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Cobenfy (xanomeline and trospium chloride) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat schizophrenia in adults.
Cobenfy is a medicine that acts on muscarinic receptors. One part of the drug, xanomeline, turns on M1 and M4 receptors in the brain. The other part, trospium, blocks muscarinic receptors mostly outside the brain.
The exact way Cobenfy works is not fully known. In schizophrenia, this may help reduce abnormal brain signaling linked to symptoms.
Doctors prescribe Cobenfy to treat schizophrenia in adults. By targeting this pathway, the medication may help manage symptoms.
Cobenfy comes as a capsule taken by mouth, usually two times each day. Take it at least one hour before a meal or at least two hours after a meal. Do not open the capsules.
Typical Dosing for Schizophrenia
The recommended starting dose is 50 milligrams/20 milligrams taken by mouth twice daily for at least two days. Then the dose is increased to 100 milligrams/20 milligrams twice daily for at least five days.
If needed, the doctor may increase the dose to 125 milligrams/30 milligrams twice daily based on how well it works and how well it is tolerated. For older adults, doctors may increase the dose more slowly. The maximum dose for older adults is 100 milligrams/20 milligrams twice daily.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
In clinical studies of Cobenfy for schizophrenia in adults, the most common side effects occurred in about 5 percent to 19 percent of people. These include:
Cobenfy can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Bristol Myers Squibb, the manufacturer of Cobenfy, offers the Cobenfy Cares Patient Support Program. Eligible people with commercial insurance may pay as little as $0 per month through a copay savings offer.
The Cobenfy Cares Patient Support Program also provides free, personalized support and resources. This includes one-on-one support from a dedicated Cobenfy Cares Champion, help with practical needs like transportation to appointments or the pharmacy, assistance with understanding insurance coverage, and tips to help you stay on track with taking Cobenfy as prescribed.
To learn more, visit the Cobenfy Cares Patient Support Program or call 877-262-3639.
Before starting Cobenfy, your doctor will check your liver enzymes, bilirubin, and heart rate.
Do not drive, operate heavy machinery, or do other dangerous activities until you know how Cobenfy affects you. Cobenfy may cause dizziness, confusion, hallucinations, and sleepiness.
Tell your doctor if you have any allergies to xanomeline and trospium chloride or any ingredients in Cobenfy.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Also tell your doctor if you have or have had an enlarged prostate, trouble passing urine, bladder problems, liver problems, gallstones or problems with your bile ducts or pancreas, stomach or bowel problems including constipation, ulcerative colitis, slow stomach emptying, myasthenia gravis, narrow-angle glaucoma, or kidney problems.
Do not take Cobenfy if you have urinary retention, moderate or severe liver impairment, gastric retention, a history of hypersensitivity to Cobenfy or trospium chloride, or untreated narrow-angle glaucoma.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Cobenfy, talk with your doctor about the risks and benefits. There is a pregnancy exposure registry for people who take Cobenfy during pregnancy. To learn more, call 866-961-2388.
These answers have been fact-checked by our editorial staff.
How effective is Cobenfy?
In two five-week studies in adults with schizophrenia, people who took Cobenfy had greater improvement in symptom scores than those who took placebo (an inactive treatment).
Doctors used a scale called PANSS to measure symptoms. PANSS scores can range from 30 to 210. Higher scores mean worse symptoms, so a bigger drop in the score means more improvement.
In the first study, people taking Cobenfy improved by 21.2 points. People taking placebo improved by 11.6 points. This means Cobenfy improved symptoms by 9.6 points more than placebo.
In the second study, people taking Cobenfy improved by 20.6 points. People taking placebo improved by 12.2 points. This means Cobenfy improved symptoms by 8.4 points more than placebo.
These results show that Cobenfy reduced symptoms more than placebo over five weeks.
How long does Cobenfy take to work for schizophrenia?
The studies measured symptom improvement over five weeks. The available results do not give an exact day or week when people first noticed improvement.
What tests or monitoring are needed with Cobenfy for schizophrenia?
Your doctor should check your liver enzymes and bilirubin before starting treatment and as needed during treatment. Your heart rate should also be checked at the start and during treatment as needed.
On MyDepressionTeam, people share their experiences with mental health issues, get advice, and find support from others who understand.
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