Description
COBENFY (KarXT), a novel antipsychotic medication composed of xanomeline and trospium, is indicated for the treatment of schizophrenia in adults. Xanomeline, a muscarinic receptor agonist, targets M1 and M4 receptors to modulate dopaminergic and cholinergic signaling, while trospium is included to mitigate peripheral cholinergic side effects by acting as a peripherally restricted muscarinic antagonist. This dual-mechanism therapy represents a significant advancement in antipsychotic treatment, offering efficacy without direct dopamine receptor antagonism. Individuals seeking to buy COBENFY or exploring COBENFY medication options should consult a licensed healthcare provider for guidance on access and suitability.
| Fact Table |
| Formula | C21H29NO (xanomeline) + C25H30NO3 (trospium) |
| License | FDA approved (September 2024) |
| Bioavailability | Xanomeline: Moderate; Trospium: Low (~10%) |
| Legal status | Prescription only (Rx) |
| Chemical Name | Xanomeline and Trospium Chloride |
| Elimination half-life | Xanomeline: ~4–6 hours; Trospium: ~20 hours |
| Dosage (Strength) | Xanomeline 150 mg + Trospium 30 mg, twice daily |
| Pregnancy | Consult healthcare provider |
| Brands | COBENFY™ |
| Protein binding | Xanomeline: ~60%; Trospium: ~50% |
| PubChem CID | Xanomeline: 5487158; Trospium: 72034 |
| MedlinePlus | Not assigned |
| ChEBI | Xanomeline: 145074; Trospium: 94848 |
| ATC code | N05AX (not yet fully assigned) |
| DrugBank | Xanomeline: DB14854; Trospium: DB00209 |
| KEGG | Xanomeline: D10795; Trospium: D08687 |
| Routes of administration | By mouth |
Directions
COBENFY is administered orally with the recommended dose being determined by a healthcare professional based on individual patient needs. The dosing regimen typically begins with a titration phase to establish tolerability, followed by a maintenance dose. COBENFY should be taken consistently with or without food, and patients are advised to adhere strictly to their prescribed schedule. Dose modifications should only be made under medical supervision to ensure therapeutic efficacy and minimize adverse effects.
Ingredients
The active pharmaceutical ingredients in COBENFY are xanomeline and trospium. Xanomeline functions as a centrally acting muscarinic receptor agonist, primarily affecting the M1 and M4 subtypes. Trospium is a quaternary ammonium compound that does not cross the blood-brain barrier, allowing it to selectively inhibit peripheral muscarinic receptors. These components work synergistically to reduce psychotic symptoms while minimizing undesirable peripheral side effects.
Cautions
Before initiating COBENFY, clinicians should evaluate patients for conditions that may be exacerbated by anticholinergic effects, such as urinary retention, gastrointestinal motility disorders, or a history of prostatic hypertrophy. Caution is also warranted in elderly patients, particularly those with cognitive impairment. Regular monitoring is recommended to assess for therapeutic response and emergent side effects. Patients interested in learning about COBENFY cost should consult with pharmacies or insurance providers, as pricing may vary depending on coverage and geographic region.
Contraindications
COBENFY is contraindicated in individuals with a known hypersensitivity to xanomeline, trospium, or any excipients in the formulation. It should not be used in patients with severe renal impairment or in those with untreated narrow-angle glaucoma. Concomitant use with other anticholinergic agents may increase the risk of cumulative anticholinergic burden and should be avoided.
Side Effects
Commonly reported side effects include:
- Nausea
- Constipation
- Dry mouth
- Dyspepsia
- Headache
- Dizziness
- Increased heart rate
- Urinary retention
Serious adverse events are rare but may include severe gastrointestinal obstruction, cognitive impairment, or hypersensitivity reactions. Patients should report any unusual or persistent symptoms to their healthcare provider promptly.
Frequently Asked Questions about COBENFY (KarXT; xanomeline-trospium)
What is COBENFY and what is it used to treat?
COBENFY (KarXT; xanomeline-trospium) is a medication approved for the treatment of schizophrenia in adults. It works through a novel mechanism targeting muscarinic receptors in the brain.
How does COBENFY differ from other antipsychotic medications?
Unlike traditional antipsychotics that primarily block dopamine receptors, COBENFY works by activating muscarinic acetylcholine receptors. This different mechanism may offer benefits for treating certain symptoms while potentially avoiding some side effects associated with dopamine blockers.
What are the most common side effects of COBENFY?
Common side effects include constipation, indigestion, nausea, vomiting, dry mouth, headache, and dizziness. These are typically mild to moderate and often diminish over time with continued treatment.
How is COBENFY taken?
COBENFY is taken orally as directed by your healthcare provider, typically twice daily with or without food. Follow your doctor's instructions precisely regarding dosage and timing.
Can COBENFY be taken with other medications?
COBENFY may interact with certain medications. Always inform your healthcare provider about all medications, supplements, and herbs you are taking before starting COBENFY to avoid potential interactions.
How long does it take for COBENFY to work?
While some patients may notice improvements within the first few weeks, it typically takes 4-6 weeks to experience the full therapeutic benefits of COBENFY. Consistent daily use as prescribed is important.
What should I do if I miss a dose of COBENFY?
If you miss a dose, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Does COBENFY cause weight gain or metabolic issues?
Clinical trials suggest COBENFY has a more favorable weight and metabolic profile compared to many traditional antipsychotics, with minimal impact on weight, blood glucose, and lipid levels for most patients.
Can I drive or operate machinery while taking COBENFY?
COBENFY may cause dizziness or drowsiness in some people. Avoid driving, operating machinery, or performing activities requiring alertness until you know how COBENFY affects you.
Is COBENFY addictive or can it be stopped suddenly?
COBENFY is not considered addictive. However, do not stop taking COBENFY abruptly without consulting your healthcare provider, as sudden discontinuation may lead to symptom recurrence or withdrawal effects. Your doctor can guide you on safely tapering the medication if needed.
IMPORTANT NOTE:
The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.
Product Code : 15332
Prescription Required