Evoxac (cevimeline HCl 30mg) reduces dryness of Sjogren's Syndrome

Note: This is an unofficial page for Evoxac, maintained by an enthusiastic Evoxac user for whom the drug is very effective.

Evoxac was approved by the US FDA in February 2000 as indicated for dry mouth.

As with pilocarpine, a lot of individual variation is seen from patient to patient; what is effective for one person may not be effective for another. Some patients report Evoxac is effective for dry mouth, dry eyes, dry airways, stuffy eustachian tubes, and dry vagina. In other patients, Evoxac appears to be an inert substance.

There are even subtle variations within an individual; for example, Evoxac may stimulate plentiful parotid flow but inadequate sublingual/submaxillary flow in the same individual. Such individuals have been treated with combinations of pilocarpine and cevimeline, or guaifenesin and cevimeline.

The standard dose of 30mg 3x daily is reportedly too much for some people (side effects include chills) and is too little for other people. The capsule is easily opened for purposes of reducing the dose. Evoxac is highly soluble in water.

Evoxac has some similarities to pilocarpine (Salagen) and carries many of the same warnings of side effects. One notable difference is that Evoxac's effects last longer, and make it practical for some patients to sleep all night without dryness problems. Another difference is that Evoxac has shown in vitro a much smaller (1/10th as much) effect on the M2 receptors, which should translate into a much smaller side effect on the heart. This may be of value to patients who notice such side effects on pilocarpine. Details are in this Medscape continuing education for medical professionals. (When you follow this link you will need to register, free of charge, with Medscape, if you have not already done so.)

Evoxac (pronounced EE-vo-zak) is now available (by prescription) in U.S. pharmacies. Retail pricing in 2009 was about US$220 for 90 30-mg capsules. Price-sensitive or remotely located patients might prefer generic pilocarpine, pharmacologically equivalent to Salagen at about US$10/month and available worldwide (details on pilocarpine this way are at http://publish.dry.org/archivessl/2004/msg04792.html )

Further information

Evoxac is being marketed in the USA by Daiichi pharmaceuticals, who answer questions from patients and physicians by telephone at 1-877-324-4244

Summary information from a pharmacists' site.

Neuroscience for Kids: The Autonomic Nervous System gives basic background on the biological systems influenced by Evoxac.

The Evoxac package insert on the USA's FDA web site contains the usual Federally mandated statement, the "fine print" details. (This document requires Adobe Acrobat reader software. You can download Adobe Acrobat here if you don't already have it).

Evoxac users are discussing Evoxac on the SS-L email list. The discussion to date can be read in the Archives of the SS-L.

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