Cevimeline is used to improve dry mouth caused by Sjögren's syndrome, but it may cause various side effects when used.
I. Major Side Effects of Cevimeline
1. Digestive System Side Effects
(1) The most common are nausea (incidence about 10-13%), abdominal pain (about 6-8%), and diarrhea (about 5%).
(2) Some patients may also experience vomiting, loss of appetite, salivary gland pain/swelling, dyspepsia, constipation, or stomach discomfort.
2. Nervous System Side Effects
(1) Headache is relatively common.
(2) A small number of patients may experience dizziness, tremor, insomnia, depression, or drowsiness.
3. Ocular Side Effects
(1) This drug can cause miosis (pupil constriction), leading to blurred vision and difficulty seeing in the dark.
(2) This is a normal reaction due to the drug's action on M receptors in the eye.
4. Circulatory System Side Effects
Palpitations, ECG abnormalities, arrhythmia, hypertension, or tachycardia may occur.
5. Respiratory System Side Effects
A small number of patients experience dyspnea or pulmonary infiltration, and worsening of interstitial pneumonia should be monitored.
6. Hepatobiliary System Side Effects
It can cause elevations in ALT, AST, γ-GTP, ALP, LDH, and total bilirubin, and occasional abnormal liver function.
7. Other Side Effects
Hyperhidrosis, rash, pruritus, frequent urination, elevated serum amylase, blood cell count decreases, malaise, taste abnormality, edema, fever, etc.
8. Serious Side Effects (Require Immediate Medical Attention)
(1) Worsening of interstitial pneumonia manifests as dyspnea, dry cough; severe gastrointestinal symptoms such as severe abdominal pain, frequent vomiting.
(2) In clinical studies, about 20% of patients discontinued treatment due to side effects, nearly 70% of which were due to gastrointestinal reactions.
II. Ways to Alleviate Side Effects
1. Managing Nausea, Abdominal Pain and Other GI Reactions
(1) Take after meals: Taking strictly after meals can significantly reduce gastric irritation. Start with low dose: If side effects are pronounced, discuss starting from a lower dose and gradually increasing with your doctor.
(2) Bland diet: Avoid greasy and spicy foods during medication to reduce gastrointestinal burden. Inform your doctor promptly if symptoms persist; do not endure them forcefully.
2. Managing Miosis and Blurred Vision
(1) Avoid night driving: Miosis affects vision in low light; do not drive at night or operate hazardous machinery during medication.
(2) Keep indoor areas well-lit: Ensure adequate lighting during nighttime activities. Miosis is generally reversible and recovers after stopping the drug.
3. Managing Hyperhidrosis
(1) Hyperhidrosis is usually not severe; just maintain adequate hydration and wear breathable cotton clothing.
(2) If it affects daily life, consult your doctor to evaluate whether regimen adjustment is needed.
4. Management of Serious Side Effects
(1) If dyspnea, severe abdominal pain, hematemesis, melena, jaundice (yellowing of skin or eyes), or severe rash occur, stop the drug immediately and seek medical attention.
(2) The doctor may give symptomatic treatment such as corticosteroids.
5. Special Precautions for Patients with Comorbidities
Patients with a history of interstitial pneumonia, pancreatitis, peptic ulcer, gallstones, prostatic hypertrophy, etc., may experience worsening of underlying diseases when using this drug. Close monitoring and use under doctor's guidance are required.
III. Storage Conditions for Cevimeline
1. Temperature Requirements
(1) Store at room temperature, generally 1–30°C.
(2) Avoid freezing or high temperatures (e.g., inside a car in summer, near heating).
2. Moisture Protection Requirements
After opening the aluminum blister package, it should be protected from light and moisture. Do not store in humid places such as bathrooms or kitchens.
3. Original Packaging
It is recommended to keep in the original aluminum blister (PTP) packaging. Remove each dose from the blister at the time of use; do not remove them in advance for later use.
