Cevimeline is a muscarinic agonist with parasympathomimetic activities that is used for the symptomatic treatment of dry mouth in patients with Sjögren's Syndrome. It can be found under the brand name Evoxac. Cevimeline is a parasympathomimetic agent that act as an agonist at the muscarinic acetylcholine receptors M1 and M3. Muscarinic agonists such as cevimeline bind and activate the muscarinic M1 and M3 receptors. The M1 receptors are common in secretory glands (exocrine glands such as salivary and sweat glands), and their activation results in an increase in secretion from the secretory glands. The M3 receptors are found on smooth muscles and in many glands which help to stimulate secretion in salivary glands, and their activation generally results in smooth muscle contraction and increased glandular secretions. Therefore, as saliva excretion is increased, the symptoms of dry mouth are relieved. Salivary secretion is largely dependent upon the activation of acinar cell fluid transport, achieved through intracellular formation of inositol triphosphate and elevated calcium concentration and activation of ion transporting proteins. Sustained salivary secretion requires influx of extracellular calcium across the plasma membrane of acinar cells, which is referred to as store-operated calcium entry. Possible side effects of using Civimeline may include bladder pain, body aches, and difficulty breathing.

Cevimeline M3 Salivary Gland Smooth Muscle Contraction Pathway References