Pharm
Muscarinic Agonist
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Muscarinic Agonist
, Pilocarpine, Salagen, Cevimeline, Evoxac
Mechanism
Cholinergic
agonist acting at muscarinic receptors
Indications
Sjogren's Syndrome
Dry Eye
s (and possibly
Dry Mouth
) refractory to general measures
Contraindications
Angle closure
Glaucoma
Uncontrolled
Asthma
Adverse effects
Diaphoresis
Decreased night vision
Nonselective agents (Pilocarpine) may have cardiopulmonary effects
Preparation
Pilocarpine (Salagen)
Nonselective (may have cardiac or lung effects)
Dose: 5 mg orally twice daily
Preparation
Cevimeline (Evoxac)
Selective for exocrine glands
Dose: 30 mg orally three times daily
References
Fife (2002) Arch Intern Med 162(11): 1293-300 [PubMed]
Ono (2004) Am J Ophthalmol 138(1): 6-17 [PubMed]
Tsifetaki (2003) Ann Rheum Dis 62(12): 1204-7 [PubMed]
Wu (2006) J Formos Med Assoc 105(10): 796-803 [PubMed]
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