Cevimeline (Evoxac ®) overdose

Cevimeline (Evoxac ®) is an oral muscarinic agent that has been recently approved for the treatment of xerostomia in the setting of Sjogren's syndrome. Its toxicity in overdose has not been reported in the medical literature to date. We report a previously healthy patient who intentionally ingested approximately 10 mg/kg of cevimeline and presented with symptoms of muscarinic excess and mental status depression. The patient recovered uneventfully after receiving activated charcoal and supportive care. This report describes the first documented cevimeline overdose.