Cobenfy Dosage: Forms, Strengths, How to Take, & More

What Is Cobenfy & How Is It Used?

Cobenfy is a newly FDA-approved medication to treat schizophrenia in adults and is a type of antipsychotic medication called a muscarinic agonist. FDA approval means that the FDA has determined the drug to be safe and effective when used as intended based on data from clinical trials. Cobenfy is not intended to be used by children or anyone under eighteen years old. The usual dose schedule of Cobenfy is one capsule twice daily 1 hour before or 2 hours after having a meal.¹

Cobenfy is a combination of two medications called xanomeline and trospium chloride that work in the body on muscarinic receptors.¹ The two medications work together to reduce all types of schizophrenia symptoms, while limiting the usual negative side effects of schizophrenia medications. In studies, patients taking Cobenfy showed a significant lessening in all symptoms of schizophrenia.¹

Cobenfy Forms & Strengths

Cobenfy is available as an oral capsule in multiple strengths. Your prescriber will decide what is the best dose for you based on your age, health history, and your symptoms. When starting treatment with Cobenfy, most patients will slowly increase their dose. It is important to only change your dose at the instruction of your prescriber and take the medication exactly as they tell you. Changing doses without your provider’s direction can put you at risk of unwanted and serious side effects.¹

Cobenfy is available in the following forms:¹

• 50 milligram (mg) /20 mg capsules
• 100 mg/20 mg capsules
• 125 mg/30 mg capsules

Cobenfy is also available as a starter pack with two different doses. This package can be helpful for those starting treatment to slowly and effectively increase the dose. If your doctor decides to prescribe you this version, be sure to follow the package directions exactly. Always take your Cobenfy dose 1 hour before or 2 hours after a meal, and do not open the capsules. Do your best to never forget or skip doses, as this can interfere with your treatment.¹

How to Take Cobenfy

For best treatment results, take Cobenfy as instructed by your provider. Cobenfy should be taken two times a day without food. To ensure this, always take Cobenfy at least 1 hour before eating or at least 2 hours after eating a meal. Do your best to take Cobenfy doses exactly 12 hours apart. Taking Cobenfy with food, or too close together in time, can cause unwanted side effects.¹

It is likely your doctor will increase your dose slowly over time. Only change your dose when your doctor tells you to. Do not stop taking Cobenfy unless instructed by your prescriber. Finally, Cobenfy comes as a capsule to take by mouth. It should not be chewed, crushed, or opened.¹ If you have trouble swallowing pills talk to your pharmacist for tips.

Cobenfy Dosage for Adults With Schizophrenia

Cobenfy only has one FDA-approved use, to treat schizophrenia in adult patients.¹ All doses of Cobenfy are intended to be taken by mouth twice daily. Most patients will start on the lowest strength capsule twice daily and increase the dose over the course of the week. After some time, the dose can be increased again based on the response to the medication. Dose increases should only be done at the direction of your prescriber to ensure your safety.¹

Here is Cobenfy dosage information for adults with schizophrenia:

• Typical starting dosage: The recommended starting dose is one 50 mg/20 mg capsule taken by mouth twice daily. This dose should be taken for at least two days before increasing the dose.
• Dosage increases: After at least two days at the starting dose, Cobenfy can be increased to the 100 mg/20 mg capsule twice daily. Patients should stay at this dose for at least five days before increasing the dose further.
• Maximum dosage: The maximum recommended dose for Cobenfy is one 125 mg/30 mg capsule taken twice daily. This dose should only be used if recommended by your prescriber based on your response to the medication.

Cobenfy Dosage Adjustments

There are many reasons your prescriber may decide to adjust your dose throughout therapy. Some of the reasons are listed below. Remember, never change your dose or stop taking Cobenfy without the direction of your provider.

Dosage for Geriatric Patients

It is recommended that elderly patients increase the dose of Cobenfy slower than other people. Patients over 65 years old will also have a maximum dose of Cobenfy of 100mg/20mg twice daily.

In elderly patients, Cobenfy can cause more severe side effects at lower doses than adults aged 18 to 65. Additionally, elderly patients are more likely to have other diseases that can be made worse by Cobenfy side effects. A reminder that Cobenfy has not been studied in geriatric patients and should be used with caution, only at the direction of a prescriber.¹

Dosage for Adults With Impaired Renal Function

Studies have shown that patients with less than normal functioning kidneys, have higher amounts of Cobenfy in their body. Patients with mild kidney function impairment can take normal doses of Cobenfy. However, if you have severe renal impairment, taking Cobenfy is not recommended. Your doctor will determine how healthy your kidneys are and if Cobenfy is safe for you.¹

Dosage for Patients With Liver Disease

Patients with any amount of liver disease or hepatic impairment should not take Cobenfy. A liver that is not functioning properly can cause dangerously high amounts of xanomeline in their body. This is dangerous for patients and can cause many severe side effects. If you are unsure of the health of your liver, your provider will conduct blood tests before beginning prescribing Cobenfy.

What If I Miss a Dose of Cobenfy?

If you miss one Cobenfy dose and it is more than 8 hours before the next dose, take the missed dose right away. If you realize you have missed a dose but it is near the next dose time, skip the missed dose and take your next regularly prescribed dose. DO NOT double up on a dose to catch up or make up doses. This can cause more serious side effects than usual and is dangerous.¹

If you have missed more than one dose in a row, reach out to your prescriber for direction. In some cases it may be necessary to restart Cobenfy at a lower dose and slowly increase again.¹

You should never suddenly stop taking your medication. Talk with your healthcare provider if you would like to stop taking your medication. They will help you create a plan to taper (slowly reduce) the medication.

Can You Overdose on Cobenfy?

Yes, it is possible to overdose on Cobenfy. Overdose from Cobenfy is unique, however, since it is a combination of two medications, xanomeline and trospium chloride. These two medications work in opposite ways in the body. This means an overdose from Cobenfy can have a wide array of symptoms depending on the specific drug in excess. Familiarize yourself with the signs of an overdose below and always be on the lookout for these symptoms.

Signs of an overdose on Cobenfy include:¹

Overdose of xanomeline:

• Seizures
• Vomiting
• Diarrhea
• Abdominal pain
• Over salivation or spit production
• Excessive sweating
• Low blood pressure or fainting

Overdose of trospium chloride:

• Delirium
• Agitation
• Garbled speech
• Dizziness
• High blood pressure
• Fast heart beat
• Dry mouth or eyes
• Blurred vision
• Urinary retention

What Should You Do If You Take Too Much Cobenfy?

Contact your provider, call 911, or call the Poison Help Line at 1-800-222-1222 if you suspect an overdose. Time is crucial and it is better to be safe and get help even if you are unsure.

How to Save Money on Cobenfy

Cobenfy is a newly approved medication and therefore is only available as a name brand medication. It will be many years before a lower cost, generic version will be available. However, there are many options for obtaining Cobenfy for a reasonable price. Several factors may impact the cost of your Cobenfy prescription, including your choice of pharmacy, and the specific dosage prescribed by your provider.

If you have insurance, work with your provider and pharmacy to ensure proper billing and approval. You can also check with your insurance company for a copay estimate before picking up your prescription. Be aware that deductibles or higher tiered copays may apply. If your copay is too high or you do not have insurance, visit the Cobenfy official website. There you can sign up for or see if you qualify for copay assistance.