cevimeline (Rx)

Brand and Other Names:Evoxac
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 30mg
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Xerostomia

Indicated for xerostomia in patients with Sjogren's syndrome

30 mg PO q8hr

Safety and efficacy not established

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Interactions

Interaction Checker

and cevimeline

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Sweating (18.7%)

            Nausea (13.8%)

            Rhinitis (11.2%)

            Sinusitis (12%)

            Upper respiratory infection (11%)

            1-10%

            Vomiting (4.6%)

            Fatigue (3%)

            Insomnia (2%)

            Hot flashes (2%)

            Abdominal pain (8%)

            Excessive salivation (2%)

            Urinary tract infection (6%)

            Back pain (5%)

            Arthralgia (4%)

            Skeletal pain (3%)

            Weakness (1%)

            Coughing (6%)

            Bronchitis (4%)

            Frequency Not Defined

            Dizziness

            Tremor

            Pharyngitis

            Dyspepsia

            Angina

            Bronchospasm

            Dehydration

            Delirium

            Esophagitis

            Hematuria

            Impotence

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            Warnings

            Contraindications

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

            Hypersensitivity

            Cautions

            Use caution in controlled asthma, chronic bronchitis, COPD, history of nephrolithiasis

            Excessive sweating may lead to dehydration

            May cause decreased visual acuity

            Use caution in patients with history of billiary stones

            Use caution in patients with cardiovascular disease

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown whether distributed into breast milk, avoid or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Muscarinic receptor agonist (quinuclidine derivative of acetylcholine), exhibits high binding affinity for muscarinic M3 receptors on lacrimal & salivary gland epithelium: increases salivation

            Absorption

            Bioavailability: Rapid absorption, food decrease rate of absorption

            Peak Plasma Time: 1.5-2 hr

            Distribution

            Protein Bound: <20%

            Vd: 6 L/kg

            Metabolism

            Metabolized by CYP3A4 and CYP2D6

            Metabolites: Cis- & trans-sulfoxide (inactive), glucuronic acid conjugate (inactive), N-Oxide (inactive)

            Elimination

            Half-Life: ~5 hr

            Excretion: Urine 97%; feces 0.5%

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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