Cevimeline

Introduction

Written by Melanie Sangobowale, PharmD
Medically reviewed by Patricia Weiser, PharmD
Updated on August 22, 2023

Cevimeline (se vi ME leen) is a generic medication prescribed to treat dry mouth in adults with Sjögren disease. Cevimeline belongs to a group of drugs called cholinergic agonists.

Side effects of cevimeline

Cevimeline may cause mild or serious side effects. More common mild side effects of cevimeline and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about cevimeline’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for cevimeline listed in the “Resources” section.

Mild side effects

More common mild side effects reported with cevimeline are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about cevimeline’s side effects, refer to the prescribing information for cevimeline listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Cevimeline oral capsule’s mild side effects include:

• diarrhea
• nausea
• runny or stuffy nose
• sweating
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for cevimeline” section.

Serious side effects

Serious side effects of cevimeline are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about cevimeline’s side effects, refer to the prescribing information for cevimeline listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, cevimeline’s serious side effects include:

• excess sweating that can lead to dehydration
• vision changes, which can make it unsafe to drive at night
• changes in heart rate or blood pressure
• mental health changes, such as confusion or anxiety
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for cevimeline” section.

Common questions about cevimeline

Below you’ll find answers to a few commonly asked questions about cevimeline.

Is cevimeline similar to pilocarpine?

Yes, similar to cevimeline oral capsule, pilocarpine oral tablet (Salagen) is used to treat dry mouth. Both cevimeline and pilocarpine belong to the group of drugs called cholinergic agonists. Cevimeline and pilocarpine work by increasing saliva production.

These medications differ across their usual dosages for treating dry mouth in adults with Sjögren disease.* Pilocarpine oral tablet is typically taken four times per day. Cevimeline is usually prescribed three times per day.

To learn more about how cevimeline and pilocarpine are alike and different, talk with your doctor or pharmacist.

* For more details about this condition, see the “Uses of cevimeline” section.

Can cevimeline cause withdrawal symptoms?

No, cevimeline is not known to cause withdrawal symptoms. Withdrawal symptoms can occur when you stop taking a drug your body is dependent on.

If you stop taking cevimeline capsule, you should not experience withdrawal symptoms. But once you stop taking the medication, your symptoms of dry mouth will likely return.

If you have questions about what to expect when you stop taking cevimeline, talk with your doctor or pharmacist.

How does cevimeline work? And how long does it take to start working?

Cevimeline oral capsule works by causing your salivary glands to produce more saliva. This mechanism of action (the way the drug works) helps treat dry mouth in adults with Sjögren disease.*

After you take cevimeline oral capsule, the drug starts to increase saliva production in about 2 hours. But it may take 6 weeks of continued treatment for the drug to reach its full effects and ease your dry mouth symptoms.

If you have more questions about this medication, talk with your doctor or pharmacist.

* For more details about this condition, see the “Uses of cevimeline” section.

Uses of cevimeline

The Food and Drug Administration (FDA) approves prescription drugs such as cevimeline for certain conditions. Approved uses for cevimeline are described below.

Use for dry mouth

Doctors may prescribe cevimeline oral capsule to treat dry mouth in adults with Sjögren disease. It’s usually prescribed as a long-term treatment.

Sjögren disease is an autoimmune disease. It causes your body to attack the glands that produce saliva and tears. This causes symptoms such as dry mouth and dry eyes.  

Interactions and warnings for cevimeline

Below, you’ll find information about cevimeline’s possible interactions and warnings.

Interactions of cevimeline

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take cevimeline, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for cevimeline” section.

Warnings for cevimeline

Some people should not take cevimeline, and others should take it cautiously.

Cevimeline could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether cevimeline is a safe option for you.

Ask your doctor about specific warnings for cevimeline, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Cevimeline can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to cevimeline or any of its ingredients, your doctor will likely not prescribe cevimeline. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to cevimeline, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of cevimeline

If you take cevimeline by mouth, you should not take more cevimeline than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much cevimeline, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and cevimeline

Information about cevimeline and pregnancy and breastfeeding is described below.

Cevimeline and pregnancy

It’s not known whether cevimeline should be taken during pregnancy. No studies of the drug have been done in pregnant females.* If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Also, talk with your doctor about treatment options for dry mouth during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take cevimeline during pregnancy.

* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Cevimeline and breastfeeding

It’s not known whether cevimeline should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

If you’re planning to breastfeed, talk with your doctor about treatment options for dry mouth. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take cevimeline during this time. Your doctor may recommend other healthy ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about cevimeline or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How long will I have to take cevimeline capsules?
• Can I take cevimeline with grapefruit juice?
• How much water should I drink while taking cevimeline?

Resources

• Cevimeline hydrochloride. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/61dd5ee1-cf89-43ea-ada4-4e4a4d9d133b/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.