cevimeline
cevimeline
[sĕ-vim´ah-lēn]cevimeline
(se-vim-e-leen) cevimeline,Evoxac
(trade name)Classification
Therapeutic: xerostomia therapy adjunctsPharmacologic: cholinergics
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (blood levels)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | unknown | 1.5–2 hr | unknown |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- coughing
Ear, Eye, Nose, Throat
- rhinitis (most frequent)
- visual disturbances
Gastrointestinal
- nausea (most frequent)
- diarrhea
- excessive salivation
Dermatologic
- excessive sweating (most frequent)
- hot flashes
Interactions
Drug-Drug interaction
Concurrent beta blocker therapy may ↑ the risk of cardiac conduction disturbances.Additive parasympathetic and muscarinic effects may occur with drugs that have parasympathetic or muscarinic properties.Drugs that inhibit CYP2D6 and CYP3A3/4 liver enzymes may inhibit the metabolism of cevimeline and ↑ its effects and risk of toxicity.St. John's wort may ↑ the metabolism of cevimeline and ↓ its levels.Angel's trumpet, jimson weed, and scopolia may antagonize cholinergic effects.Route/Dosage
Availability (generic available)
Nursing implications
Nursing assessment
- Assess patient for dry mouth prior to and periodically during therapy.
- Lab Test Considerations: May cause ↑ GGT, AST, and ALT.
Potential Nursing Diagnoses
Impairedoral mucous membrane, altered (Indications)Deficient knowledge, related to medication regimen (Patient/Family Teaching)
Implementation
- Oral: Administer 30 mg three times daily.
Patient/Family Teaching
- Instruct patient to take cevimeline as directed.
- May cause visual disturbances, especially at night, that could impair ability to drive safely.
- Advise patient to drink extra water if sweating excessively. May cause dehydration.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
- Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Evaluation/Desired Outcomes
- Decrease in dry mouth in patients with Sjögren's disease.