Cobenfy(KarXT)是治疗什么疾病的

Cobenfy (KarXT) is a new oral combination drug approved in the United States in 2024. It consists of xanomeline (a muscarinic agonist) and trospiumchloride (a muscarinic antagonist) for adults with schizophrenia.

What diseases does Cobenfy (KarXT) treat?

It is suitable for the treatment of adult schizophrenia. Its mechanism of action is not completely clear, but it is believed that xanomeline exerts its therapeutic effect by stimulating central M1 and M4 muscarinic acetylcholine receptors, while trospiumchloride mainly antagonizes muscarinic receptors in peripheral tissues to reduce the peripheral side effects of xanomeline.

Cobenfy (KarXT) Medication Guide

1. Dosage and usage

(1). Starting dose: 50mg/20mg, twice a day, for at least 2 consecutive days.

(2) First adjustment: increase to 100mg/20mg, twice a day, for at least 5 consecutive days.

(3) Further adjustment: According to the patient’s tolerance and efficacy, it can be increased to 125mg/30mg twice a day.

(4). Maximum dose: 125mg/30mg, twice a day.

2. Precautions for taking

It should be taken at least 1 hour before a meal or at least 2 hours after a meal. Do not open the capsule and swallow it whole.

The pictures come from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

3. Medication for elderly patients

The starting dose is 50mg/20mg, twice a day. It is recommended to adjust the dose slowly, with the maximum dose not exceeding 100mg/20mg twice daily.

4. Monitoring before and during medication

(1) Liver function: Detect liver enzymes and bilirubin before medication and when clinically necessary.

(2) Heart rate: Monitor heart rate regularly at baseline and during treatment.

Contraindications of Cobenfy (KarXT)

Cobenfy is contraindicated in the following patients:

1. Urinary retention.

2. Moderate or severe liver insufficiency.

3. Gastric retention.

4. Allergic to Cobenfy.

5. Untreated angle-closure glaucoma.

Cobenfy (KarXT) adverse reactions

1. Common adverse reactions (incidence ≥5%, and more than twice that of the placebo group)

Including nausea, indigestion, constipation, vomiting, hypertension, abdominal pain, diarrhea, tachycardia, dizziness, and gastroesophageal reflux disease.

2. Serious adverse reactions

(1) Urinary retention: Especially elderly men and patients with bladder outlet obstruction are at higher risk.

(2) Abnormal liver function: elevated liver enzymes may be accompanied by biliary obstruction.

(3). Decreased gastrointestinal motility: Use with caution in patients with gastrointestinal obstruction.

(4) Angioedema: rare but potentially life-threatening.

(5). Increased heart rate: Heart rate needs to be monitored during treatment.

(6) Effects on the central nervous system: such as dizziness, hallucinations, and drowsiness, affecting the ability to drive and operate machinery.