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Cobenfy is a prescription combination of xanomeline and trospium chloride approved for schizophrenia in adults. Xanomeline is a muscarinic agonist, while trospium is a muscarinic antagonist. Capsules come in 50 mg with 20 mg, 100 mg with 20 mg, and 125 mg with 30 mg strengths.
read more about cobenfy ...The exact mechanism of xanomeline in schizophrenia is unclear. Its activity is thought to come from agonism at M1 and M4 muscarinic acetylcholine receptors in the central nervous system. Trospium blocks muscarinic receptors mainly in peripheral tissues, reducing peripheral cholinergic effects from xanomeline.
Cobenfy is approved for treatment of schizophrenia in adults. Before treatment, liver enzymes, bilirubin, and heart rate are assessed. Current labeling does not establish pediatric safety and efficacy. The medicine is not recommended in moderate or severe kidney impairment or in mild liver impairment.
Treatment starts with 50 mg of xanomeline and 20 mg of trospium twice daily for at least two days. The dose then increases to 100 mg with 20 mg twice daily for at least five days. It can then increase to 125 mg with 30 mg twice daily according to tolerability and response. Capsules are taken on an empty stomach.
Serious concerns include urinary retention, liver injury, biliary disorders, reduced gastrointestinal motility, angioedema, narrow-angle glaucoma, increased heart rate, anticholinergic reactions, and central nervous system effects such as dizziness, confusion, hallucinations, or sleepiness. Contraindications include urinary retention, gastric retention, untreated narrow-angle glaucoma, and moderate or severe liver impairment.
Cobenfy is approved for treatment of schizophrenia in adults.
Cobenfy is taken twice daily using a stepwise dose titration schedule.
No. It is taken at least one hour before a meal or at least two hours after a meal.
Cobenfy contains xanomeline, a muscarinic agonist, and trospium chloride, a muscarinic antagonist.
COBENFY (xanomeline and trospium chloride) Prescribing Information. https://packageinserts.bms.com/pi/pi_cobenfy.pdf. Date Accessed September 23, 2026.
DailyMed - COBENFY (xanomeline and trospium chloride) capsule. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8f0e73bf-6025-44f6-ab64-0983322de0df. Date Accessed September 23, 2026.
Drug Trials Snapshot: COBENFY. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-trials-snapshots/drug-trials-snapshot-cobenfy. Date Accessed September 23, 2026.
FDA Approves Drug with New Mechanism of Action for Treatment of Schizophrenia. https://www.fda.gov/news-events/press-announcements/fda-approves-drug-new-mechanism-action-treatment-schizophrenia. Date Accessed September 23, 2026.
Xanomeline and Trospium Chloride. MedlinePlus. https://medlineplus.gov/druginfo/meds/a624070.html. Date Accessed September 23, 2026.