II. Mechanism

  1. Cholinergic agonist acting at muscarinic receptors

III. Indications

  1. Sjogren's Syndrome Dry Eyes (and possibly Dry Mouth) refractory to general measures

IV. Contraindications

  1. Angle closure Glaucoma
  2. Uncontrolled Asthma

V. Adverse effects

  1. Diaphoresis
  2. Decreased night vision
  3. Nonselective agents (Pilocarpine) may have cardiopulmonary effects

VI. Preparation: Pilocarpine (Salagen)

  1. Nonselective (may have cardiac or lung effects)
  2. Dose: 5 mg orally twice daily

VII. Preparation: Cevimeline (Evoxac)

  1. Selective for exocrine glands
  2. Dose: 30 mg orally three times daily

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Cost: Medications

pilocarpine (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
PILOCARPINE 1% EYE DROPS Generic $4.54 per ml
PILOCARPINE 2% EYE DROPS Generic $5.08 per ml
PILOCARPINE 4% EYE DROPS Generic $5.48 per ml
PILOCARPINE HCL 5 MG TABLET Generic $1.13 each
PILOCARPINE HCL 7.5 MG TABLET Generic $1.22 each
cevimeline (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
CEVIMELINE HCL 30 MG CAPSULE Generic $1.93 each
evoxac (on 4/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
EVOXAC 30 MG CAPSULE Generic $1.93 each

Ontology: Muscarinic Agonists (C0242947)

Definition (MSH) Drugs that bind to and activate muscarinic cholinergic receptors (RECEPTORS, MUSCARINIC). Muscarinic agonists are most commonly used when it is desirable to increase smooth muscle tone, especially in the GI tract, urinary bladder and the eye. They may also be used to reduce heart rate.
Concepts Pharmacologic Substance (T121)
MSH D018721
English Agonist, Muscarinic, Agonist, Muscarinic Cholinergic, Agonists, Muscarinic, Agonists, Muscarinic Cholinergic, Cholinergic Agonist, Muscarinic, Cholinergic Agonists, Muscarinic, Muscarinic Agonist, Muscarinic Cholinergic Agonist, Muscarinic Cholinergic Agonists, CHOLINERGIC AG MUSCARINIC, MUSCARINIC AGON, CHOLINERGIC AGON MUSCARINIC, MUSCARINIC AG, muscarinic agonist, muscarinic agonists, Muscarinic Agonists, Cholinergic Muscarinic Agonists, Agonists, Cholinergic Muscarinic, Muscarinic Agonists, Cholinergic
French Agoniste muscarinique, Agonistes cholinergiques muscariniques, Agonistes muscariniques
Swedish Muskarinstimulerare
Czech muskarin - agonisté
Finnish Muskariiniagonistit
Italian Agonisti colinergici muscarinici, Agonista colinergico muscarinico, Agonista muscarinico, Agonisti muscarinici
Russian MUSKARINOVYE AGONISTY, KHOLINERGICHESKIE AGONISTY MUSKARINOVYE, МУСКАРИНОВЫЕ АГОНИСТЫ, ХОЛИНЕРГИЧЕСКИЕ АГОНИСТЫ МУСКАРИНОВЫЕ
Croatian MUSKARINSKI AGONISTI
Polish Agoniści cholinergiczni muskaryny, Agoniści muskaryny
Japanese ムスカリン作動剤, ムスカリンアゴニスト, ムスカリンコリン作用薬
German Cholinerge Agonisten, Muscarin-, Muscarinagonisten
Portuguese Agonistas Colinérgicos Muscarínicos, Agonistas Muscarínicos
Spanish Agonistas Colinérgicos Muscarínicos, Agonistas Muscarínicos