Cevimeline (Saligren) is a prescription medication indicated for relieving xerostomia in patients with Sjögren's syndrome. It alleviates dry mouth discomfort by stimulating the M-type muscarinic receptors in the salivary glands to promote salivary secretion. A range of adverse reactions may occur during the administration of this medication, some of which can even be life-threatening.

Adverse Reactions of Cevimeline (Saligren)

Common Adverse Reactions

Gastrointestinal system: Nausea (with a relatively high incidence of 11.3% in long-term clinical trials), abdominal pain, diarrhea, vomiting, anorexia, etc.

Nervous system: Headache, dizziness, tremor, insomnia, somnolence, etc.

Circulatory system: Palpitations, electrocardiogram abnormalities, elevated blood pressure, tachycardia, etc.

Other: Hyperhidrosis, blurred vision, frequent micturition, elevated hepatic function markers (e.g., ALT, AST), etc.

Severe Adverse Reactions

Exacerbation of interstitial pneumonia: With an incidence of 0.2%, patients may present with symptoms such as dyspnea, cough and fever. In case of suspicion, the medication must be discontinued immediately and the patient should receive hormone therapy and other relevant treatments.

Cardiovascular events: In patients with pre-existing severe ischemic heart disease (e.g., myocardial infarction, angina pectoris), the medication may exacerbate the condition and even induce cardiac arrhythmias.

Bronchospasm: In patients with asthma or chronic obstructive pulmonary disease, it may trigger bronchoconstriction, leading to dyspnea.

Epileptic seizures: The risk of seizures is increased in patients with a history of epilepsy after medication administration.

Obstruction of the gastrointestinal and urinary systems: It may exacerbate gastrointestinal or bladder neck obstruction, resulting in pain or dysfunctio.

Precautions for Cevimeline (Saligren)

Absolute Contraindications

Patients with severe ischemic heart disease (e.g., myocardial infarction, angina pectoris).

Patients with asthma or chronic obstructive pulmonary disease.

Patients with gastrointestinal or bladder neck obstruction.

Epileptic patients.

Patients with Parkinson's disease or parkinsonism.

Patients with iritis.

Populations Requiring Cautious Use

Patients with hepatic or renal impairment: Impaired drug metabolism may lead to elevated plasma drug concentration and an increased risk of adverse reactions.

Geriatric patients: Hepatic and renal function tends to decline naturally; treatment should be initiated at a low dose with close monitoring.

Pregnant and lactating women: Use only when the therapeutic benefit outweighs the potential risk. Animal studies have shown that the drug can pass into breast milk and affect infants and young children.

Administrative and Lifestyle Precautions

Dosage and administration: The usual adult dose is 30 mg three times a day, taken orally after meals to reduce gastrointestinal irritation. Do not use the medication blindly for a long period of time; if no therapeutic effect is achieved within 4 weeks, discontinue the medication and conduct a re-evaluation.

Driving and operating machinery: Due to the potential for blurred vision or somnolence, avoid night driving or operating hazardous machinery during the medication period.

Administration method: Capsules in PTP packaging must be removed from the aluminum foil blister before taking to prevent esophageal injury caused by accidental ingestion of the packaging.