Accession Number

Drugs that mimic the effects of parasympathetic nervous system activity. Included here are drugs that directly stimulate muscarinic receptors and drugs that potentiate cholinergic activity, usually by slowing the breakdown of acetylcholine (CHOLINESTERASE INHIBITORS). Drugs that stimulate both sympathetic and parasympathetic postganglionic neurons (GANGLIONIC STIMULANTS) are not included here.

ATC Classification
DrugDrug Description
CevimelineA muscarinic agonist with parasympathomimetic activities that is used for the symptomatic treatment of dry mouth in patients with Sjögren's Syndrome.
BethanecholA muscarinic agonist used to treat postoperative and postpartum nonobstructive functional urinary retention and neurogenic atony of the bladder with retention.
AmbenoniumA cholinesterase inhibitor that targets both muscarinic and nicotinic receptors indicated for the treatment of myasthenia gravis.
NeostigmineA cholinesterase inhibitor used in the symptomatic treatment of myasthenia gravis by improving muscle tone.
EchothiophateAn acetylcholinesterase inhibitor used in ophthalmic preparations to increase the drainage of intraocular fluid; most commonly used for the treatment of glaucoma.
AceclidineAceclidine has been marketed in Europe but has not been used clinically in the United States. It is used in the treatment of open-angle glaucoma and is a parasympathomimetic agent.
TacrineFor the palliative treatment of mild to moderate dementia of the Alzheimer's type.
GalantamineA cholinesterase inhibitor used to manage mild to moderate dementia associated with Alzheimer's Disease.
MethacholineA parasympathomimetic bronchoconstrictor used to diagnose bronchial hyperreactivity in subjects who do not have clinically apparent asthma.
CarbamoylcholineA direct acting miotic agent administered ophthalmically to decrease intraocular pressure after cataract surgery, and to induce miosis during surgery.
PyridostigmineA cholinesterase inhibitor used for symptomatic treatment of myasthenia gravis and congenital myasthenic syndromes and to reverse neuromuscular blockade by nondepolarizing muscle relaxants.
DemecariumFor the topical treatment of chronic open-angle glaucoma.
PilocarpineA muscarinic cholinergic agonist used on the eye to treat elevated intraocular pressure, various types of glaucoma, and to induce miosis. Also available orally to treat symptoms of dry mouth associated with Sjogren's syndrome and radiotherapy.
AcetylcholineA parasympathomimetic neurotransmitter used to induce miosis of the iris in seconds after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy and other anterior segment surgery where rapid miosis may be required.
Choline alfoscerateA component of phosphatidylcholines (lecithins), in which the two hydroxy groups of glycerol are esterified with fatty acids. (From Stedman, 26th ed) It counteracts the effects of urea on enzymes...
ParaoxonNot Annotated
DistigmineDistigmine is a parasympathomimetic agent with a longer duration of action and enhanced drug accumulation compared to DB00545 and DB01400. It is an anticholinergic drug and long-acting reversible carbamate cholinesterase...
PhysostigmineA cholinesterase inhibitor used to treat glaucoma and anticholinergic toxicity.
XanomelineXanomeline is under investigation in clinical trial NCT02831231 (Pilot Study Comparing Effects of Xanomeline Alone to Xanomeline Plus Trospium).
Drugs & Drug Targets
CevimelineMuscarinic acetylcholine receptor M1target
CevimelineMuscarinic acetylcholine receptor M3target
CevimelineCytochrome P450 3A4enzyme
CevimelineCytochrome P450 2D6enzyme
CevimelineDimethylaniline monooxygenase [N-oxide-forming] 1enzyme
BethanecholMuscarinic acetylcholine receptor M2target
BethanecholMuscarinic acetylcholine receptor M1target
BethanecholMuscarinic acetylcholine receptor M3target
BethanecholMuscarinic acetylcholine receptor M4target
BethanecholMuscarinic acetylcholine receptor M5target
EchothiophateSerum albumincarrier
TacrineCytochrome P450 1A2enzyme
TacrineP-glycoprotein 1transporter
TacrineLiver carboxylesterase 1target
GalantamineCytochrome P450 3A4enzyme
GalantamineCytochrome P450 2D6enzyme
GalantamineP-glycoprotein 1transporter
GalantamineNeuronal acetylcholine receptor subunit alpha-7target
GalantamineMuscle nicotinic acetylcholine receptortarget
MethacholineMuscarinic acetylcholine receptor M3target
MethacholineMuscarinic acetylcholine receptor M2target
MethacholineMuscarinic acetylcholine receptor M1target
MethacholineMuscarinic acetylcholine receptor M4target
MethacholineMuscarinic acetylcholine receptor M5target
MethacholineSolute carrier family 22 member 5transporter
CarbamoylcholineMuscarinic acetylcholine receptor M1target
CarbamoylcholineMuscarinic acetylcholine receptor M2target
CarbamoylcholineNeuronal acetylcholine receptor subunit alpha-2target
CarbamoylcholineCytosolic phospholipase A2enzyme
CarbamoylcholineMuscarinic acetylcholine receptor M3target
CarbamoylcholineMuscarinic acetylcholine receptor M4target
PyridostigmineCytochrome P450 3A4enzyme
PilocarpineMuscarinic acetylcholine receptor M1target
PilocarpineMuscarinic acetylcholine receptor M2target
PilocarpineCytochrome P450 2A6enzyme
PilocarpineMuscarinic acetylcholine receptor M3target
PilocarpineCytochrome P450 3A4enzyme
PilocarpineMuscarinic acetylcholine receptor M4target
AcetylcholineSolute carrier family 22 member 5transporter
AcetylcholineSolute carrier family 22 member 1transporter
AcetylcholineMuscarinic acetylcholine receptor M1target
AcetylcholineMuscarinic acetylcholine receptor M2target
AcetylcholineMuscarinic acetylcholine receptor M3target
AcetylcholineMuscarinic acetylcholine receptor M4target
AcetylcholineNeuronal acetylcholine receptor subunit alpha-7target
Choline alfoscerateGanglioside GM2 activatortarget
PhysostigmineNeuronal acetylcholine receptor subunit alpha-4target
PhysostigmineNeuronal acetylcholine receptor subunit beta-2target