Cobenfy(KarXT)的功效与作用

Cobenfy (KarXT) does not directly act on the dopamine system, but works by stimulating the central M1/M4 muscarinic receptors.

Efficacy and role of Cobenfy (KarXT)

It is suitable for the treatment of adult schizophrenia.

Cobenfy (KarXT) usage and dosage

1. Recommended testing and monitoring before starting Cobenfy treatment and during treatment

Evaluate liver enzymes and bilirubin before starting Cobenfy treatment and during treatment as clinically necessary.

Assess heart rate at baseline and as clinically necessary during treatment.

2. Recommended dose

The recommended starting dose is to take one 50mg/20mg capsule (containing 50mg xanomeline and 20mg trospium chloride) orally twice a day for at least two days.

Increase the dose to one 100 mg/20 mg capsule (containing 100 mg xanomeline and 20 mg trospium chloride) orally twice daily for at least five days.

Based on the patient's tolerance and response, the dose can be increased to oral administration of one 125 mg/30 mg capsule (containing 125 mg of xanomeline and 30 mg of trospium chloride) twice daily.

The maximum recommended dose is 125mg/30mg, taken orally twice daily.

3. Medication time

Cobenfy should be taken orally at least one hour before or two hours after a meal.

4. Dosage recommendation for elderly patients

The recommended starting dose of Cobenfy for elderly patients is one 50mg/20mg capsule, taken orally twice a day. Consider slower dose titration in elderly patients. The maximum recommended dose for elderly patients is one 100 mg/20 mg capsule twice daily.

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.

Adverse reactions of Cobenfy (KarXT)

1. Cardiovascular: chest pain, hypertensive crisis, palpitations, supraventricular tachycardia, syncope.

2. Gastrointestinal tract: gastritis.

3. Whole body: rash.

4. Musculoskeletal: rhabdomyolysis.

5. Nervous system: confusion, delirium, dizziness, hallucinations, drowsiness, and abnormal vision.

6. Skin and subcutaneous tissue diseases: angioedema, allergic reactions, Stevens-Johnson syndrome.

Cobenfy (KarXT) Pharmacokinetics

1. Absorption

The Tmax of Xanomeline is about 2 hours, and that of trespium chloride is about 1 hour. High-fat or low-fat diets significantly reduced the Cmax and AUC of trespium chloride.

2. Distribution

Xanomeline has a large distribution volume (about 10,800 L) and a protein binding rate of about 95%; trespium chloride has a small distribution volume (about 531 L) and a protein binding rate of about 80%.

3. Metabolism

Xanomeline is mainly metabolized by CYP2D6, 2B6, 1A2, 2C9, and 2C19; trespium chloride is metabolized less, mainly through ester hydrolysis and glucuronidation.

4. Excretion

Xanomeline is mainly excreted through urine (78%), and trespium chloride is mainly excreted unchanged through urine (85%–90%).