Xanomeline-trospium ($ Cobenfy)
Antipsychotic (cholinergic muscarinic paired with peripheral anticholinergic trospium)
- Schizophrenia1
- Not known to work in mood disorders
- Ineffective: Augmenting antipsychotics
Features
Dosing
Start at 50 mg/20 mg BID for at least 2 days, then 100 mg/20 mg BID.
Management
About as effective as other antipsychotics, but lacking in long-term risks (does not block dopamine). Can be combined with other antipsychotics but does not augment them. Does not improve cognition in schizophrenia.
TOLERABILITY: Urinary retention, nausea, gastric slowing, rare risk of hepatotoxicity/angioedema.
EMR Text
Schizophrenia
Xanomeline-trospium (Cobenfy) use based on FDA approval in schizophrenia. Side effects, including cholinergic and anticholinergic, reviewed with patient.