Cevimeline
Clinical data
Trade namesEvoxac
AHFS/Drugs.comMonograph
MedlinePlusa608025
Pregnancy
category
  • C
Routes of
administration		By mouth (capsules)
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Protein binding<20%
Identifiers
  • (2R,2R)-2'-Methylspiro[4-azabicyclo[2.2.2]octane-2,5'-[1,3]oxathiolane]
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC10H17NOS
Molar mass199.31 g·mol−1
3D model (JSmol)
  • O1[C@H](SC[C@@]12CN3CCC2CC3)C
  • InChI=1S/C10H17NOS/c1-8-12-10(7-13-8)6-11-4-2-9(10)3-5-11/h8-9H,2-7H2,1H3/t8-,10-/m1/s1 checkY
  • Key:WUTYZMFRCNBCHQ-PSASIEDQSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Cevimeline (trade name Evoxac) is a synthetic analog of the natural alkaloid muscarine with a particular agonistic effect on M1 and M3 receptors. It is used in the treatment of dry mouth and Sjögren's syndrome.

Medical uses

Cevimeline is used in the treatment of xerostomia (dry mouth)[1][2] and Sjögren's syndrome.[1] It increases the production of saliva.[2]

Side effects

Known side effects include nausea, vomiting, diarrhea, excessive sweating, rash, headache, runny nose, cough, drowsiness, hot flashes, blurred vision, and difficulty sleeping.[3]

Contraindications include asthma and angle closure glaucoma.

Mechanism of action

Cevimeline is a cholinergic agonist.[2] It has a particular effect on M1 and M3 receptors.[2] By activating the M3 receptors of the parasympathetic nervous system, cevimeline stimulates secretion by the salivary glands, thereby alleviating dry mouth.

See also

  • Pilocarpine — a similar parasympathomimetic medication for dry mouth (xerostomia)
  • Bethanechol — a similar muscarinic parasympathomimetic with longer-lasting effect

References

  1. 1 2 Ono M, Takamura E, Shinozaki K, Tsumura T, Hamano T, Yagi Y, Tsubota K (July 2004). "Therapeutic effect of cevimeline on dry eye in patients with Sjögren's syndrome: a randomized, double-blind clinical study". American Journal of Ophthalmology. 138 (1): 6–17. doi:10.1016/j.ajo.2004.02.010. PMID 15234277.
  2. 1 2 3 4 Fox RI, Fox CM (2019). "Management of Sjögren's". Dubois' Lupus Erythematosus and Related Syndromes (9th ed.). Elsevier. pp. 745–758. doi:10.1016/B978-0-323-47927-1.00060-8. ISBN 978-0-323-47927-1.
  3. ↑ "Cevimeline". MedicineNet. Retrieved 12 October 2007.
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