Side Effects of cevimeline: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Main Research Findings

Cevimeline, a muscarinic M3 receptor agonist, has been shown to have a dosage-dependent effect in preventing olanzapine-induced metabolic side-effects in female rats. 16 This suggests that cevimeline could be a potential therapeutic agent for managing weight gain and metabolic disturbances associated with antipsychotic medications.

Cevimeline has been investigated as a treatment option for xerostomia (dry mouth), a common side effect of radiation therapy for head and neck cancer. 22 While cevimeline has shown some promise in improving xerostomia outcomes, it can come with side effects.

Cevimeline is also used as a sialagogue (saliva-stimulating agent) to manage xerostomia caused by conditions such as Sjogren's syndrome, which is an autoimmune disorder. 10 The use of cevimeline in these cases is based on its ability to stimulate salivary gland function.

Reasons for Side Effects

Cevimeline, as a muscarinic receptor agonist, acts on various muscarinic receptors throughout the body, not just those in the salivary glands. 1 This lack of tissue specificity can lead to side effects in other organ systems.

Common Side Effects

Sweating

One common side effect of cevimeline is increased sweating. 17 This is due to the stimulation of muscarinic receptors in sweat glands.

Gastrointestinal Symptoms

Cevimeline can also cause nausea, vomiting, and diarrhea, which are gastrointestinal side effects. 4 17 2 14 11 7 These effects are likely due to its action on muscarinic receptors in the gastrointestinal tract.

Respiratory Symptoms

Cevimeline has the potential to trigger respiratory symptoms such as asthma attacks. 11 This is attributed to its action on muscarinic receptors in the bronchi.

Other Side Effects

Other reported side effects of cevimeline include headache, dizziness, visual disturbances, increased heart rate, and low blood pressure. 17 1 2 14 11 5 These effects are likely due to the stimulation of muscarinic receptors in various parts of the body.

Countermeasures for Side Effects

Sweating

Mild sweating caused by cevimeline can be managed by simple adjustments like wearing cooler clothing. Severe sweating requires medical attention. 2

Gastrointestinal Symptoms

Gastrointestinal symptoms associated with cevimeline can be minimized by eating smaller, more frequent meals and staying well-hydrated. If these symptoms are severe, consult a doctor. 2

Respiratory Symptoms

For respiratory symptoms caused by cevimeline, it is essential to consult a doctor. 11

Other Side Effects

For any other side effects related to cevimeline, it is recommended to consult with a healthcare professional. 2

Comparison Between Studies

Commonalities in Studies

Across multiple studies, cevimeline has consistently been shown to promote salivary secretion, but it also comes with side effects such as sweating and gastrointestinal symptoms. The severity of these side effects generally increases with higher doses of cevimeline. 2 8 11

Differences in Studies

The effectiveness and side effects of cevimeline can differ depending on the individual patient and the specific condition being treated. For example, cevimeline is considered an effective treatment for xerostomia associated with Sjogren's syndrome, but its efficacy in managing xerostomia caused by radiation therapy may be less established. Additionally, individual responses to cevimeline's side effects can vary. Some individuals might experience excessive sweating while others might experience more pronounced gastrointestinal symptoms. 4 22 10

Points to Note Regarding Application to Real Life

While cevimeline can be beneficial in promoting saliva production, it is crucial to remember that it also carries the risk of side effects. Before using cevimeline, it is essential to consult a doctor to discuss potential risks and benefits and to understand the proper usage instructions. If you experience any symptoms that could be side effects of cevimeline, it is important to seek medical advice promptly. 21

Limitations of Current Research

Research on cevimeline is still in progress and has limitations. In particular, there is a need for further research to fully understand the long-term effects of cevimeline use and the potential interactions between cevimeline and other medications. 22

Future Research Directions

Further research is crucial to better understand the safety and efficacy of cevimeline. It is particularly important to conduct extensive studies on the long-term effects of cevimeline use and its interactions with other medications. Additionally, research into new methods to minimize cevimeline's side effects is needed. 11 9

Conclusion

Cevimeline holds potential for stimulating saliva production, but it's important to be aware of its associated side effects. Consulting a doctor before starting cevimeline treatment is crucial to discuss potential risks and benefits and to ensure proper usage. More research is necessary to fully understand cevimeline's long-term effects and to find ways to mitigate its side effects. 9

Literature analysis of 22 papers
Positive Content
20
Neutral Content
1
Negative Content
1
Article Type
1
0
0
6
22
1.

General pharmacological profile of the novel muscarinic receptor agonist SNI-2011, a drug for xerostomia in Sjögren's syndrome. 2nd communication: effects on somatic nervous system and on autonomic nervous system and smooth muscle.

Author: ArisawaHirohiko, FukuiKenji, FujiseNobuaki, MasunagaHiroaki

Saliva stimulation
Xerostomia treatment
Mydriasis
Smooth muscle effects

This study investigates the general pharmacological properties of SNI-2011, a novel muscarinic receptor agonist, on the somatic nervous system, autonomic nervous system, and smooth muscle in various animal models.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Assessment of the use of sialogogues in the clinical management of patients with xerostomia.

Author: Chainani-WuNita, GorskyMeir, MayerPriscilla, BostromAlan, EpsteinJoel B, SilvermanSol

Increased saliva
Reduced symptoms
Carryover effect
Sweating

A crossover study involving 20 patients with xerostomia found that pilocarpine, bethanechol, and cevimeline effectively increased saliva production and reduced symptoms. Bethanechol showed a greater increase in stimulated saliva compared to pilocarpine. The most common side effect was sweating, which occurred more frequently with pilocarpine than bethanechol or cevimeline. A carryover effect was observed beyond the washout period, suggesting that intermittent treatment might be an alternative to continuous therapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

3.

Efficacy of cevimeline vs. pilocarpine in the secretion of saliva: a pilot study.

Author: BrimhallJae, JhaveriMalhar A, YepesJuan F

Increased saliva secretion
Similar side effects

Both cevimeline and pilocarpine increased the secretion of saliva in patients with xerostomia, with a slightly higher increment in saliva with pilocarpine.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Recent advances in the management of ocular complications of Sjögren's syndrome.

Author: SamarkosMichael, MoutsopoulosHaralampos M

Decreased symptoms
Dry eye treatment
Increased tear production
Side effects of tear stimulators

Sjögren's syndrome is an autoimmune disorder that causes dry eyes. Cyclosporine A is a topical anti-inflammatory agent that has been shown to be effective in treating the ocular manifestations of Sjögren's syndrome. Other treatments include stimulators of tear secretion and punctal plugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Comparison of the discontinuation rates and side-effect profiles of pilocarpine and cevimeline for xerostomia in primary Sjögren's syndrome.

Author: NoaisehGhaith, BakerJoshua F, VivinoFrederick B

pSS treatment
Side effects

This study compared the tolerability and side effect profile of pilocarpine and cevimeline in patients with Primary Sjögren's syndrome (pSS), identifying clinical, laboratory, and pathological variables associated with therapeutic failure.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Suspected cholinergic toxicity due to cevimeline hydrochloride and Bacopa monnieri interaction: a case report.

Author: AcquaruloBlake, TandonPriya, MacicaCarolyn M

Glaucoma treatment
Ileus treatment
Sjogren's syndrome treatment
Urinary retention treatment
Side effects

Muscarinic agonists are used for treating conditions such as ileus, urinary retention, glaucoma, and Sjögren's syndrome. These drugs can cause undesirable side effects due to their lack of tissue specificity, and their effects can be potentiated by supplements that impact their half-life.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Xerostomia: causes and treatment.

Author: WickJeanette Y

Xerostomia

Xerostomia is a common symptom affecting up to 30% of the population, caused by reduced salivary flow, leading to dry mouth and sticky saliva. This can cause digestive issues, weight loss, and dental problems. Several medications, cancer, autoimmune diseases, and bone marrow transplants can cause or worsen xerostomia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Salivary enhancement therapies.

Author: FoxPhilip C

Salivary function enhancement

This study explores the challenges and future directions in enhancing salivary function to prevent dental caries. While masticatory and gustatory stimulation remain effective, the search for improved secretagogues with fewer side effects and greater potency continues. Future research may focus on gene therapy, artificial salivary glands, and salivary transplantation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Management of xerostomia and salivary gland hypofunction.

Author: RamSaravanan, KumarSatish, NavazeshMahvash

Xerostomia management
Increased candidiasis
Increased caries
Increased periodontitis

Oral health care providers need to be aware of the etiologies and clinical manifestations of salivary gland hypofunction to identify patients and prevent complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management.

Author: BarbeAnna Greta

Dry mouth treatment
Bronchoconstriction
Emesis
Nausea

Medication-induced xerostomia (dry mouth) is a common issue for older patients. This article discusses various treatment options including medication changes, multidisciplinary approaches, topical agents, and innovative methods like electrostimulation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Using cholinergic M1 receptor positive allosteric modulators to improve memory via enhancement of brain cholinergic communication.

Author: ChambonCaroline, JatzkeClaudia, WegenerNico, GraviusAndreas, DanyszWojciech

Cognitive enhancement
Memory improvement

Benzylquinolone carboxylic acid (BQCA) is a cholinergic muscarinic M(1) receptor positive allosteric modulator with potential as a cognitive enhancer in dementia. This study characterized BQCA's mode of action, demonstrating that it attenuated scopolamine-induced memory deficit in rats without showing side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation.

Author: FaragArwa M, HollidayCraig, CimminoJoseph, RoomianTamar, PapasAthena

Higher adherence
Improved SS
More side effects

Cevimeline (CEV) and pilocarpine (PILO) were comparable in effectiveness for hyposalivation, but PILO was associated with more side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Distinct effects of cevimeline and pilocarpine on salivary mechanisms, cardiovascular response and thirst sensation in rats.

Author: OnoK, InagakiT, IidaT, Wakasugi-SatoN, HosokawaR, InenagaK

Sialogogues in xerostomia treatment
Cardiovascular effects
Central mechanism effects
Salivary mechanism effects

This study compared the comprehensive effects of cevimeline and pilocarpine, muscarinic receptor agonists, on salivary, cardiovascular, and central mechanisms in rats. These drugs are used as sialogogues for xerostomia treatment.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Cevimeline co-treatment attenuates olanzapine-induced metabolic disorders via modulating hepatic M3 muscarinic receptor: AMPKα signalling pathway in female rats.

Author: HanMei, LianJiamei, SuYueqing, DengChao

Metabolic disorder prevention

Olanzapine, a commonly used antipsychotic drug, is associated with metabolic disorders. It is a potent antagonist of the M3 acetylcholine muscarinic receptor (M3R), and downregulation of the hepatic M3R-AMPKα signaling pathway is implicated in these metabolic disturbances.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

(+-)-cis-2-methyl-spiro(1,3-oxathiolane-5,3')quinuclidine, an M1 selective cholinergic agonist, attenuates cognitive dysfunctions in an animal model of Alzheimer's disease.

Author: FisherA, BrandeisR, KartonI, PittelZ, GurwitzD, HaringR, SapirM, LevyA, HeldmanE

Alzheimer's disease treatment

AF102B, a selective M1 agonist, reversed cognitive impairments induced by AF64A in rats, suggesting its potential for treating Alzheimer's disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Buccal drug delivery technologies for patient-centred treatment of radiation-induced xerostomia (dry mouth).

Author: MalallahOsamah S, GarciaCristina M Aller, ProctorGordon B, ForbesBen, RoyallPaul G

Dry mouth treatment
Gastrointestinal distress
Lacrimation
Sweating

This review examines the technologies for the local delivery of saliva-stimulating agents, including oral disintegrating tablets, oral disintegrating films, medicated chewing gums, and implantable drug delivery devices.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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