{"id":53484,"date":"2022-09-30T22:14:30","date_gmt":"2022-10-01T02:14:30","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53484"},"modified":"2022-09-30T22:14:30","modified_gmt":"2022-10-01T02:14:30","slug":"cevimeline-alternatives","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/cevimeline-alternatives\/","title":{"rendered":"Cevimeline alternatives: What can I take instead of cevimeline?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#compare-cevimeline-alternatives\">Compare cevimeline alternatives<\/a> | <a href=\"#salagen\">Salagen<\/a> | <a href=\"#salivasure\">Salivasure<\/a> | <a href=\"#biotene-oral-balance-gel\">Biotene Oral Balance Gel<\/a> | <a href=\"#oasis-moisturizing-mouth-spray\">Oasis Moisturizing Mouth Spray<\/a> | <a href=\"#plaquenil\">Plaquenil<\/a> | <a href=\"#natural-alternatives\">Natural alternatives<\/a> | <a href=\"#how-to-switch-meds\">How to switch meds<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finding a solution for your dry mouth from <\/span><a href=\"https:\/\/www.hopkinssjogrens.org\/disease-information\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Sjogren\u2019s syndrome<\/span><\/a><span style=\"font-weight: 400;\"> can require a lot of patience. <\/span><a href=\"https:\/\/www.ada.org\/resources\/research\/science-and-research-institute\/oral-health-topics\/xerostomia\"><span style=\"font-weight: 400;\">Xerostomia<\/span><\/a><span style=\"font-weight: 400;\"> (dry mouth) is only a part of this autoimmune condition, which can include sicca symptoms (dry eyes, skin, mouth, and nasal passages) as well as disease effects on multiple organ systems. The xerostomia it causes is more than just uncomfortable; it is a major risk factor for dental and gum disease. When all of the tips and tricks for stimulating saliva flow have failed, <\/span><span style=\"font-weight: 400;\">Evoxac<\/span><span style=\"font-weight: 400;\"> (cevimeline) is often called upon for relief. Unfortunately, it may not be your final answer. The brand name drug\u2019s expense or adverse effects could dissuade you, or you may not see adequate efficacy. At this point, you want to know where you can turn. We will take you through your options here.<\/span><\/p>\n<p><b>Related: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/health-and-saliva\/\"><b>What your saliva says about your health<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">What can I take in place of cevimeline?<\/span><\/h2>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/evoxac\/what-is\"><span style=\"font-weight: 400;\">Evoxac<\/span><\/a><span style=\"font-weight: 400;\"> is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/cholinergic-agonists\"><span style=\"font-weight: 400;\">cholinergic agonist<\/span><\/a><span style=\"font-weight: 400;\">, stimulating muscarinic receptors for acetylcholine in salivary glands. The activated receptors function as part of the parasympathetic nervous system, which has branches throughout the body, including the eyes, heart, and intestinal tract. When natural acetylcholine or the drug cevimeline activates these receptors within salivary glands, the resultant salivary flow can be significant. Evoxac is not the only <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/muscarinic-agonists\"><span style=\"font-weight: 400;\">muscarinic agonist<\/span><\/a><span style=\"font-weight: 400;\"> used for this purpose. Therefore, even if Evoxac is failing you, an alternative could still work out. If not, saliva substitutes can be reconsidered, and if you are suffering from more serious complications of Sjogren\u2019s syndrome, immunosuppressants might be reasonable.<\/span><\/p>\n<table class=\" singlecare-table\">\n<thead>\n<tr>\n<th>\n<h2 id=\"compare-cevimeline-alternatives\"><span class=\"title\">Compare cevimeline alternatives<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Drug name<\/b><\/td>\n<td><b>Uses<\/b><\/td>\n<td><b>Dosage<\/b><\/td>\n<td><b>Coupons<\/b><\/td>\n<\/tr>\n<tr>\n<td>Evoxac (cevimeline)<\/td>\n<td>Sjogren\u2019s syndrome-associated xerostomia<\/td>\n<td>30 mg three times daily<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/evoxac\">Evoxac coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>Salagen (pilocarpine hydrochloride)<\/td>\n<td>Sjogren\u2019s syndrome-associated xerostomia, head and neck cancer treatment-associated xerostomia<\/td>\n<td>5 mg four times daily<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/salagen\">Salagen coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>Salivasure (artificial saliva)<\/td>\n<td>Xerostomia<\/td>\n<td>1 lozenge every hour as needed<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/salivasure\">Salivasure coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>Biotene Oral Balance Gel (artificial saliva)<\/td>\n<td>Xerostomia<\/td>\n<td>Half inch applied to tongue and spread around mouth as needed<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/biotene-oralbalance-dry-mouth\">Biotene Oral Balance gel coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>SalivaMax (artificial saliva)<\/td>\n<td>Xerostomia<\/td>\n<td>Swish and spit 2 to 10 times daily<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/salivamax\">SalivaMax coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>Oasis Moisturizing Mouth Spray (artificial saliva)<\/td>\n<td>Xerostomia<\/td>\n<td>1 to 2 sprays up to 30 times daily<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/oasis-moisturizing-mouth-spray\">Oasis Moisturizing Mouth Spray coupons<\/a><\/td>\n<\/tr>\n<tr>\n<td>Plaquenil (hydroxychloroquine)<\/td>\n<td>Sjogren\u2019s syndrome (off-label)<\/td>\n<td>200 to 400 mg once daily<\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/plaquenil\">Plaquenil coupons<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><span style=\"font-weight: 400;\">Top 5 cevimeline alternatives<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The following are some of the most common alternatives to cevimeline.<\/span><\/p>\n<h3 id=\"salagen\"><span style=\"font-weight: 400;\">1. Salagen<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Evoxac and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/salagen\/what-is\"><span style=\"font-weight: 400;\">Salagen<\/span><\/a><span style=\"font-weight: 400;\"> are the only two primary <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16927740\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">sialogogues<\/span><\/a><span style=\"font-weight: 400;\">, drugs that stimulate saliva production above baseline. They both work by mimicking acetylcholine, turning on the compound\u2019s muscarinic receptors. The cholinergic effect throughout the body can result in benefits for those with Sjogren\u2019s syndrome, like increased saliva and tear production.Salagen may even help with vaginal, skin, and nasal dryness. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9927101\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Evidence<\/span><\/a><span style=\"font-weight: 400;\"> from a randomized, placebo-controlled clinical trial backs up the use of Salagen and provides the basis for why it has an official indication from the Food and Drug Administration (FDA) for xerostomia related to Sjogren\u2019s syndrome. Evoxac has this same indication and has solid backing from a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11920411\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">randomized, placebo-controlled, and double-blind stud<\/span><\/a><span style=\"font-weight: 400;\">y too. Choosing between these two effective drugs is often a matter of cost and insurance coverage. If expense is the concern driving you to contemplate changing from Evoxac, then presenting a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare discount card<\/span><\/a><span style=\"font-weight: 400;\"> at your <\/span><a href=\"https:\/\/www.singlecare.com\/pharmacy-near-me\"><span style=\"font-weight: 400;\">local pharmacy<\/span><\/a><span style=\"font-weight: 400;\"> could be an easy solution.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Side effects are another common reason to look at Salagen as an alternative to Evoxac. Cholinergic activity from either drug can lead to sweating, flushing, chills, bradycardia (slow heartbeat), low blood pressure, bronchial tube constriction, urinary frequency, nausea, and diarrhea. Which particular side effects are caused by a cholinergic agonist is typically determined by whether it has more or less affinity for M1, M2, or M3 muscarinic receptors. For example, by virtue of having less action on M2 muscarinic receptors, which are located in the heart, Evoxac might be less likely to have cardiac side effects. Evoxac may produce <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12038948\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">more nausea<\/span><\/a><span style=\"font-weight: 400;\">, while Salagen may result in <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9927101\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">more sweating<\/span><\/a><span style=\"font-weight: 400;\">. Trading one sialogogue for another may just result in trading one set of side effects for another. Nonetheless, without many alternatives, it might be worth a try unless there is a contraindication. For instance, neither Evoxac or Salagen should be used in the setting of angle-closure glaucoma or uncontrolled asthma.<\/span><\/p>\n<h3 id=\"salivasure\"><span style=\"font-weight: 400;\">2. Salivasure<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Based on the scarcity of viable medications that stimulate saliva in a safe manner, you may have to rely on saliva substitutes. <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/salivasure\/what-is\"><span style=\"font-weight: 400;\">Salivasure<\/span><\/a><span style=\"font-weight: 400;\"> lozenges dissolve on the tongue. The product relies on its key ingredients, xylitol and malic acid, to spark more saliva. Beneficial effects could extend beyond relieving the discomfort of a dry mouth. Enhanced saliva secretion can mean fewer dental caries (cavities), less gum disease, and better smelling breath. Xylitol-based products can taste appealing and not be sugary, making them better for your teeth than most candies that can get you salivating. Unfortunately, having too much xylitol from Saliasure or other products could leave you with <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27840639\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">diarrhea<\/span><\/a><span style=\"font-weight: 400;\">. This adverse effect though is much less intimidating than the list of Evoxac\u2019s common side effects. For that reason, Salivasure or other saliva substitutes are usually tried before Evoxac or Salagen.<\/span><\/p>\n<h3 id=\"biotene-oral-balance-gel\"><span style=\"font-weight: 400;\">3. Biotene Oral Balance Gel<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Biotene Oral Balance Gel combines xylitol with glycerin to help wet and coat the mouth. As a concentrated gel rather than a mouthwash, it might be a good choice at bedtime to help last overnight. Using different topical saliva substitutes at different times of day can be an effective solution.\u00a0<\/span><\/p>\n<h3 id=\"oasis-moisturizing-mouth-spray\"><span style=\"font-weight: 400;\">4. Oasis Moisturizing Mouth Spray<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A quick spritz of Oasis Moisturizing Mouth Spray could prove to be helpful for you in times of need. A spray can be a convenient product to carry with you through the day. Oasis Moisturizing Mouth Spray also combines xylitol and glycerin. Xylitol can stimulate saliva flow. Glycerin is a humectant, meaning it attracts and retains moisture. This product, as well as Salivasure and Biotene Oral Balance Gel, can be obtained without a prescription, unlike Evoxac.<\/span><\/p>\n<h3 id=\"plaquenil\"><span style=\"font-weight: 400;\">5. Plaquenil<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Sjogren\u2019s syndrome is an autoimmune disease. The immune system attacks different body tissues, particularly the lacrimal (tear) and salivary glands. The resultant inflammation in these glands causes them to malfunction, leaving you with dry eyes and mouth. It makes sense that suppressing the immune system could theoretically lessen the inflammation, improve the function of these glands, and help alleviate xerostomia.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/plaquenil\/what-is\"><span style=\"font-weight: 400;\">Plaquenil<\/span><\/a><span style=\"font-weight: 400;\">, a drug with established utility in treating autoimmune conditions like lupus erythematosus and rheumatoid arthritis, has been evaluated for use in Sjogren\u2019s syndrome. Although it has shown <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5812283\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">utility in helping muscle and joint symptoms of the disease<\/span><\/a><span style=\"font-weight: 400;\"> and it did <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10364906\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">reduce markers of salivary gland inflammation<\/span><\/a><span style=\"font-weight: 400;\">, proof of effectiveness is still lacking. Consequently, Plaquenil is used <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/off-label-prescription-drugs\/\"><span style=\"font-weight: 400;\">off-label<\/span><\/a><span style=\"font-weight: 400;\"> and has no FDA indication for treatment of Sjogren\u2019s syndrome. Taking the risk of infection that comes from suppressing the immune system may not appeal to you when efficacy has not been well established.<\/span><\/p>\n<h2 id=\"natural-alternatives\"><span style=\"font-weight: 400;\">Natural alternatives to cevimeline<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You might be better off getting back to basics on addressing your symptoms of dry mouth. Before trying another prescription or over-the-counter medication, you may want to make sure you have tried natural options for treating xerostomia. Maintaining adequate hydration by <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/benefits-of-drinking-water\/\"><span style=\"font-weight: 400;\">drinking plenty of water<\/span><\/a><span style=\"font-weight: 400;\"> is a good start. Keeping the air more humid in your home might help too. You can also review your habits for any that might be contributing to dry mouth, such as caffeine, alcohol, and smoking. <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medications-that-cause-dry-mouth\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Medications are another potential cause of xerostomia<\/span><\/a><span style=\"font-weight: 400;\"> to consider. The anticholinergic effects of some antidepressants, for example, can lead to this issue.<\/span><span style=\"font-weight: 400;\">If reflecting on hydration, habits, and medications did not turn up a solution, you can try to increase saliva production without formal products for treatment. Simple sugar-free gum and candy could get the job done. Even better, some sugar-free gum and candy varieties contain xylitol or malic acid which may help even more. You may have to keep trying different options to find what works best. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22161442\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Studies have not yet identified one approach that works best<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"how-to-switch-meds\"><span style=\"font-weight: 400;\">How to switch to a cevimeline alternative<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The search for a remedy to your dry mouth should not be undertaken alone. Your healthcare provider should be notified of your concerns with Evoxac, whether they are based on cost or effectiveness. The two of you can go over your list of prescription drugs, over-the-counter medications, and supplements to see if there are potential causes of xerostomia among your therapeutic regimen. The professional can provide medical advice on whether any of the alternatives to Evoxac discussed here make sense for you. Once properly vetted by you both, you should be able to confidently make a decision on whether to continue Evoxac and what to try next.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Compare cevimeline alternatives | Salagen | Salivasure | Biotene Oral Balance Gel | Oasis Moisturizing Mouth Spray | Plaquenil | Natural alternatives | How to switch meds Finding a solution for your dry mouth from Sjogren\u2019s syndrome can require a lot of patience. Xerostomia (dry mouth) is only a part of this autoimmune condition, which [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":53488,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[790,4350],"coauthors":[20732],"class_list":["post-53484","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-chronic-disease","tag-prescription-savings","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Top cevimeline alternatives and how to switch your Rx | SingleCare<\/title>\n<meta name=\"description\" content=\"Salagen, Salivasure, Biotene Oral Balance Gel, Oasis Moisturizing Mouth Spray, and Plaquenil are some cevimeline alternatives. 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