    Uncontrolled asthma, conditions in which miosis is undesirable (eg, narrow-angle glaucoma, acute iritis)

    Hypersensitivity

    • Sweating (18.7%)
    • Nausea (13.8%)
    • Rhinitis (11.2%)
    • Sinusitis (12%)
    • Upper respiratory infection (11%)
    • Vomiting (4.6%)
    • Fatigue (3%)
    • Insomnia (2%)
    • Hot flashes (2%)
    • Abdominal pain (8%)
    • Excessive salivation (2%)
    • Urinary tract infection (6%)
    • Back pain (5%)
    • Arthralgia (4%)
    • Skeletal pain (3%)
    • Weakness (1%)

    Excessive sweating may lead to dehydration

    Treatment can potentially increase airway resistance, bronchial smooth muscle tone, and bronchial secretions; administer with caution and with close medical supervision to patients with controlled asthma, chronic bronchitis, or chronic obstructive pulmonary disease

    Ophthalmic formulations of muscarinic agonists have been reported to cause visual blurring which may result in decreased visual acuity, especially at night and in patients with central lens changes, and to cause impairment of depth perception; caution should be advised while driving at night or performing hazardous activities in reduced lighting

    Cevimeline toxicity is characterized by an exaggeration of its parasympathomimetic effects; these may include: headache, visual disturbance, lacrimation, sweating, respiratory distress, gastrointestinal spasm, nausea, vomiting, diarrhea, atrioventricular block, tachycardia, bradycardia, hypotension, hypertension, shock, mental confusion, cardiac arrhythmia, and tremors

    Pregnancy Category: C

    Lactation: unknown whether distributed into breast milk, avoid or do not nurse

    Adults

    90 mg/day PO.

    Elderly

    90 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Cevimeline hydrochloride

    capsule

    • 30mg