What is cevimeline?
Cevimidine stimulates ejective salivary glands.
Cevimeline has been used as a treatment option when a person has the Sjögren syndrome.
Cevimeline may have uses other than those described in the medication guides.
This medicine is a white, oblong, capsule imprinted with “EVOXAC” and “30mg”. cevimeline 30 mg capsule Color: white Shape: oblong Imprint: P 657
Tell me the use of Evoxac?
Evoxacetam is an anticholinergic antagonist that increases saliva production in people with Sjogren Syndrome and causes dry mouth.
Evoxac can be purchased as a generic drug.
INDICATIONS
Cevimeline may help relieve symptoms of dry mouth in patients who have Sjogren syndrome.
Before Using
Choosing a drug requires considering the risks of the use of the medication and their potential benefits and consequences.
Cevimeline side effects
Get urgent help if you’re having hives, difficulty breathing, or facial pain.
Cevimeline is dangerous for patients.
Stop taking cevimeline if you experience severe nausea, vomiting, slowed heart rate, urination or nausea.
Symptoms with Cevimeline can include: increased sweat; excessive urination, salivation and vomiting; numbness, diarrhea.
Carcinogenesis, Mutagenesis And Impairment Of Fertility
Lifetime carcinogenesis tests were performed with CD-1 mouse et rats F-344.
A statistically significant increase in the incidence of adenocarcinomas of the uterus was observed in female rats that received cevimeline at a dosage of 100 mg/kg/day (approximately 8 times the maximum human exposure based on comparisons).
No other significant differences have been detected for tumors in humans nor in animals.
Cevimelines had a negative correlation with human clastogenicities and mutagenicity in a range of tests including chromosomal anomalies in a mouse cell, and Ames tests.
Check with your doctor immediately if any of the following side effects occur:
More Common
- Bladder pain
- bloody or cloudy urine
- body aches or pain chills
- cough difficult,
- burning,
- painful urination
- difficulty in breathing
- dryness or soreness of the throat
- ear congestion
- frequent urge to urinate
- headache
- hoarseness loss of voice
- lower back or side pain
- runny or stuffy nose
- sneezing
- tender, swollen glands in the neck
- trouble in swallowing
- unusual tiredness
- weakness voice changes
Less common
Accumulation of pus bloating or swelling of the face, arms, hands, lower legs, or feet.
Side effects that usually do not require medical attention
- diarrhea
- excessive sweating
- headache
- nausea
- runny nose
- stomach pain
This list may not describe all possible side effects. Call your doctor for medical advice about side effects.
Cevimeline – drug interactions
Cevimeline is advised to give cautious doses to beta-adrenergic antagonist patients to avoid conduction problems.
Using combination cevimeline with drug parasympathomimetics is able to induce an additive effect.
Cevimeline can cause undesirable antimuscarinic actions when combined with a drug.
In addition, cyclic inhibitory drugs inhibit cevimide metabolism.
Cevimeline is recommended for individuals who have CYP2D6 deficiencies and have previously reported a high potential for adverse reactions.
Drugs that interact
Cymbalta); erythromycin (E.E.S., Erythrocin, E-Mycin); fluoxetine (Prozac, Sarafem); fluvoxamine; haloperidol (Haldol); ipratropium (Atrovent); certain medications for HIV such as indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir); medications for Alzheimer’s disease, glaucoma, irritable bowel syndrome, motion sickness, Myastenia Gravis, Parkinson’s disease, ulcers, or urinary problems; methadone (Dolophine); nefazodone; paroxetine (Paxil, Paxil CR, Pexeva); quinidine; and troleandomycin. Many other medications may also interact with cevimeline, so be sure to tell your doctor about all the medications you take.
Pharmacodynamics
Cevimeline is an acholinergic antagonist whose action is induced by the Muscarinoid receptor. Muscarinidic agonists are useful in improving exocrine gland activity in the intestinal and digestive tract and promoting smooth muscle tone.
After administration of a single 30 mg capsule, cevimeline was rapidly absorbed with a mean time to peak concentration of 1.5 to 2 hours.
DESCRIPTION
Cevimeline is a hydrochloric octathiol hydrochloride in cis2’methylspiron.
Cevimeline has a molecular weight of 243.69 molecular weight / kilograms.
Its white to off white crystalline peaks have melting points of 201 to 202 °C.
It has soluble properties with a wide range of solvents: alcohols, chloroform, very soluble with water and almost insoluble with ethers.
PH of 1 – 2% solution is around 4.66 g.
Inactive components contain lactose monohydrate, hydroxypropylaminocellulose.
General information
Cevimeline sensitivity has a pronounced parasympathomimetic impact. These can be: headaches visual disturbances,
- lacrimations,
- sweating,
- respiratory distresses,
- gastrointestinal spasms,
- tachycardia,
- atrioventricular block or ventricular hypertension.
Cevimeline can also be prescribed for people with previous nephrolithiasis or cholelithiases.
Symptomatic contractiles to the biliary, smooth muscle or gall bladder can be caused by cholecystis.
How should I take cevimeline?
Do not use cevimeline as a dietary supplement more than once a day.
Take cavimeline in small doses. It will help maintain a healthy kidney function.
Cevimeline can be taken three times daily.
Take the dosage prescribed by the doctor.
Store at room temperature away from air or moisture.
What should I avoid when taking cevimeline?
Cevimeline can cause blind spots and affect the ability of the eye to think.
Make sure you’re careful when driving and doing anything which requires alertness and a clear sight.
Keep yourself away from getting overheated and dehydrated at the gym.
Cesiumine can increase your sweat, causing your blood to get thinner.
What should I tell my healthcare provider before taking cevimeline?
You must stop consuming cevimeline for allergies.
Tell your doctor if you have asthma or other respiratory problems such as chest pain. The cause of the pregnancy is still unknown and the drug does not cause serious side effects for babies.
Tell the doctor if you want a baby.
Tell your doctor what herbal products you are taking, especially St. John’s wort. tell your doctor if you have asthma, acute iritis (uveitis; swelling and irritation inside the eye), or glaucoma (an eye disease).
Your doctor may tell you not to take cevimeline.
Tell your doctor if you have or have ever had chest pain or a heart attack, chronic bronchitis, chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes chronic bronchitis and emphysema), kidney stones, gallstones or heart disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
They need to know if you have any of these conditions: angina glaucoma heart disease history of a heart attack iritis irregular heart beat lung or breathing disease, like asthma an unusual or allergic reaction to cevimeline, other medicines, foods, dyes, or preservatives.
Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breathing problems changes in vision irregular heartbeat tremors upper respiratory infections like sinus infections.
Cevimeline dosage information
Usage for adults to take the Sjogrens Syndrome medication: 30 mg daily, 3 to 4 times daily Comment: There is no adequate safety information or evidence of additional efficacy.
Use: Treatments to relieve mouth dryness for those with Sjögren Syndrome.
For dry mouth in patients with Sjögren’s syndrome: Adults—30 milligrams 3 times a day.
DOSAGE AND ADMINISTRATION
Cevimeline is an oral solution containing 30 mg three times daily.
The toxicity and safety data have been proven for dosages exceeding 30mg tid.
What happens when I missed dose?
If you have a missed dose, skip your next planned dosage when the next dose has passed. You don’t need additional medication in order to compensate for the lack of dose.
What happens if I overdose?
Please contact an emergency doctor for help or call Poison Help at 888-844-1222.
Overdose symptoms can include headache, vision loss, confused sweating, tremors, vomiting, nausea and irregular heartbeat.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include headache , vision problems, confusion, sweating, tremors, vomiting , diarrhea , feeling short of breath, and irregular heartbeats.
Management Of Overdoses
Symptoms of overdose may include: extreme sweating , shakiness, slowed/irregular heartbeat, severe breathing problems , confusion, fainting , stomach /abdominal cramping
Treatment of acute overdose symptoms should follow the guidelines of muscarinic agonists and be carried out as follows: general support measures are needed.
Atropine may be useful in emergency situations when a patient overdoses on cevimeline or other drugs.
Epinamycin has the potential of being beneficial when the heart is depressed and bronchoconstricted.
If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call 911.
Otherwise, call a poison control center right away.
US residents can call their local poison control center at 1-800-222-1222.
Canada residents can call a provincial poison control center.
Warnings
Do not take cevimeline unless you’re prone to ocular alopecia otitis.
Geriatric use
Although clinical trials of cevimeline involved subjects aged over 65, the number was insufficient in finding differences in responses.
When a treatment for the symptoms associated with dementia is initiated with cavimidine in a patient with high blood pressure and high cholesterol it is essential to monitor the risk for death or disability from the condition.
Pregnancy
In a study of Sprague-Dawley, pregnant Sprague rat implantations had risen by 57% during a period between 7 days and 15 days. The effects could be secondary to maternal toxicity.
There have been little or no studies on pregnant women.
Cevimeline should not be taken during pregnant women unless its possible advantages justify any potential risk on the baby.
Cardiovascular disease
Cevimimeline can affect cardiac contractions and heart rates in patients.
Patients who are prone to serious cardiovascular disease may have a limited capacity to compensate for sudden changes in hemodynamics caused by EVOXAC.
EvoxAC is recommended for patients with cardiopathic angina pectoris or myocardia if used cautiously.
Ocular
Ophthalmic formulations of muscarinic agonist has been reported to cause a visual blurry, which results in decreased vision sensitivity particularly at night, when the eye is at the edge.
It is advised to avoid driving at night and performing unsafe tasks under reduced illumination.
Nursing mothers
There is no evidence to suggest that the drug has been found in humans. Due to the excretion of some drug products from human milk and because of a possible adverse reaction in nursing infants of EVOXAC®, this drug may cause a significant loss of life to the baby.
Pulmonary Disease
Cevimelines may be useful in improving the bronchial muscle tone and airway resistance.
When given to children or adolescents, cevimeline may have a negative effect on the immune system.
CONTRAINDICATIONS
Cevimeline has been shown to cause uncontrollable bronchitis in patients with obstructive respiratory infections known hypersensitivity to cevimeline or with obstructible bronchitis.
Clinical Studies
Double blind controlled study was conducted in 212 patients (11 men, 201 women) with a mean age of 55.3 years (range 24-75).
The racial distribution was Caucasian 88.7%, Black 1.9% and other 9.4%.
The effects of cevimeline at 15 mg tid (45 mg/day) and 30 mg tid (90 mg/day) were compared to those of placebo.
No statistically significant differences were noted in the patient global evaluations.
However, there was a higher placebo response rate in this study compared to other studies.
The 30 mg tid group showed a statistically significant increase in salivary flow from pre-dose to post-dose compared to placebo.
ARE THESE SUPPLIERS?
EVOXAC® is available in a white hard-gel capsule with 20 grams of cevimeline hydrochloride.
EvoxAC capsules have white opaque caps with white opaque body. The pills have been branded “EVOXACTA” at their caps and 30 mg at their tops.
This is sold in an infant-resistant bottle with 125 capsules (NDC 6395-211-13).
Store in a cool place with a temperature of 15 degrees (77°F).
Conclusion
The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else.
A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
