Cobenfy(KarXT)的用药注意事项

Cobenfy (KarXT) is an innovative compound drug containing xanomeline and trospium chloride.

Precautions before taking Cobenfy (KarXT)

1. Comprehensive medical condition assessment

(1) Absolute contraindications: Use of this product is strictly prohibited if there is urinary retention, moderate or severe hepatic insufficiency, gastric retention, untreated angle-closure glaucoma, or allergies to any of its ingredients.

(2) Diseases that require careful evaluation: If you have mild hepatic insufficiency, any degree of renal insufficiency, symptomatic biliary disease, bladder outlet obstruction, benign prostatic hyperplasia, heart disease, gastrointestinal obstructive disease, ulcerative colitis, myasthenia gravis, etc., the doctor needs to carefully weigh the pros and cons before deciding whether to use it.

2. Necessary baseline examinations

(1) Liver function test: detect liver enzyme and bilirubin levels.

(2) Heart rate assessment: measure resting heart rate.

(3) Renal function assessment: Determine the renal function status by estimating the glomerular filtration rate.

3. Notification of medication history and pregnancy status

(1) Inform all medications currently being used: including prescription drugs, over-the-counter drugs and herbal supplements. Pay special attention to whether you are using other anticholinergic drugs, drugs that are strong inhibitors of the CYP2D6 enzyme, drugs that actively excrete tubular secretion through the kidneys, etc., because these drugs may interact with Cobenfy.

(2) Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant or breastfeeding, please be sure to inform your doctor. There is currently insufficient data to confirm the safety of Cobenfy for pregnant women and fetuses, and the drug may be excreted in breast milk.

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.

Precautions during the use of Cobenfy (KarXT)

1. Strict dosage titration and administration method

(1) Follow the increasing schedule: The dosage of Cobenfy needs to start at a low dose and gradually increase over at least a few days to a week to help the body adapt. Never speed up the dosage on your own.

(2) Correct medication time: It must be taken at least 1 hour before a meal or at least 2 hours after a meal to ensure that drug absorption is not affected by food.

(3) Swallow the whole capsule: Do not open or chew the capsule. Take the whole capsule with water.

2. Closely monitor adverse reactions

(1), common adverse reactions

Gastrointestinal tract: nausea, indigestion, constipation, vomiting, abdominal pain, diarrhea, gastroesophageal reflux disease. These reactions are very common and usually lessen as treatment continues.

Cardiovascular: increased heart rate, high blood pressure, dizziness.

(2) Serious adverse reactions that need to be reported immediately

Urinary retention: If you have difficulty urinating, thin urine stream, feeling of incomplete urination or painful urination, you should report to your doctor immediately. Older men and those with a history of prostate enlargement are at higher risk.

Allergic reaction: If angioedema occurs on the face, lips, tongue or throat, causing difficulty in breathing, stop taking the drug immediately and seek emergency medical assistance.

Hepatobiliary problems: If jaundice, skin itching, right upper quadrant pain, dark urine, persistent indigestion, nausea and vomiting occur, it may indicate liver or biliary tract problems.

Central nervous system effects: If dizziness, drowsiness, confusion, hallucinations, etc. occur, you should avoid driving or operating machinery.

3. Precautions for lifestyle and activities

(1) Driving and mechanical operation: Before the impact of Cobenfy on your nervous system is clearly known, you should avoid activities that require high alertness.

(2) Avoid contact transmission: Although this is an oral medicine, maintaining good personal hygiene habits is always the basis for preventing infection.

Precautions after taking Cobenfy (KarXT) and long-term treatment

1. Long-term efficacy and safety monitoring

Even if the physical condition is stable, regular follow-up consultations should be carried out according to the doctor's advice, so that the doctor can evaluate the control of mental symptoms and monitor the possible long-term effects of the drug, such as continued heart rate changes, weight changes, etc.

2. Continuous attention for special groups

(1) Elderly patients: Elderly patients have a reduced ability to clear drugs and are at a higher risk of urinary retention and anticholinergic side effects. It is usually recommended to use a lower maintenance dose and require the assistance of family members to observe related symptoms.

(2) Patients with renal insufficiency: It is not recommended for patients with moderate to severe renal insufficiency to use this product. Although regular doses may be used in mild cases, side effects such as dry mouth, constipation, urinary tract infections, and urinary retention need to be closely monitored.

3. Recognition and treatment of drug overdose

It is important to understand the symptoms of drug overdose. Overdose may exhibit both cholinergic and anticholinergic symptoms, including:

(1) Cholinergic symptoms: seizures, vomiting, diarrhea, abdominal pain, profuse sweating, salivation, and hypotension.

(2) Anticholinergic symptoms: delirium, restlessness, slurred speech, tachycardia, blurred vision, urinary retention.

If overdose is suspected, call emergency services immediately or go to the nearest hospital emergency room and contact a poison control center.