MUSCARINIC AGONIST/ANTAGONIST COMBINATION
Overview
Cobenfy is a combination medication of xanomeline, a muscarinic agonist, and trospium chloride, a muscarinic antagonist, approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia in adults. It is typically prescribed to individuals who meet certain criteria, such as those needing pharmacologic intervention for schizophrenia. The treatment is not recommended for individuals with moderate or severe hepatic impairment or significant urinary or gastric issues due to contraindications. Cobenfy is also known by its drug names, xanomeline and trospium chloride.
Cobenfy works by targeting muscarinic receptors in the brain. Xanomeline activates (agonizes) these receptors, which are thought to be involved in symptoms of schizophrenia, while trospium chloride blocks (antagonizes) other muscarinic receptors to help minimize certain side effects related to excessive receptor activation.
How do I take it?
Prescribing information states that Cobenfy is taken as an oral capsule. The recommended dosing schedule involves taking the combination twice daily for at least two days. After this period, the dose is typically increased and taken twice daily for at least five days. Depending on a person’s response and tolerance, the dosage may be increased further and taken twice daily. The capsules should be taken at least one hour before a meal or two hours after a meal and must not be opened. Cobenfy should be taken exactly as prescribed by a health care provider.
Side effects
Common side effects of Cobenfy include nausea, dyspepsia (indigestion), constipation, vomiting, hypertension (high blood pressure), abdominal pain, diarrhea, tachycardia (rapid heart rate), dizziness, and gastroesophageal reflux disease (acid reflux).
Rare but serious side effects may include urinary retention, substantial liver injury, gastrointestinal obstruction (gastric retention), angioedema (swelling of the face, lips, or throat), increased heart rate, and central nervous system effects such as dizziness or confusion. Individuals with renal impairment may experience heightened anticholinergic effects, so use in this population is not recommended.
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