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CEVIMELINE
Generic Name: CEVIMELINE
ABSTRACT -
Cevimeline (Evoxac) is an FDA-approved oral selective agonist of M1 and M3 muscarinic acetylcholine receptors, approved for the treatment of dry mouth (xerostomia) in patients with Sjögren's syndrome. By stimulating M3 receptors on exocrine gland cells, it enhances salivary and lacrimal secretion. Its selectivity for M1/M3 over M2 receptors aims to reduce cardiac adverse effects compared to non-selective muscarinic agonists.
DOSAGE -
30 mg orally three times daily.
SIDE EEFECTS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Skin rash
- Urticaria
- Drug hypersensitivity
- Anaphylaxis (rare)
ALLERGIC REACTIONS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Skin rash
- Urticaria
- Drug hypersensitivity
- Anaphylaxis (rare)
DRUG INTERACTIONS-
- Beta-blockers may cause conduction disturbances with muscarinic agonists — use with caution
- Anticholinergics antagonise cevimeline's effect — avoid concurrent use
- Drugs with cholinergic effects — additive salivation/GI effects
PREAUTONS–
- Avoid in uncontrolled asthma, narrow-angle glaucoma, acute iritis
- Cardiovascular disease — M2 receptor-mediated bradycardia possible
- Driving impairment — sweating and dizziness may affect concentration
- Renal/hepatic impairment: no specific dose adjustment but monitor tolerability
WARNINGS –
- Cardiovascular effects including bradycardia — avoid in significant cardiac disease
- Pulmonary effects — avoid in uncontrolled asthma or COPD
- Visual disturbances (blurred vision) — caution driving or operating machinery
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