Take on the full spectrum of schizophrenia symptoms

with COBENFY1-3*

The only non-D2† treatment for adults with schizophrenia4,5

98% of Medicare and Medicaid patients are COVERED for COBENFY‡

Take on the full spectrum of symptoms with COBENFY1-3

Significant Symptom Improvement

2x greater reduction in pooled PANSS total score with COBENFY vs placebo2,3§‖

Full Spectrum Control

Improvement across schizophrenia symptoms1,6¶

Unique Safety Profile

Demonstrated safety profile in over 1250 patients across 5 clinical trials4

* EMERGENT-2 (N=252) and EMERGENT-3 (N=256) were two randomized, double-blind, placebo-controlled, phase 3 studies that assessed the safety and efficacy of COBENFY. The primary end point was the change from baseline in PANSS total score at Week 5 vs placebo (EMERGENT-2: –21.2 vs –11.6, P<0.0001; EMERGENT-3: –20.6 vs –12.2, P<0.0001).1-3,7
† D2 treatments bind to dopamine D2 receptors; COBENFY does not bind to dopamine D2 receptors. COBENFY is a combination of xanomeline (M4 muscarinic agonist) and trospium chloride (muscarinic antagonist).4,5
‡ Formulary data are provided by Fingertip Formulary Data and are current as of 10/25. Because formularies change and many payers offer more than one formulary, please check directly with the payer to confirm coverage requirements and status for individual patients. Coverage and benefits are subject to change without notice. The accurate completion of reimbursement or cover-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item. Bristol Myers Squibb does not endorse any individual health plans.
§ These results were observed in the COBENFY clinical trial program, which included three 5-week, randomized, double-blind, placebo-controlled studies: EMERGENT-1 (N=182) was a phase 2 trial, and EMERGENT-2 (N=252) and EMERGENT-3 (N=256) were phase 3 trials.2,3,7,8 The primary end point was the change from baseline in PANSS total score at Week 5 vs placebo (EMERGENT-1: –17.4 vs –5.9; EMERGENT-2: –21.2 vs –11.6, P<0.0001; EMERGENT-3: –20.6 vs –12.2, P<0.0001).2,3,7,8
‖ End points in the pooled analysis were analyzed descriptively and are considered exploratory.1
As measured by PANSS total score.1,7
  PANSS=Positive and Negative Syndrome Scale.
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COBENFY is COVERED for 98% of Medicare and Medicaid patients.*

Ten dollars

9 out of 10 patients paid less than $10 out of pocket for COBENFY.†

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84% of claims were approved for COBENFY.†

* Formulary data are provided by Fingertip Formulary Data and are current as of 10/25. Because formularies change and many payers offer more than one formulary, please check directly with the payer to confirm coverage requirements and status for individual patients. Coverage and benefits are subject to change without notice. The accurate completion of reimbursement or cover-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item. Bristol Myers Squibb does not endorse any individual health plans.
† This is based on information licensed from IQVIA: IQVIA Patient Cost Disclosure Data for the period July 2025 - September 2025 reflecting estimates of real-world activity. All rights reserved. This includes prescriptions filled among Commercial, Medicare, and Medicaid patients and reflects any financial assistance that was used. “Commercially Insured Patients” is inclusive of commercially insured patients eligible and receiving assistance through the Co-Pay Assistance Program. “Medicare and Medicaid Patients” are not eligible for the Co-Pay Assistance Program, but may be eligible for other forms of third-party co-pay assistance. Some patients may pay more than the cost listed above.

References: 

  1. Kaul I, Sawchak S, Claxton A, et al. Efficacy of xanomeline and trospium chloride in schizophrenia: pooled results from three 5-week, randomized, double-blind, placebo-controlled, EMERGENT trials. Schizophrenia (Heidelb). 2024;10(1):102.
  2. Kaul I, Sawchak S, Correll CU, et al. Efficacy and safety of the muscarinic receptor agonist KarXT (xanomeline-trospium) in schizophrenia (EMERGENT-2) in the USA: results from a randomised, double-blind, placebo-controlled, flexible-dose phase 3 trial. Lancet. 2024;403(10422):160-170.
  3. Kaul I, Sawchak S, Walling DP, et al. Efficacy and safety of xanomeline-trospium chloride in schizophrenia: a randomized clinical trial. JAMA Psychiatry. 2024;81(8):749-756.
  4. COBENFY. Prescribing Information. Bristol-Myers Squibb Company; 2024.
  5. Paul SM, Yohn SE, Popiolek M, Miller AC, Felder CC. Muscarinic acetylcholine receptor agonists as novel treatments for schizophrenia. Am J Psychiatry. 2022;179(9):611-627.
  6. Data on file. Karuna Therapeutics, Inc., a Bristol Myers Squibb company; Boston, MA.
  7. Kaul I, Sawchak S, Walling DP, et al. Efficacy and safety of xanomeline-trospium chloride in schizophrenia: a randomized clinical trial. JAMA Psychiatry. 2024;81(8)(suppl):749-756.
  8. Brannan SK, Sawchak S, Miller AC, Lieberman JA, Paul SM, Breier A. Muscarinic cholinergic receptor agonist and peripheral antagonist for schizophrenia. N Engl J Med. 2021;384(8):717-726.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

COBENFY™ is contraindicated in patients with: urinary retention; moderate or severe (Child-Pugh Class B or C) hepatic impairment; gastric retention; history of hypersensitivity to COBENFY or trospium chloride—angioedema has been reported with COBENFY and trospium chloride; and untreated narrow-angle glaucoma.

WARNINGS AND PRECAUTIONS

Risk of Urinary Retention: COBENFY can cause urinary retention. Geriatric patients and patients with clinically significant bladder outlet obstruction and incomplete bladder emptying (e.g., patients with benign prostatic hyperplasia (BPH), diabetic cystopathy) may be at increased risk of urinary retention.

COBENFY is contraindicated in patients with pre-existing urinary retention and is not recommended in patients with moderate or severe renal impairment.

In patients taking COBENFY, monitor for symptoms of urinary retention, including urinary hesitancy, weak stream, incomplete bladder emptying, and dysuria. Instruct patients to be aware of the risk and promptly report symptoms of urinary retention to their healthcare provider. Urinary retention is a known risk factor for urinary tract infections. In patients with symptoms of urinary retention, consider reducing the dose of COBENFY, discontinuing COBENFY, or referring patients for urologic evaluation as clinically indicated.

Risk of Use in Patients with Hepatic Impairment: Patients with hepatic impairment have higher systemic exposures of xanomeline, a component of COBENFY, compared to patients with normal hepatic function, which may result in increased incidence of COBENFY-related adverse reactions.

COBENFY is contraindicated in patients with moderate or severe hepatic impairment. COBENFY is not recommended in patients with mild hepatic impairment.

Assess liver enzymes prior to initiating COBENFY and as clinically indicated during treatment.

Risk of Use in Patients with Biliary Disease: In clinical studies with COBENFY, transient increases in liver enzymes with rapid decline occurred, consistent with transient biliary obstruction due to biliary contraction and possible gallstone passage.

COBENFY is not recommended for patients with active biliary disease such as symptomatic gallstones. Assess liver enzymes and bilirubin prior to initiating COBENFY and as clinically indicated during treatment. The occurrence of symptoms such as dyspepsia, nausea, vomiting, or upper abdominal pain should prompt assessment for gallbladder disorders, biliary disorders, and pancreatitis, as clinically indicated.

Discontinue COBENFY in the presence of signs or symptoms of substantial liver injury such as jaundice, pruritus, or alanine aminotransferase levels more than five times the upper limit of normal or five times baseline values.

Decreased Gastrointestinal Motility: COBENFY contains trospium chloride. Trospium chloride, like other antimuscarinic agents, may decrease gastrointestinal motility. Administer COBENFY with caution in patients with gastrointestinal obstructive disorders because of the risk of gastric retention. Use COBENFY with caution in patients with conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis.

Risk of Angioedema: Angioedema of the face, lips, tongue, and/or larynx has been reported with COBENFY and trospium chloride, a component of COBENFY. In one case, angioedema occurred after the first dose of trospium chloride. Angioedema associated with upper airway swelling may be life-threatening. If involvement of the tongue, hypopharynx, or larynx occurs, discontinue COBENFY and initiate appropriate therapy and/or measures necessary to ensure a patent airway. COBENFY is contraindicated in patients with a history of hypersensitivity to trospium chloride.

Risk of Use in Patients with Narrow-angle Glaucoma: Pupillary dilation may occur due to the anticholinergic effects of COBENFY. This may trigger an acute angle closure attack in patients with anatomically narrow angles. In patients known to have anatomically narrow angles, COBENFY should only be used if the potential benefits outweigh the risks and with careful monitoring.

Increases in Heart Rate: COBENFY can increase heart rate. Assess heart rate at baseline and as clinically indicated during treatment with COBENFY.

Anticholinergic Adverse Reactions in Patients with Renal Impairment: Trospium chloride, a component of COBENFY, is substantially excreted by the kidney. COBENFY is not recommended in patients with moderate or severe renal impairment (estimated glomerular filtration rate (eGFR) <60 mL/min). Systemic exposure of trospium chloride is higher in patients with moderate and severe renal impairment. Therefore, anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) are expected to be greater in patients with moderate and severe renal impairment.

Central Nervous System Effects: Trospium chloride, a component of COBENFY, is associated with anticholinergic central nervous system (CNS) effects. A variety of CNS anticholinergic effects have been reported with trospium chloride, including dizziness, confusion, hallucinations, and somnolence. Monitor patients for signs of anticholinergic CNS effects, particularly after beginning treatment or increasing the dose. Advise patients not to drive or operate heavy machinery until they know how COBENFY affects them. If a patient experiences anticholinergic CNS effects, consider dose reduction or drug discontinuation.

Most Common Adverse Reactions (≥5% and at least twice placebo): nausea, dyspepsia, constipation, vomiting, hypertension, abdominal pain, diarrhea, tachycardia, dizziness, and gastroesophageal reflux disease.

Use in Specific Populations:

 
  • Moderate or Severe Renal Impairment: Not recommended
  • Mild Hepatic Impairment: Not recommended

Pregnancy and Lactation: There is a pregnancy exposure registry that monitors outcomes in women exposed to psychiatric medications, including COBENFY, during pregnancy. Healthcare providers are encouraged to advise patients to register by calling 1-866-961-2388 or visiting https://womensmentalhealth.org/research/pregnancyregistry/atypicalantipsychotic/.

There are no available data on COBENFY use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Additionally, there are no data on the presence of xanomeline or trospium in human milk, the effects on the breastfed infant, or the effects on milk production. However, xanomeline and trospium are present in animal milk, suggesting they may also be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for COBENFY and any potential adverse effects on the breastfed infant from COBENFY or the underlying maternal condition.

COBENFY (xanomeline and trospium chloride) is available in 50mg/20mg, 100mg/20mg, and 125mg/30mg capsules.

INDICATION

COBENFY™ (xanomeline and trospium chloride) is indicated for the treatment of schizophrenia in adults.

Please see U.S. Full Prescribing Information, including Patient Information.

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Cobenfy, Cobenfy Cares, and the Cobenfy logo are trademarks of Karuna Therapeutics, Inc., a Bristol Myers Squibb company.
© 2025 Bristol-Myers Squibb Company.

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