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Cevimeline

Clinical data
Trade names	Evoxac
AHFS/Drugs.com	Monograph
MedlinePlus	a608025
Pregnancy category	C
Routes of administration	By mouth (capsules)
ATC code	N07AX03 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Protein binding	<20%
Identifiers
IUPAC name (2R,2R)-2'-Methylspirooctane-2,5'-oxathiolane]
CAS Number	107233-08-9
PubChem CID	83898
DrugBank	DB00185
ChemSpider	75707
UNII	K9V0CDQ56E
KEGG	D07667
ChEBI	CHEBI:3568
ChEMBL	ChEMBL1201267
CompTox Dashboard (EPA)	DTXSID801342027 DTXSID40274384, DTXSID801342027
Chemical and physical data
Formula	C10H17NOS
Molar mass	199.31 g·mol
3D model (JSmol)	Interactive image
SMILES O1(SC12CN3CCC2CC3)C
InChI 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 Key:WUTYZMFRCNBCHQ-PSASIEDQSA-N
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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) and Sjögren's syndrome. It increases the production of saliva.

Side effects

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

Contraindications include asthma and angle closure glaucoma.

Mechanism of action

Cevimeline is a cholinergic agonist. It has a particular effect on M₁ and M₃ receptors. 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. ^ 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. ^ 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.

External links

• Evoxac (cevimeline HCl hydrate capsules) Full Prescribing Information

• Daiichi Sankyo
• M1 receptor agonists
• M3 receptor agonists
• Oxathiolanes
• Quinuclidines
• Spiro compounds