For U.S. Healthcare Professionals only.

For U.S. Healthcare Professionals only.

U.S. Full Prescribing Information

Patient Information

Indication

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Titration and dosing with COBENFY for adults with schizophrenia

COBENFY offers flexible titration and 2 recommended dosages1

COBENFY is taken orally and dose is expressed as mg xanomeline/mg trospium chloride.1

COBENFY recommended dosages timeline

Start at 50 mg/20 mg orally BID for at least 2 days. Increase to 100 mg/20 mg BID for at least 5 days.1
Dosage may be increased to 125 mg/30 mg BID based on patient tolerability and response.1
Maximum recommended dosage is 125 mg/30 mg BID.1

Geriatric dosing1

  • Recommended starting dosage is 50 mg/20 mg orally BID
  • Consider a slower titration
  • Maximum recommended dosage is 100 mg/20 mg BID

Your patients can start and end their day with COBENFY

COBENFY should be dosed BID on an empty stomach at least 1 hour before or at least 2 hours after a meal. Not following dosing recommendations may result in increased side effects.1

COBENFY dosing schedule

Recommended testing and monitoring prior to initiation and during treatment1

  • It is recommended to assess heart rate at baseline and as clinically indicated during treatment
  • It is recommended to assess liver enzymes and bilirubin prior to initiating COBENFY and as clinically indicated during treatment

BID=twice daily.

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COBENFY Dosing Guide

Learn more about dosing for COBENFY

Understanding drug interactions with COBENFY
Understanding drug interactions with Cobenfy

Additional consideration:

Anticholinergics (muscarinic antagonists) and muscarinic agonists may affect the pharmacological activity of one another.

*This is not an exhaustive list and is only used to show clinically relevant examples of medications. For a full list, visit FDA.gov.2

Starting and staying on COBENFY

COBENFY can be initiated with a starter titration pack and continued with maintenance bottles.1

Cobenfy™ titration packs

100mg/20mg Starter titration pack
(28-day supply)

Cobenfy™ pill bottles

Maintenance bottles
(60 capsules, 30-day supply)

  • 50mg/20mg, 100mg/20mg, 125mg/30mg

Consider starting your patients today with COBENFY sample packs.

Cobenfy™ titration and sample packs

Samples are not for sale or reimbursement.

Titration sample pack

  • 50mg/20mg BID for 2 days and 100mg/20mg BID for 5 days

14-count wallets (7-day supply) available:

  • 50mg/20mg, 100mg/20mg, 125mg/30mg
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Request a COBENFY representative or samples through our chatbot

Explore the efficacy data of COBENFY

Learn more about the safety data of COBENFY

See how COBENFY works

References:

  1. COBENFY. Prescribing Information. Bristol Myers Squibb Company; 2024.
  2. For healthcare professionals | FDA’s examples of drugs that interact with CYP enzymes and transporter systems. U.S. Food & Drug Administration. Accessed October 1, 2024. https://www.fda.gov/drugs/drug-interactions-labeling/healthcare-professionals-fdas-examples-drugs-interact-cyp-enzymes-and-transporter-systems#table%201
  3. P-glycoprotein substrates with a narrow therapeutic index. DrugBank Online. Accessed October 1, 2024. https://go.drugbank.com/categories/DBCAT004027
  4. Hansten PD, Tan MS, Horn JR, et al. Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management. Drug Saf. 2023;46(3):223-242.
  5. Ammar H, Govindu RR. A dangerous and unrecognized interaction of apixaban. Cureus. 2021;13(11):e19688.
  6. Xu Y, Zhang L, Dou X, Dong Y, Guo X. Physiologically based pharmacokinetic modeling of apixaban to predict exposure in populations with hepatic and renal impairment and elderly populations. Eur J Clin Pharmacol. 2024;80(2):261-271.
  7. Muscarinic antagonists. DrugBank Online. Accessed October 1, 2024. https://go.drugbank.com/categories/DBCAT000534

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

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

INDICATION

COBENFY™ is indicated for the treatment of schizophrenia in adults.

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

Cobenfy, Cobenfy Cares, and the Cobenfy logo are trademarks of Karuna Therapeutics, Inc., a Bristol Myers Squibb company.
© 2024 Bristol-Myers Squibb Company. 1629-US-2400140 10/24

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