Muscarinic Agonist

Aka: Muscarinic Agonist, Pilocarpine, Salagen, Cevimeline, Evoxac

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II. Mechanism

  1. Cholinergic Agonist acting at Muscarinic Receptors

III. Indications

  1. Sjogren's Syndrome Dry Eyes (and possibly Dry Mouth) refractory to general measures

IV. Contraindications

  1. Angle closure Glaucoma
  2. Uncontrolled Asthma

V. Adverse effects

  1. Diaphoresis
  2. Decreased night Vision
  3. Nonselective agents (Pilocarpine) may have cardiopulmonary effects

VI. Medications

  1. Pilocarpine (Salagen)
    1. Nonselective (may have cardiac or lung effects)
    2. Dose: 5 mg orally twice daily
  2. Cevimeline (Evoxac)
    1. Selective for exocrine glands
    2. Dose: 30 mg orally three times daily

VII. References

  1. Fife (2002) Arch Intern Med 162(11): 1293-300 [PubMed]
  2. Ono (2004) Am J Ophthalmol 138(1): 6-17 [PubMed]
  3. Tsifetaki (2003) Ann Rheum Dis 62(12): 1204-7 [PubMed]
  4. Wu (2006) J Formos Med Assoc 105(10): 796-803 [PubMed]

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