cevimeline (Rx)

Brand and Other Names:Evoxac
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 30mg

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

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              Serious - Use Alternative (0)

                Monitor Closely (81)

                • aclidinium

                  cevimeline increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • amitriptyline

                  cevimeline increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

                • amoxapine

                  cevimeline increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • anticholinergic/sedative combos

                  cevimeline increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atracurium

                  cevimeline increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine

                  cevimeline increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine IV/IM

                  cevimeline increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • belladonna alkaloids

                  cevimeline increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • belladonna and opium

                  cevimeline increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • bethanechol

                  bethanechol and cevimeline both increase cholinergic effects/transmission. Use Caution/Monitor.

                • carbachol

                  carbachol and cevimeline both increase cholinergic effects/transmission. Use Caution/Monitor.

                • carbamazepine

                  carbamazepine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • cimetidine

                  cimetidine will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • cisatracurium

                  cevimeline increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • clarithromycin

                  clarithromycin will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • clomipramine

                  cevimeline increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclizine

                  cevimeline increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclobenzaprine

                  cevimeline increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • darifenacin

                  cevimeline increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dichlorphenamide

                  dichlorphenamide and cevimeline both decrease serum potassium. Use Caution/Monitor.

                • dicyclomine

                  cevimeline increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • diphenhydramine

                  cevimeline increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • donepezil

                  cevimeline and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

                • dosulepin

                  cevimeline increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • doxepin

                  cevimeline increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • echothiophate iodide

                  cevimeline and echothiophate iodide both increase cholinergic effects/transmission. Use Caution/Monitor.

                • erythromycin base

                  erythromycin base will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin ethylsuccinate

                  erythromycin ethylsuccinate will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin lactobionate

                  erythromycin lactobionate will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin stearate

                  erythromycin stearate will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • fesoterodine

                  cevimeline increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • flavoxate

                  cevimeline increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • galantamine

                  cevimeline and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • glycopyrrolate

                  cevimeline increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • glycopyrrolate inhaled

                  cevimeline increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • henbane

                  cevimeline increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • homatropine

                  cevimeline increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • huperzine A

                  cevimeline and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.

                • hyoscyamine

                  cevimeline increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • hyoscyamine spray

                  cevimeline increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • imipramine

                  cevimeline increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • ipratropium

                  cevimeline increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • isoniazid

                  isoniazid will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • itraconazole

                  itraconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • ketoconazole

                  ketoconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • letermovir

                  letermovir increases levels of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • lofepramine

                  cevimeline increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • maprotiline

                  cevimeline increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • meclizine

                  cevimeline increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • methscopolamine

                  cevimeline increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • nefazodone

                  nefazodone will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • neostigmine

                  cevimeline and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • nortriptyline

                  cevimeline increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • onabotulinumtoxinA

                  cevimeline increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • orphenadrine

                  cevimeline increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin

                  cevimeline increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin topical

                  cevimeline increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin transdermal

                  cevimeline increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pancuronium

                  cevimeline increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • physostigmine

                  cevimeline and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine

                  cevimeline and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine ophthalmic

                  cevimeline and pilocarpine ophthalmic both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pralidoxime

                  cevimeline increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • propantheline

                  cevimeline increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • protriptyline

                  cevimeline increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pyridostigmine

                  cevimeline and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • rapacuronium

                  cevimeline increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • ribociclib

                  ribociclib will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • rifabutin

                  rifabutin will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • rifampin

                  rifampin will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • rivastigmine

                  cevimeline and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                  rivastigmine and cevimeline both increase decreasing elimination. Use Caution/Monitor.

                • rocuronium

                  cevimeline increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • scopolamine

                  cevimeline increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • solifenacin

                  cevimeline increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • St John's Wort

                  St John's Wort will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • succinylcholine

                  cevimeline and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • tiotropium

                  cevimeline increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • tolterodine

                  cevimeline increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trimipramine

                  cevimeline increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trospium chloride

                  cevimeline increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • vecuronium

                  cevimeline increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                Minor (79)

                • acebutolol

                  cevimeline increases effects of acebutolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • amobarbital

                  amobarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • aprepitant

                  aprepitant will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • armodafinil

                  armodafinil will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • artemether/lumefantrine

                  artemether/lumefantrine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • atazanavir

                  atazanavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • atenolol

                  cevimeline increases effects of atenolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • betaxolol

                  cevimeline increases effects of betaxolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • bisoprolol

                  cevimeline increases effects of bisoprolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • bosentan

                  bosentan will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • budesonide

                  budesonide will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • butabarbital

                  butabarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • butalbital

                  butalbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • carvedilol

                  cevimeline increases effects of carvedilol by unspecified interaction mechanism. Minor/Significance Unknown.

                • celiprolol

                  cevimeline increases effects of celiprolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • conivaptan

                  conivaptan will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • cortisone

                  cortisone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • cyclosporine

                  cyclosporine will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • darifenacin

                  darifenacin will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • darunavir

                  darunavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • dasatinib

                  dasatinib will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • deferasirox

                  deferasirox will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • desipramine

                  cevimeline increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

                • dexamethasone

                  dexamethasone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • DHEA, herbal

                  DHEA, herbal will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • donepezil

                  donepezil increases effects of cevimeline by pharmacodynamic synergism. Minor/Significance Unknown.

                • dronedarone

                  dronedarone will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • efavirenz

                  efavirenz will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • eslicarbazepine acetate

                  eslicarbazepine acetate will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • esmolol

                  cevimeline increases effects of esmolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • etravirine

                  etravirine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fluconazole

                  fluconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fludrocortisone

                  fludrocortisone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fosamprenavir

                  fosamprenavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fosphenytoin

                  fosphenytoin will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • galantamine

                  galantamine increases effects of cevimeline by pharmacodynamic synergism. Minor/Significance Unknown.

                • grapefruit

                  grapefruit will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • griseofulvin

                  griseofulvin will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • hydrocortisone

                  hydrocortisone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • indinavir

                  indinavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • labetalol

                  cevimeline increases effects of labetalol by unspecified interaction mechanism. Minor/Significance Unknown.

                • lapatinib

                  lapatinib will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • lumefantrine

                  lumefantrine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • marijuana

                  marijuana will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • methylprednisolone

                  methylprednisolone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • metoprolol

                  cevimeline increases effects of metoprolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • metronidazole

                  metronidazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • miconazole vaginal

                  miconazole vaginal will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • modafinil

                  modafinil will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nadolol

                  cevimeline increases effects of nadolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • nebivolol

                  cevimeline increases effects of nebivolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • nelfinavir

                  nelfinavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nevirapine

                  nevirapine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nifedipine

                  nifedipine will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nilotinib

                  nilotinib will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • oxcarbazepine

                  oxcarbazepine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • pantothenic acid

                  pantothenic acid, cevimeline. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.

                • penbutolol

                  cevimeline increases effects of penbutolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • pentobarbital

                  pentobarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • phenobarbital

                  phenobarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • phenytoin

                  phenytoin will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • pindolol

                  cevimeline increases effects of pindolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • posaconazole

                  posaconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • prednisone

                  prednisone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • primidone

                  primidone will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • procainamide

                  procainamide decreases effects of cevimeline by pharmacodynamic antagonism. Minor/Significance Unknown.

                • propranolol

                  cevimeline increases effects of propranolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • quinupristin/dalfopristin

                  quinupristin/dalfopristin will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • rifapentine

                  rifapentine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • ritonavir

                  ritonavir will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • rufinamide

                  rufinamide will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • secobarbital

                  secobarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • sotalol

                  cevimeline increases effects of sotalol by unspecified interaction mechanism. Minor/Significance Unknown.

                • timolol

                  cevimeline increases effects of timolol by unspecified interaction mechanism. Minor/Significance Unknown.

                • topiramate

                  topiramate will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • trazodone

                  cevimeline increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

                • verapamil

                  verapamil will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • voriconazole

                  voriconazole will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • zafirlukast

                  zafirlukast will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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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 biliary 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

                BRAND FORM. UNIT PRICE PILL IMAGE
                cevimeline oral
                -
                30 mg capsule
                cevimeline oral
                -
                30 mg capsule
                cevimeline oral
                -
                30 mg capsule
                Evoxac oral
                -
                30 mg capsule

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                cevimeline oral

                CEVIMELINE - ORAL

                (seh-VIMM-eh-leen)

                COMMON BRAND NAME(S): Evoxac

                USES: This medication is used to treat symptoms of dry mouth due to a certain immune disease (Sjogren's syndrome). Cevimeline belongs to a class of drugs known as cholinergic agonists. It works by stimulating certain nerves to increase the amount of saliva you produce, making it easier and more comfortable to speak and swallow.

                HOW TO USE: Take this medication by mouth with or without food, usually 3 times daily or as directed by your doctor.Dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.You may continue to drink water or use saliva substitutes as needed for moisture in your mouth.You may start to feel some benefit in 1 to 2 weeks. However, it may take up to 6 weeks to feel the full benefit. Tell your doctor if your condition persists or worsens.

                SIDE EFFECTS: See also Precautions.Sweating, nausea, runny nose, flushing, frequent urge to urinate, dizziness, weakness, diarrhea, and blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.This medication may cause an increase in tears. This can be helpful if you have dry eyes. Tell your doctor if runny eyes become a problem.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: slow/fast/irregular heartbeat, shakiness (tremor), fainting, lung problems (such as increased wheezing/cough/phlegm), mental/mood changes (such as confusion, agitation), severe stomach/abdominal pain.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking cevimeline, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, chronic bronchitis, chronic obstructive pulmonary disease-COPD), certain eye conditions (such as night blindness, acute iritis, narrow-angle glaucoma), heart disease (such as chest pain, heart failure, heart attack, slow heartbeat), low or high blood pressure, liver problems, gallbladder disease (such as gallstones), kidney stones, mental/mood disorders (such as depression, psychoses, thinking/understanding problems like dementia, Alzheimer's), stomach problems (such as chronic heartburn, ulcer).This drug may make you dizzy or cause vision problems, especially at night. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision, especially at night, until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).If cevimeline makes you sweat heavily, drink plenty of fluids so that you do not become dehydrated. If you are unable to drink enough fluids, talk with your doctor right away.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.

                DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Some products that may interact with this drug include: beta blockers (such as metoprolol, atenolol).Other medications can affect the removal of cevimeline from your body, which may affect how cevimeline works. Examples include cimetidine, amiodarone, ritonavir, fluoxetine, among others.Cevimeline may cause drugs with "drying" effects (some antihistamines, anticholinergics such as certain drugs for asthma, over-active bladder, and Parkinson's) to work less well. Examples of affected drugs include chlorpheniramine, diphenhydramine, atropine, belladonna alkaloids, ipratropium, and tolterodine. These medications can also worsen dry mouth, causing cevimeline to work less well. Consult your doctor or pharmacist for more information.Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could have a drying effect. Ask your pharmacist for more details.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

                OVERDOSE: 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. Symptoms of overdose may include: extreme sweating, shakiness, slowed/irregular heartbeat, severe breathing problems, confusion, fainting, stomach/abdominal cramping.

                NOTES: Do not share this medication with others.Keep all regular medical and laboratory appointments so that your doctor can monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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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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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.