[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Muscarinic (cholinergic) agonists](https://durgical.com/en/pharmacology/classes/muscarinic-agonists/) › Cevimeline

[Pharmacology](https://durgical.com/en/pharmacology/) · [Muscarinic (cholinergic) agonists](https://durgical.com/en/pharmacology/classes/muscarinic-agonists/)

# Cevimeline

A muscarinic agonist taken by mouth to increase saliva in people with dry mouth from Sjögren disease.

Updated 2026-11-01

- Class: [Muscarinic (cholinergic) agonists](https://durgical.com/en/pharmacology/classes/muscarinic-agonists/)
- Receptor: Muscarinic M1 and M3 receptors
- ATC code: N07AX03

◎**Muscarinic M1 and M3 receptors**Cevimeline

ⓘ No structure of cevimeline bound to its receptor exists. The figure shows iperoxo, a potent research agonist, in the acetylcholine (orthosteric) pocket of the active human M3 muscarinic receptor, the subtype on glands, the eye and the bladder that cevimeline stimulates.

**Target in 3D:** Muscarinic M1 and M3 receptors. PDB structure 8E9Z (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8E9Z) · Drag to rotate · pinch to zoom

## Mechanism of action

Cevimeline preferentially activates M1 and M3 muscarinic receptors on salivary and tear glands, producing a long-lasting increase in saliva. Sjögren disease is an autoimmune disease that damages these glands; the drug works only while some gland tissue still functions.

- Activates M1 and M3 receptors on salivary glands
- Gland cells secrete more saliva
- Dry mouth eases while gland tissue remains

## Pharmacokinetics

**Absorption**
Rapidly absorbed by mouth; food slows absorption

**Metabolism**
In the liver by CYP2D6 and CYP3A4

**Half-life**
About 5 hours

## Indications

- Dry mouth in Sjögren disease [Sjögren disease →](https://durgical.com/en/conditions/sjogren-disease/)

## Adverse effects

### Common

- Excessive sweating
- Nausea
- Runny nose
- Diarrhoea
- Excess salivation and urinary frequency

### Serious (rare, important)

- Changes in heart rate or conduction in heart disease
- Bronchospasm in asthma or COPD
- Dehydration from heavy sweating

## Contraindications

- Uncontrolled asthma
- When miosis is undesirable: acute iritis or narrow-angle glaucoma
- Hypersensitivity to cevimeline

## Key interactions

**Beta blockers**
Possible heart conduction disturbances

**CYP2D6 and CYP3A4 inhibitors**
Slower metabolism and more side effects; caution also in people who lack CYP2D6 activity

**Antimuscarinic drugs**
Opposite effects

## What is monitored

- Heart rate and rhythm in heart disease
- Breathing in asthma or COPD
- Hydration if sweating is heavy

## Administration and safety

- Taken by mouth; food slows its absorption
- Extra water is advised if sweating is heavy

## Nursing care

- Warn about blurred vision at night and driving
- Teach to drink extra water if sweating heavily
- Ask about asthma, glaucoma and heart disease before starting

## Pregnancy and breastfeeding

No adequate studies in pregnant women; used only if the benefit justifies the risk.

## Memory aid

CEVImeline for «Sjögren's SEVere dry mouth»: wet mouth, sweaty skin.

## Test yourself

Think of the answer, then tap the question to see it.

## Which receptor subtypes does cevimeline prefer?

M1 and M3 muscarinic receptors.

## Why must some salivary gland tissue remain for cevimeline to work?

It stimulates existing gland cells; it does not replace destroyed glands.

## Which eye conditions are contraindications?

Acute iritis and narrow-angle glaucoma, where miosis is undesirable.

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## Related drugs

- [Pilocarpine](https://durgical.com/en/pharmacology/pilocarpine/)

## Related conditions

- [Sjögren disease](https://durgical.com/en/conditions/sjogren-disease/)

[← Back to the class: Muscarinic (cholinergic) agonists](https://durgical.com/en/pharmacology/classes/muscarinic-agonists/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - CEVIMELINE HYDROCHLORIDE capsule](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8da082f8-a6a3-46b3-8405-fbc4c220e60b) (DailyMed (U.S. National Library of Medicine), 2026); [Cevimeline: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a608025.html) (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 11 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/cevimeline/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/cevimeline/