Cevimeline

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'-Methylspiro[4-azabicyclo[2.2.2]octane-2,5'-[1,3]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−1
3D model (JSmol)	Interactive image;
	SMILES O1[C@H](SC[C@@]12CN3CCC2CC3)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 disease.

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.^{[citation needed]}

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.

References

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.
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.
↑ "Cevimeline". MedicineNet. Retrieved 12 October 2007.

External links

Evoxac (cevimeline HCl hydrate capsules) Full Prescribing Information

[Ono_2004-1] 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.

[Fox_2019-2] 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.