Cevimeline

Cevimeline is a prescription medication used for treating dry mouth associated with Sjogren’s syndrome

• Cevimeline is available under the following different brand names: Evoxac

Common side effects of Cevimeline include:

• sweating,
• excessive salivating or drooling,
• nausea,
• loss of appetite,
• runny or stuffy nose,
• flushing,
• frequent urge to urinate,
• dizziness,
• weakness,
• diarrhea,
• constipation,
• blurred vision,
• dry eyes,
• dry mouth,
• muscle pain, or
• vaginal itching or discharge

Serious side effects of Cevimeline include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe pain in the stomach, side, or lower back;
• vomiting;
• fast, slow, or uneven heart rate;
• painful or difficult urination;
• a light-headed feeling; or
• dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.

Rare side effects of Cevimeline include:

none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Capsule

• 30 mg

Xerostomia

Adult dosage

• 30 mg orally every 8 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Cevimeline has severe interactions with no other drugs.
• Cevimeline has serious interactions with no other drugs.
• Cevimeline has moderate interactions with at least 81 other drugs.
• Cevimeline has minor interactions with at least 78 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

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

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Cevimeline?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Cevimeline?”

Cautions

• 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
• Cevimeline should be administered with caution to patients with a history of nephrolithiasis or cholelithiasis; contractions of gallbladder or biliary smooth muscle could precipitate complications such as cholecystitis, cholangitis, and biliary obstruction; an increase in ureteral smooth muscle tone could theoretically precipitate renal colic or ureteral reflux in patients with nephrolithiasis
• Cardiovascular disease
  • Cevimeline can potentially alter cardiac conduction and/or heart rate; patients with significant cardiovascular disease may potentially be unable to compensate for transient changes in hemodynamics or rhythm induced by therapy
  • Administer with caution and under close medical supervision in patients with a history of cardiovascular disease evidenced by angina pectoris or myocardial infarction

Pregnancy and Lactation

• Use with caution if benefits outweigh risks durin pregnancy
• Lactation
  • Unknown whether distributed into breast milk, avoid or do not nurse