Cobenfy

Overview

trospium

anticholinergic

• anticholinergic effects
• CNS depression
• potential for modified drug release
• tachycardia

• avoid combo with beverages or products containing ethanol within 2h of trospium extended-release (ER) capsules administration; combo may incr. trospium release rate, levels, risk of adverse effects, decr. duration of efficacy

xanomeline

cholinergic agent

• CYP2D6 substrate
• CYP3A4 inhibitor, weak
• P-gp inhibitor, weak

Contraindicated

• cisapride
Cobenfy (xanomeline/ trospium)

+

cisapride

2 interactions

Contraindicated

xanomeline + cisapride

contraindicated: combo may incr. cisapride levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + cisapride

caution advised: combo may decr. cisapride efficacy (antagonistic effects)

• colchicine
Cobenfy (xanomeline/ trospium)

+

colchicine

1 interaction

Contraindicated

xanomeline + colchicine

CV RISK REDUCTION: consider monitoring CK, myopathy s/sx; GOUT OR FMF: contraindicated in pts w/ renal or hepatic impairment; otherwise, use alternative or consider decr. colchicine dose during and x14 days after xanomeline use: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• eliglustat
Cobenfy (xanomeline/ trospium)

+

eliglustat

1 interaction

Contraindicated

xanomeline + eliglustat

CYP2D6 EM: contraindicated if Child-Pugh Class A and if also combined w/ moderate or strong CYP2D6 inhibitor; if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 IM: if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 PM: avoid combo: combo may incr. eliglustat levels, risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• potassium chloride
Cobenfy (xanomeline/ trospium)

+

potassium chloride

1 interaction

Contraindicated

trospium + potassium chloride

contraindicated w/ solid potassium formulations; consider alternative, incl. liquid potassium formulations: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• potassium citrate
Cobenfy (xanomeline/ trospium)

+

potassium citrate

1 interaction

Contraindicated

trospium + potassium citrate

contraindicated w/ solid potassium formulations; consider alternative, incl. liquid potassium formulations: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

Avoid/Use Alternative

• aclidinium inhaled
Cobenfy (xanomeline/ trospium)

+

aclidinium inhaled

1 interaction

Avoid/Use Alternative

trospium + aclidinium inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• alprazolam
Cobenfy (xanomeline/ trospium)

+

alprazolam

2 interactions

Avoid/Use Alternative

xanomeline + alprazolam

use alternative or monitor respiratory rate; consider decr. alprazolam dose: combo may incr. alprazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

Monitor/Modify Tx

trospium + alprazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• apixaban
Cobenfy (xanomeline/ trospium)

+

apixaban

1 interaction

Avoid/Use Alternative

xanomeline + apixaban

ADULT PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, decr. apixaban 5mg bid or 10 mg bid dose by 50% or avoid combo if already on 2.5 mg bid; PEDS PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• benztropine
Cobenfy (xanomeline/ trospium)

+

benztropine

1 interaction

Avoid/Use Alternative

trospium + benztropine

consider alternative or monitor HR: combo may incr. risk of tachycardia, life-threatening anticholinergic adverse effects, including constipation, paralytic ileus, hyperthermia (additive effects)

• butalbital
Cobenfy (xanomeline/ trospium)

+

butalbital

1 interaction

Avoid/Use Alternative

trospium + butalbital

avoid combo: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• clonidine
Cobenfy (xanomeline/ trospium)

+

clonidine

1 interaction

Avoid/Use Alternative

trospium + clonidine

if ADHD use, avoid combo; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• clozapine
Cobenfy (xanomeline/ trospium)

+

clozapine

2 interactions

Avoid/Use Alternative

trospium + clozapine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment, life-threatening anticholinergic adverse effects, including constipation, paralytic ileus (additive effects)

Monitor/Modify Tx

xanomeline + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (GI metabolism possibly inhibited)

• codeine
Cobenfy (xanomeline/ trospium)

+

codeine

2 interactions

Avoid/Use Alternative

trospium + codeine

avoid combo if antitussive use; otherwise monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

xanomeline + codeine

use alternative or monitor respiratory rate, consider decr. codeine dose: combo may incr. codeine and active metabolite morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited, may incr. production of active metabolite morphine)

• dabigatran
Cobenfy (xanomeline/ trospium)

+

dabigatran

1 interaction

Avoid/Use Alternative

xanomeline + dabigatran

ATRIAL FIBRILLATION: avoid combo if CrCl <30 mL/min; OTHER INDICATIONS: avoid combo if CrCl <50 mL/min; if dabigatran use for DVT/PE prophylaxis post-hip replacement and CrCl >50 mL/min, consider separating admin. at least 2h apart: combo may incr. dabigatran levels, risk of bleeding (including life-threatening), other adverse effects (gut P-gp-mediated transport possibly inhibited)

• doxylamine
Cobenfy (xanomeline/ trospium)

+

doxylamine

1 interaction

Avoid/Use Alternative

trospium + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting, otherwise caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• dronabinol
Cobenfy (xanomeline/ trospium)

+

dronabinol

1 interaction

Avoid/Use Alternative

trospium + dronabinol

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment, tachycardia (additive effects)

• eluxadoline
Cobenfy (xanomeline/ trospium)

+

eluxadoline

1 interaction

Avoid/Use Alternative

trospium + eluxadoline

avoid combo: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• ensartinib
Cobenfy (xanomeline/ trospium)

+

ensartinib

1 interaction

Avoid/Use Alternative

xanomeline + ensartinib

avoid combo: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• ephedra
Cobenfy (xanomeline/ trospium)

+

ephedra

1 interaction

Avoid/Use Alternative

trospium + ephedra

avoid combo: combo may incr. risk of tachycardia (additive effects)

• epinephrine inhaled
Cobenfy (xanomeline/ trospium)

+

epinephrine inhaled

1 interaction

Avoid/Use Alternative

trospium + epinephrine inhaled

avoid combo: combo may incr. risk of tachycardia (additive effects)

• ethanol (alcoholic beverage)
Cobenfy (xanomeline/ trospium)

+

ethanol (alcoholic beverage)

1 interaction

Avoid/Use Alternative

trospium + ethanol (alcoholic beverage)

avoid combo: combo with all trospium formulations may incr. risk of profound CNS and respiratory depression, psychomotor impairment; coingestion of oral ethanol with trospium ER capsules may incr. trospium levels, further incr. risk of adverse effects, decr. duration of trospium efficacy; dose dumping not observed with other trospium formulations (additive effects; rapid release from trospium ER)

• ethanol injection
Cobenfy (xanomeline/ trospium)

+

ethanol injection

1 interaction

Avoid/Use Alternative

trospium + ethanol injection

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• glucagon
Cobenfy (xanomeline/ trospium)

+

glucagon

1 interaction

Avoid/Use Alternative

trospium + glucagon

avoid combo if glucagon used as radiologic diagnostic aid: combo may incr. risk of severe constipation, paralytic ileus, other GI adverse effects (additive effects)

• glycopyrrolate inhaled
Cobenfy (xanomeline/ trospium)

+

glycopyrrolate inhaled

1 interaction

Avoid/Use Alternative

trospium + glycopyrrolate inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• glycopyrronium topical
Cobenfy (xanomeline/ trospium)

+

glycopyrronium topical

1 interaction

Avoid/Use Alternative

trospium + glycopyrronium topical

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• haloperidol
Cobenfy (xanomeline/ trospium)

+

haloperidol

1 interaction

Avoid/Use Alternative

trospium + haloperidol

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• hydrocodone
Cobenfy (xanomeline/ trospium)

+

hydrocodone

2 interactions

Avoid/Use Alternative

trospium + hydrocodone

avoid combo if antitussive use; otherwise monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

xanomeline + hydrocodone

use alternative or monitor respiratory rate, ECG, consider decr. (benz)hydrocodone dose: combo may incr. hydrocodone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• ipratropium inhaled
Cobenfy (xanomeline/ trospium)

+

ipratropium inhaled

1 interaction

Avoid/Use Alternative

trospium + ipratropium inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• isocarboxazid
Cobenfy (xanomeline/ trospium)

+

isocarboxazid

1 interaction

Avoid/Use Alternative

trospium + isocarboxazid

use alternative during and x10 days after isocarboxazid use: combo may incr. risk of CNS depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• kava
Cobenfy (xanomeline/ trospium)

+

kava

1 interaction

Avoid/Use Alternative

trospium + kava

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• kratom
Cobenfy (xanomeline/ trospium)

+

kratom

1 interaction

Avoid/Use Alternative

trospium + kratom

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• meperidine
Cobenfy (xanomeline/ trospium)

+

meperidine

2 interactions

Avoid/Use Alternative

xanomeline + meperidine

use alternative or monitor respiratory rate, ECG w/ oral meperidine: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Monitor/Modify Tx

trospium + meperidine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• metaxalone
Cobenfy (xanomeline/ trospium)

+

metaxalone

1 interaction

Avoid/Use Alternative

trospium + metaxalone

use alternative or monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• methadone
Cobenfy (xanomeline/ trospium)

+

methadone

2 interactions

Avoid/Use Alternative

xanomeline + methadone

use alternative or monitor respiratory rate, ECG, consider decr. methadone dose w/ oral methadone: combo may incr. methadone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Monitor/Modify Tx

trospium + methadone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• metoclopramide
Cobenfy (xanomeline/ trospium)

+

metoclopramide

1 interaction

Avoid/Use Alternative

trospium + metoclopramide

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may decr. metoclopramide efficacy (additive effects; antagonistic effects; absorption of oral metoclopramide affected by delayed gastric emptying)

• midazolam
Cobenfy (xanomeline/ trospium)

+

midazolam

2 interactions

Avoid/Use Alternative

trospium + midazolam

use alternative or monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

xanomeline + midazolam

monitor respiratory rate w/ oral midazolam: combo may incr. midazolam and active metabolite levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

• neratinib
Cobenfy (xanomeline/ trospium)

+

neratinib

1 interaction

Avoid/Use Alternative

xanomeline + neratinib

avoid combo if also combined w/ mod-strong CYP3A4 inhibitor; otherwise, caution advised: combo may incr. neratinib levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• olanzapine
Cobenfy (xanomeline/ trospium)

+

olanzapine

1 interaction

Avoid/Use Alternative

trospium + olanzapine

consider alternative or monitor BP: combo may incr. risk of CNS depression, psychomotor impairment, hypotension (including orthostasis), life-threatening anticholinergic adverse effects, including constipation, paralytic ileus, hyperthermia (additive effects)

• oxybate
Cobenfy (xanomeline/ trospium)

+

oxybate

1 interaction

Avoid/Use Alternative

trospium + oxybate

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, syncope (additive effects)

• oxycodone
Cobenfy (xanomeline/ trospium)

+

oxycodone

2 interactions

Avoid/Use Alternative

xanomeline + oxycodone

use alternative or monitor respiratory rate; consider decr. oxycodone dose: combo may incr. oxycodone levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

Monitor/Modify Tx

trospium + oxycodone

monitor respiratory rate; decr. oxycodone start dose by at least 50%, consider decr. trospium dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• phenelzine
Cobenfy (xanomeline/ trospium)

+

phenelzine

1 interaction

Avoid/Use Alternative

trospium + phenelzine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• pimozide
Cobenfy (xanomeline/ trospium)

+

pimozide

2 interactions

Avoid/Use Alternative

xanomeline + pimozide

use alternative or monitor ECG: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + pimozide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• pralsetinib
Cobenfy (xanomeline/ trospium)

+

pralsetinib

1 interaction

Avoid/Use Alternative

xanomeline + pralsetinib

use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• pramlintide
Cobenfy (xanomeline/ trospium)

+

pramlintide

1 interaction

Avoid/Use Alternative

trospium + pramlintide

consider alternative: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• promethazine
Cobenfy (xanomeline/ trospium)

+

promethazine

1 interaction

Avoid/Use Alternative

trospium + promethazine

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• propafenone
Cobenfy (xanomeline/ trospium)

+

propafenone

1 interaction

Avoid/Use Alternative

xanomeline + propafenone

if CYP2D6 poor metabolizer or if also combined w/ CYP2D6 inhibitor, avoid combo; otherwise, monitor ECG, BP: combo may incr. propafenone levels, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (GI metabolism possibly inhibited)

• relugolix
Cobenfy (xanomeline/ trospium)

+

relugolix

1 interaction

Avoid/Use Alternative

xanomeline + relugolix

PROSTATE CANCER: may hold relugolix if xanomeline tx up to 2wk; otherwise, use alternative or monitor ECG, electrolytes and admin. relugolix at least 6h before xanomeline; FIBROID-ASSOC. BLEEDING: use alternative or admin. relugolix at least 6h before xanomeline: combo may incr. relugolix levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• repotrectinib
Cobenfy (xanomeline/ trospium)

+

repotrectinib

2 interactions

Avoid/Use Alternative

xanomeline + repotrectinib

avoid combo: combo may incr. repotrectinib levels, risk of adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

Caution Advised

trospium + repotrectinib

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• revefenacin inhaled
Cobenfy (xanomeline/ trospium)

+

revefenacin inhaled

1 interaction

Avoid/Use Alternative

trospium + revefenacin inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• rivaroxaban
Cobenfy (xanomeline/ trospium)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

xanomeline + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• rivastigmine
Cobenfy (xanomeline/ trospium)

+

rivastigmine

1 interaction

Avoid/Use Alternative

trospium + rivastigmine

use alternative: combo may decr. efficacy of both drugs (antagonistic effects)

• ropeginterferon alfa-2b
Cobenfy (xanomeline/ trospium)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

trospium + ropeginterferon alfa-2b

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• scopolamine
Cobenfy (xanomeline/ trospium)

+

scopolamine

1 interaction

Avoid/Use Alternative

trospium + scopolamine

use alternative: combo may increase risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• simvastatin
Cobenfy (xanomeline/ trospium)

+

simvastatin

1 interaction

Avoid/Use Alternative

xanomeline + simvastatin

use alternative or monitor CK, myopathy sx; adjust max simvastatin dose to 20 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (GI metabolism possibly inhibited)

• sofpironium topical
Cobenfy (xanomeline/ trospium)

+

sofpironium topical

1 interaction

Avoid/Use Alternative

trospium + sofpironium topical

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• thalidomide
Cobenfy (xanomeline/ trospium)

+

thalidomide

1 interaction

Avoid/Use Alternative

trospium + thalidomide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tiotropium inhaled
Cobenfy (xanomeline/ trospium)

+

tiotropium inhaled

1 interaction

Avoid/Use Alternative

trospium + tiotropium inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• topotecan
Cobenfy (xanomeline/ trospium)

+

topotecan

1 interaction

Avoid/Use Alternative

xanomeline + topotecan

avoid combo w/ oral topotecan: combo may incr. topotecan levels, risk of serious infection, myelosuppression, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• tradipitant
Cobenfy (xanomeline/ trospium)

+

tradipitant

1 interaction

Avoid/Use Alternative

trospium + tradipitant

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tranylcypromine
Cobenfy (xanomeline/ trospium)

+

tranylcypromine

1 interaction

Avoid/Use Alternative

trospium + tranylcypromine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• trimethobenzamide
Cobenfy (xanomeline/ trospium)

+

trimethobenzamide

1 interaction

Avoid/Use Alternative

trospium + trimethobenzamide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• trospium
Cobenfy (xanomeline/ trospium)

+

trospium

1 interaction

Avoid/Use Alternative

trospium + trospium

avoid combo: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic and other adverse effects (additive effects, duplicate therapy)

• umeclidinium inhaled
Cobenfy (xanomeline/ trospium)

+

umeclidinium inhaled

1 interaction

Avoid/Use Alternative

trospium + umeclidinium inhaled

avoid combo: combo may incr. risk of anticholinergic adverse effects (additive effects)

• venetoclax
Cobenfy (xanomeline/ trospium)

+

venetoclax

1 interaction

Avoid/Use Alternative

xanomeline + venetoclax

monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50%; AML: decr. venetoclax dose by at least 50%: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• zuranolone
Cobenfy (xanomeline/ trospium)

+

zuranolone

1 interaction

Avoid/Use Alternative

trospium + zuranolone

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

• abemaciclib
Cobenfy (xanomeline/ trospium)

+

abemaciclib

1 interaction

Monitor/Modify Tx

xanomeline + abemaciclib

monitor CBC: combo may incr. abemaciclib levels, risk of serious infection, myelosuppression, thromboembolism, other adverse effects (GI metabolism possibly inhibited)

• acalabrutinib
Cobenfy (xanomeline/ trospium)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

xanomeline + acalabrutinib

monitor CBC: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (GI metabolism possibly inhibited)

• afatinib
Cobenfy (xanomeline/ trospium)

+

afatinib

1 interaction

Monitor/Modify Tx

xanomeline + afatinib

decr. afatinib dose by 10 mg/day if not tolerated: combo may incr. afatinib levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• albuterol
Cobenfy (xanomeline/ trospium)

+

albuterol

1 interaction

Monitor/Modify Tx

trospium + albuterol

monitor HR: combo may incr. risk of tachycardia (additive effects)

• albuterol inhaled
Cobenfy (xanomeline/ trospium)

+

albuterol inhaled

1 interaction

Monitor/Modify Tx

trospium + albuterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• aldesleukin
Cobenfy (xanomeline/ trospium)

+

aldesleukin

1 interaction

Monitor/Modify Tx

trospium + aldesleukin

withhold aldesleukin if mod-severe somnolence occurs; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• alfentanil
Cobenfy (xanomeline/ trospium)

+

alfentanil

1 interaction

Monitor/Modify Tx

trospium + alfentanil

monitor BP, respiratory rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, severe constipation, paralytic ileus, urinary retention (additive effects)

• amiodarone
Cobenfy (xanomeline/ trospium)

+

amiodarone

1 interaction

Monitor/Modify Tx

xanomeline + amiodarone

monitor ECG w/ oral amiodarone: combo may incr. amiodarone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• amitriptyline
Cobenfy (xanomeline/ trospium)

+

amitriptyline

1 interaction

Monitor/Modify Tx

trospium + amitriptyline

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, hyperthermia, anticholinergic adverse effects (additive effects)

• amoxapine
Cobenfy (xanomeline/ trospium)

+

amoxapine

1 interaction

Monitor/Modify Tx

trospium + amoxapine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• amphetamine
Cobenfy (xanomeline/ trospium)

+

amphetamine

1 interaction

Monitor/Modify Tx

trospium + amphetamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• arformoterol inhaled
Cobenfy (xanomeline/ trospium)

+

arformoterol inhaled

1 interaction

Monitor/Modify Tx

trospium + arformoterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• armodafinil
Cobenfy (xanomeline/ trospium)

+

armodafinil

1 interaction

Monitor/Modify Tx

trospium + armodafinil

monitor HR: combo may incr. risk of tachycardia (additive effects)

• atomoxetine
Cobenfy (xanomeline/ trospium)

+

atomoxetine

1 interaction

Monitor/Modify Tx

trospium + atomoxetine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• atorvastatin
Cobenfy (xanomeline/ trospium)

+

atorvastatin

1 interaction

Monitor/Modify Tx

xanomeline + atorvastatin

monitor CK, myopathy sx: combo may incr. atorvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• atropine
Cobenfy (xanomeline/ trospium)

+

atropine

1 interaction

Monitor/Modify Tx

trospium + atropine

monitor HR: combo may incr. risk of tachycardia, anticholinergic adverse effects (additive effects)

• avanafil
Cobenfy (xanomeline/ trospium)

+

avanafil

1 interaction

Monitor/Modify Tx

xanomeline + avanafil

monitor BP; consider decr. avanafil dose: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (GI metabolism possibly inhibited)

• avapritinib
Cobenfy (xanomeline/ trospium)

+

avapritinib

1 interaction

Monitor/Modify Tx

xanomeline + avapritinib

monitor bleeding s/sx: combo may incr. avapritinib levels, risk of bleeding (including life-threatening), other adverse effects (GI metabolism possibly inhibited)

• baclofen intrathecal
Cobenfy (xanomeline/ trospium)

+

baclofen intrathecal

1 interaction

Monitor/Modify Tx

trospium + baclofen intrathecal

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• benzphetamine
Cobenfy (xanomeline/ trospium)

+

benzphetamine

1 interaction

Monitor/Modify Tx

trospium + benzphetamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• brigatinib
Cobenfy (xanomeline/ trospium)

+

brigatinib

1 interaction

Monitor/Modify Tx

xanomeline + brigatinib

monitor BP, HR: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects (GI metabolism possibly inhibited)

• buprenorphine
Cobenfy (xanomeline/ trospium)

+

buprenorphine

1 interaction

Monitor/Modify Tx

trospium + buprenorphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• butorphanol
Cobenfy (xanomeline/ trospium)

+

butorphanol

1 interaction

Monitor/Modify Tx

trospium + butorphanol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• caffeine
Cobenfy (xanomeline/ trospium)

+

caffeine

1 interaction

Monitor/Modify Tx

trospium + caffeine

monitor HR; avoid excessive caffeine intake: combo may incr. risk of tachycardia (additive effects)

• caffeine citrate
Cobenfy (xanomeline/ trospium)

+

caffeine citrate

1 interaction

Monitor/Modify Tx

trospium + caffeine citrate

monitor HR: combo may incr. risk of tachycardia (additive effects)

• cannabis
Cobenfy (xanomeline/ trospium)

+

cannabis

1 interaction

Monitor/Modify Tx

trospium + cannabis

monitor HR: combo may incr. risk of CNS depression, psychomotor impairment, tachycardia (additive effects)

• capivasertib
Cobenfy (xanomeline/ trospium)

+

capivasertib

1 interaction

Monitor/Modify Tx

xanomeline + capivasertib

monitor glucose: combo may incr. capivasertib levels, risk of severe hyperglycemia, other adverse effects (GI metabolism possibly inhibited)

• carbamazepine
Cobenfy (xanomeline/ trospium)

+

carbamazepine

2 interactions

Monitor/Modify Tx

trospium + carbamazepine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

xanomeline + carbamazepine

monitor carbamazepine levels: combo may incr. carbamazepine levels, risk of adverse effects (GI metabolism possibly inhibited)

• chlordiazepoxide
Cobenfy (xanomeline/ trospium)

+

chlordiazepoxide

1 interaction

Monitor/Modify Tx

trospium + chlordiazepoxide

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• chlorpromazine
Cobenfy (xanomeline/ trospium)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

trospium + chlorpromazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• clobazam
Cobenfy (xanomeline/ trospium)

+

clobazam

1 interaction

Monitor/Modify Tx

trospium + clobazam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• clomipramine
Cobenfy (xanomeline/ trospium)

+

clomipramine

1 interaction

Monitor/Modify Tx

trospium + clomipramine

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• clonazepam
Cobenfy (xanomeline/ trospium)

+

clonazepam

1 interaction

Monitor/Modify Tx

trospium + clonazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• clorazepate
Cobenfy (xanomeline/ trospium)

+

clorazepate

1 interaction

Monitor/Modify Tx

trospium + clorazepate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• cocaine
Cobenfy (xanomeline/ trospium)

+

cocaine

1 interaction

Monitor/Modify Tx

trospium + cocaine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• cyclosporine
Cobenfy (xanomeline/ trospium)

+

cyclosporine

1 interaction

Monitor/Modify Tx

xanomeline + cyclosporine

monitor oral cyclosporine levels, renal fxn: combo may incr. cyclosporine levels, risk of serious infection, nephrotoxicity, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• daridorexant
Cobenfy (xanomeline/ trospium)

+

daridorexant

2 interactions

Monitor/Modify Tx

trospium + daridorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Caution Advised

xanomeline + daridorexant

caution advised: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

• desflurane
Cobenfy (xanomeline/ trospium)

+

desflurane

1 interaction

Monitor/Modify Tx

trospium + desflurane

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• desipramine
Cobenfy (xanomeline/ trospium)

+

desipramine

1 interaction

Monitor/Modify Tx

trospium + desipramine

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• dexmedetomidine
Cobenfy (xanomeline/ trospium)

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

trospium + dexmedetomidine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexmedetomidine injection
Cobenfy (xanomeline/ trospium)

+

dexmedetomidine injection

1 interaction

Monitor/Modify Tx

trospium + dexmedetomidine injection

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• dexmethylphenidate
Cobenfy (xanomeline/ trospium)

+

dexmethylphenidate

1 interaction

Monitor/Modify Tx

trospium + dexmethylphenidate

monitor HR: combo may incr. risk of tachycardia (additive effects)

• dextroamphetamine
Cobenfy (xanomeline/ trospium)

+

dextroamphetamine

1 interaction

Monitor/Modify Tx

trospium + dextroamphetamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• diazepam
Cobenfy (xanomeline/ trospium)

+

diazepam

1 interaction

Monitor/Modify Tx

trospium + diazepam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• dicyclomine
Cobenfy (xanomeline/ trospium)

+

dicyclomine

1 interaction

Monitor/Modify Tx

trospium + dicyclomine

monitor HR: combo may incr. risk of tachycardia, anticholinergic adverse effects (additive effects)

• diethylpropion
Cobenfy (xanomeline/ trospium)

+

diethylpropion

1 interaction

Monitor/Modify Tx

trospium + diethylpropion

monitor HR: combo may incr. risk of tachycardia (additive effects)

• digoxin
Cobenfy (xanomeline/ trospium)

+

digoxin

1 interaction

Monitor/Modify Tx

xanomeline + digoxin

monitor oral digoxin levels, HR; decr. oral digoxin frequency or dose by 15-30%: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• dihydrocodeine
Cobenfy (xanomeline/ trospium)

+

dihydrocodeine

1 interaction

Monitor/Modify Tx

trospium + dihydrocodeine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• disopyramide
Cobenfy (xanomeline/ trospium)

+

disopyramide

2 interactions

Monitor/Modify Tx

xanomeline + disopyramide

monitor disopyramide levels, ECG: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + disopyramide

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• dobutamine
Cobenfy (xanomeline/ trospium)

+

dobutamine

1 interaction

Monitor/Modify Tx

trospium + dobutamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• dofetilide
Cobenfy (xanomeline/ trospium)

+

dofetilide

1 interaction

Monitor/Modify Tx

xanomeline + dofetilide

monitor ECG: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• domperidone
Cobenfy (xanomeline/ trospium)

+

domperidone

2 interactions

Monitor/Modify Tx

xanomeline + domperidone

monitor ECG, HR, electrolytes: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + domperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may decr. domperidone efficacy (additive effects; antagonistic effects)

• dopamine
Cobenfy (xanomeline/ trospium)

+

dopamine

1 interaction

Monitor/Modify Tx

trospium + dopamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• doxepin
Cobenfy (xanomeline/ trospium)

+

doxepin

1 interaction

Monitor/Modify Tx

trospium + doxepin

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, hyperthermia, anticholinergic adverse effects (additive effects)

• droperidol
Cobenfy (xanomeline/ trospium)

+

droperidol

1 interaction

Monitor/Modify Tx

trospium + droperidol

decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• edoxaban
Cobenfy (xanomeline/ trospium)

+

edoxaban

1 interaction

Monitor/Modify Tx

xanomeline + edoxaban

monitor bleeding s/sx: combo may incr. edoxaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• encorafenib
Cobenfy (xanomeline/ trospium)

+

encorafenib

1 interaction

Monitor/Modify Tx

xanomeline + encorafenib

monitor ECG: combo may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• entrectinib
Cobenfy (xanomeline/ trospium)

+

entrectinib

2 interactions

Monitor/Modify Tx

xanomeline + entrectinib

monitor ECG, CBC: combo may incr. entrectinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + entrectinib

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ephedrine injection
Cobenfy (xanomeline/ trospium)

+

ephedrine injection

1 interaction

Monitor/Modify Tx

trospium + ephedrine injection

monitor HR: combo may incr. risk of tachycardia (additive effects)

• ephedrine oral
Cobenfy (xanomeline/ trospium)

+

ephedrine oral

1 interaction

Monitor/Modify Tx

trospium + ephedrine oral

monitor HR: combo may incr. risk of tachycardia (additive effects)

• epinephrine
Cobenfy (xanomeline/ trospium)

+

epinephrine

1 interaction

Monitor/Modify Tx

trospium + epinephrine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• eplerenone
Cobenfy (xanomeline/ trospium)

+

eplerenone

1 interaction

Monitor/Modify Tx

xanomeline + eplerenone

monitor potassium: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (GI metabolism possibly inhibited)

• erythromycin
Cobenfy (xanomeline/ trospium)

+

erythromycin

2 interactions

Monitor/Modify Tx

xanomeline + erythromycin

monitor ECG w/ oral erythromycin: combo may incr. erythromycin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + erythromycin

caution advised: combo may decr. erythromycin efficacy when used for GI promotility (antagonistic effects)

• esketamine
Cobenfy (xanomeline/ trospium)

+

esketamine

1 interaction

Monitor/Modify Tx

trospium + esketamine

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• estazolam
Cobenfy (xanomeline/ trospium)

+

estazolam

1 interaction

Monitor/Modify Tx

trospium + estazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• eszopiclone
Cobenfy (xanomeline/ trospium)

+

eszopiclone

1 interaction

Monitor/Modify Tx

trospium + eszopiclone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ethanol (in some formulations)
Cobenfy (xanomeline/ trospium)

+

ethanol (in some formulations)

1 interaction

Monitor/Modify Tx

trospium + ethanol (in some formulations)

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• etomidate
Cobenfy (xanomeline/ trospium)

+

etomidate

1 interaction

Monitor/Modify Tx

trospium + etomidate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• everolimus
Cobenfy (xanomeline/ trospium)

+

everolimus

1 interaction

Monitor/Modify Tx

xanomeline + everolimus

TSC-ASSOC. SEGA, TSC-ASSOC. PARTIAL ONSET SEIZURES, TRANSPLANT: monitor everolimus levels, CBC; OTHER INDICATIONS: monitor CBC: combo may incr. everolimus levels, risk of myelosuppression, other adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• fedratinib
Cobenfy (xanomeline/ trospium)

+

fedratinib

1 interaction

Monitor/Modify Tx

xanomeline + fedratinib

if fedratinib also combined w/ CYP2C19 inhibitor, monitor CBC, LFTs: combo may incr. fedratinib levels, risk myelosuppression, hepatotoxicity, other adverse effects (GI metabolism possibly inhibited)

• felodipine
Cobenfy (xanomeline/ trospium)

+

felodipine

1 interaction

Monitor/Modify Tx

xanomeline + felodipine

monitor BP, HR: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (GI metabolism possibly inhibited)

• fentanyl
Cobenfy (xanomeline/ trospium)

+

fentanyl

1 interaction

Monitor/Modify Tx

trospium + fentanyl

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• finerenone
Cobenfy (xanomeline/ trospium)

+

finerenone

1 interaction

Monitor/Modify Tx

xanomeline + finerenone

monitor potassium: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (GI metabolism possibly inhibited)

• flibanserin
Cobenfy (xanomeline/ trospium)

+

flibanserin

2 interactions

Monitor/Modify Tx

xanomeline + flibanserin

monitor BP, especially if flibanserin also combined w/ other weak CYP3A4 inhibitors: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + flibanserin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fluphenazine
Cobenfy (xanomeline/ trospium)

+

fluphenazine

1 interaction

Monitor/Modify Tx

trospium + fluphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• flurazepam
Cobenfy (xanomeline/ trospium)

+

flurazepam

1 interaction

Monitor/Modify Tx

trospium + flurazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• formoterol inhaled
Cobenfy (xanomeline/ trospium)

+

formoterol inhaled

1 interaction

Monitor/Modify Tx

trospium + formoterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• gabapentin
Cobenfy (xanomeline/ trospium)

+

gabapentin

1 interaction

Monitor/Modify Tx

trospium + gabapentin

monitor respiratory rate; consider decreasing gabapentin dose: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• gabapentin enacarbil
Cobenfy (xanomeline/ trospium)

+

gabapentin enacarbil

1 interaction

Monitor/Modify Tx

trospium + gabapentin enacarbil

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• gepirone
Cobenfy (xanomeline/ trospium)

+

gepirone

1 interaction

Monitor/Modify Tx

xanomeline + gepirone

monitor ECG, electrolytes: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• glycopyrrolate
Cobenfy (xanomeline/ trospium)

+

glycopyrrolate

1 interaction

Monitor/Modify Tx

trospium + glycopyrrolate

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• hoodia
Cobenfy (xanomeline/ trospium)

+

hoodia

1 interaction

Monitor/Modify Tx

trospium + hoodia

monitor HR: combo may incr. risk of tachycardia (additive effects)

• hydromorphone
Cobenfy (xanomeline/ trospium)

+

hydromorphone

1 interaction

Monitor/Modify Tx

trospium + hydromorphone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• hydroxyzine
Cobenfy (xanomeline/ trospium)

+

hydroxyzine

1 interaction

Monitor/Modify Tx

trospium + hydroxyzine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• hyoscyamine
Cobenfy (xanomeline/ trospium)

+

hyoscyamine

1 interaction

Monitor/Modify Tx

trospium + hyoscyamine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• ibrutinib
Cobenfy (xanomeline/ trospium)

+

ibrutinib

1 interaction

Monitor/Modify Tx

xanomeline + ibrutinib

consider decr. ibrutinib dose: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (GI metabolism possibly inhibited)

• ifosfamide
Cobenfy (xanomeline/ trospium)

+

ifosfamide

1 interaction

Monitor/Modify Tx

trospium + ifosfamide

D/C one or both drugs if encephalopathy occurs; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• imipramine
Cobenfy (xanomeline/ trospium)

+

imipramine

1 interaction

Monitor/Modify Tx

trospium + imipramine

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• isoflurane
Cobenfy (xanomeline/ trospium)

+

isoflurane

1 interaction

Monitor/Modify Tx

trospium + isoflurane

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• isoproterenol
Cobenfy (xanomeline/ trospium)

+

isoproterenol

1 interaction

Monitor/Modify Tx

trospium + isoproterenol

monitor HR: combo may incr. risk of tachycardia (additive effects)

• ivabradine
Cobenfy (xanomeline/ trospium)

+

ivabradine

1 interaction

Monitor/Modify Tx

xanomeline + ivabradine

monitor HR, ECG: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• ivosidenib
Cobenfy (xanomeline/ trospium)

+

ivosidenib

1 interaction

Monitor/Modify Tx

xanomeline + ivosidenib

monitor ECG: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• ketamine
Cobenfy (xanomeline/ trospium)

+

ketamine

1 interaction

Monitor/Modify Tx

trospium + ketamine

monitor respiratory rate, HR; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression (including life-threatening), psychomotor impairment, tachycardia (additive effects)

• lemborexant
Cobenfy (xanomeline/ trospium)

+

lemborexant

2 interactions

Monitor/Modify Tx

trospium + lemborexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

xanomeline + lemborexant

adjust max lemborexant dose to 5 mg/day: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

• levalbuterol inhaled
Cobenfy (xanomeline/ trospium)

+

levalbuterol inhaled

1 interaction

Monitor/Modify Tx

trospium + levalbuterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• levoketoconazole
Cobenfy (xanomeline/ trospium)

+

levoketoconazole

1 interaction

Monitor/Modify Tx

xanomeline + levoketoconazole

consider monitoring ECG: combo may incr. levoketoconazole levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• levomilnacipran
Cobenfy (xanomeline/ trospium)

+

levomilnacipran

1 interaction

Monitor/Modify Tx

trospium + levomilnacipran

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment (additive effects)

• levorphanol
Cobenfy (xanomeline/ trospium)

+

levorphanol

1 interaction

Monitor/Modify Tx

trospium + levorphanol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• lifileucel
Cobenfy (xanomeline/ trospium)

+

lifileucel

1 interaction

Monitor/Modify Tx

trospium + lifileucel

monitor HR: combo may incr. risk of tachycardia (additive effects)

• liraglutide
Cobenfy (xanomeline/ trospium)

+

liraglutide

1 interaction

Monitor/Modify Tx

trospium + liraglutide

monitor HR: combo may incr. risk of tachycardia (additive effects)

• lisdexamfetamine
Cobenfy (xanomeline/ trospium)

+

lisdexamfetamine

1 interaction

Monitor/Modify Tx

trospium + lisdexamfetamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• lomitapide
Cobenfy (xanomeline/ trospium)

+

lomitapide

1 interaction

Monitor/Modify Tx

xanomeline + lomitapide

ADULT PATIENTS: if patient on stable xanomeline dose and starting lomitapide, adjust max lomitapide dose to 30 mg/day; if patient on stable lomitapide dose and starting xanomeline, decr. lomitapide dose by 50% and adjust max lomitapide dose to 30 mg/day; PEDIATRIC PATIENTS: if patient on stable xanomeline dose and starting lomitapide, adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo; if patient on stable lomitapide dose and starting xanomeline, decr. lomitapide dose by 50% and adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo: combo may incr. lomitapide levels, risk of hepatotoxicity, other adverse effects (GI metabolism possibly inhibited)

• lonafarnib
Cobenfy (xanomeline/ trospium)

+

lonafarnib

1 interaction

Monitor/Modify Tx

xanomeline + lonafarnib

consider monitoring HR, ECG, electrolytes: combo may incr. lonafarnib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• lorazepam
Cobenfy (xanomeline/ trospium)

+

lorazepam

1 interaction

Monitor/Modify Tx

trospium + lorazepam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• lovastatin
Cobenfy (xanomeline/ trospium)

+

lovastatin

1 interaction

Monitor/Modify Tx

xanomeline + lovastatin

monitor CK, myopathy sx: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (GI metabolism possibly inhibited)

• lumateperone
Cobenfy (xanomeline/ trospium)

+

lumateperone

2 interactions

Monitor/Modify Tx

xanomeline + lumateperone

monitor ECG: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + lumateperone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• lurasidone
Cobenfy (xanomeline/ trospium)

+

lurasidone

2 interactions

Monitor/Modify Tx

xanomeline + lurasidone

monitor ECG: combo may incr. lurasidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

Caution Advised

trospium + lurasidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• mavacamten
Cobenfy (xanomeline/ trospium)

+

mavacamten

1 interaction

Monitor/Modify Tx

xanomeline + mavacamten

monitor cardiac fxn, incl. LVEF: combo may incr. mavacamten levels, risk of heart failure, other adverse effects (GI metabolism possibly inhibited)

• mavorixafor
Cobenfy (xanomeline/ trospium)

+

mavorixafor

1 interaction

Monitor/Modify Tx

xanomeline + mavorixafor

monitor ECG: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• methamphetamine
Cobenfy (xanomeline/ trospium)

+

methamphetamine

1 interaction

Monitor/Modify Tx

trospium + methamphetamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• methohexital
Cobenfy (xanomeline/ trospium)

+

methohexital

1 interaction

Monitor/Modify Tx

trospium + methohexital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• methscopolamine
Cobenfy (xanomeline/ trospium)

+

methscopolamine

1 interaction

Monitor/Modify Tx

trospium + methscopolamine

monitor HR: combo may incr. risk of tachycardia, anticholinergic adverse effects (additive effects)

• methylphenidate
Cobenfy (xanomeline/ trospium)

+

methylphenidate

1 interaction

Monitor/Modify Tx

trospium + methylphenidate

monitor HR: combo may incr. risk of tachycardia (additive effects)

• milnacipran
Cobenfy (xanomeline/ trospium)

+

milnacipran

1 interaction

Monitor/Modify Tx

trospium + milnacipran

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment (additive effects)

• mirtazapine
Cobenfy (xanomeline/ trospium)

+

mirtazapine

1 interaction

Monitor/Modify Tx

trospium + mirtazapine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• mobocertinib
Cobenfy (xanomeline/ trospium)

+

mobocertinib

1 interaction

Monitor/Modify Tx

xanomeline + mobocertinib

monitor ECG: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• modafinil
Cobenfy (xanomeline/ trospium)

+

modafinil

1 interaction

Monitor/Modify Tx

trospium + modafinil

monitor HR: combo may incr. risk of tachycardia (additive effects)

• morphine
Cobenfy (xanomeline/ trospium)

+

morphine

2 interactions

Monitor/Modify Tx

trospium + morphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

xanomeline + morphine

monitor respiratory rate, consider decr. dose of one or both drugs w/ oral morphine: combo may incr. morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• nalbuphine
Cobenfy (xanomeline/ trospium)

+

nalbuphine

1 interaction

Monitor/Modify Tx

trospium + nalbuphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• nelarabine
Cobenfy (xanomeline/ trospium)

+

nelarabine

1 interaction

Monitor/Modify Tx

trospium + nelarabine

withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• nifedipine
Cobenfy (xanomeline/ trospium)

+

nifedipine

1 interaction

Monitor/Modify Tx

xanomeline + nifedipine

monitor BP, consider lowest nifedipine start dose: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (GI metabolism possibly inhibited)

• nimodipine
Cobenfy (xanomeline/ trospium)

+

nimodipine

1 interaction

Monitor/Modify Tx

xanomeline + nimodipine

monitor BP: combo may incr. nimodipine levels, risk of hypotension, other adverse effects (GI metabolism possibly inhibited)

• nisoldipine
Cobenfy (xanomeline/ trospium)

+

nisoldipine

1 interaction

Monitor/Modify Tx

xanomeline + nisoldipine

monitor BP: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (GI metabolism possibly inhibited)

• nortriptyline
Cobenfy (xanomeline/ trospium)

+

nortriptyline

1 interaction

Monitor/Modify Tx

trospium + nortriptyline

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• oliceridine
Cobenfy (xanomeline/ trospium)

+

oliceridine

1 interaction

Monitor/Modify Tx

trospium + oliceridine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, severe constipation, paralytic ileus, urinary retention (additive effects)

• olodaterol inhaled
Cobenfy (xanomeline/ trospium)

+

olodaterol inhaled

1 interaction

Monitor/Modify Tx

trospium + olodaterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• opicapone
Cobenfy (xanomeline/ trospium)

+

opicapone

1 interaction

Monitor/Modify Tx

trospium + opicapone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• opium
Cobenfy (xanomeline/ trospium)

+

opium

1 interaction

Monitor/Modify Tx

trospium + opium

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• orphenadrine
Cobenfy (xanomeline/ trospium)

+

orphenadrine

1 interaction

Monitor/Modify Tx

trospium + orphenadrine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• oxazepam
Cobenfy (xanomeline/ trospium)

+

oxazepam

1 interaction

Monitor/Modify Tx

trospium + oxazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• oxybutynin
Cobenfy (xanomeline/ trospium)

+

oxybutynin

1 interaction

Monitor/Modify Tx

trospium + oxybutynin

decr. dose of one or both drugs or consider oxybutynin transdermal patch: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; somnolence less likely with oxybutynin transdermal patch (additive effects)

• oxymorphone
Cobenfy (xanomeline/ trospium)

+

oxymorphone

1 interaction

Monitor/Modify Tx

trospium + oxymorphone

monitor respiratory rate; decr. oxymorphone start dose by at least 50%, consider decr. trospium dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• pacritinib
Cobenfy (xanomeline/ trospium)

+

pacritinib

1 interaction

Monitor/Modify Tx

xanomeline + pacritinib

monitor ECG, CBC, bleeding s/sx: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (including life-threatening), other adverse effects (GI metabolism possibly inhibited)

• pemigatinib
Cobenfy (xanomeline/ trospium)

+

pemigatinib

1 interaction

Monitor/Modify Tx

xanomeline + pemigatinib

monitor phosphate: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (GI metabolism possibly inhibited)

• pentazocine
Cobenfy (xanomeline/ trospium)

+

pentazocine

1 interaction

Monitor/Modify Tx

trospium + pentazocine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• pentobarbital
Cobenfy (xanomeline/ trospium)

+

pentobarbital

1 interaction

Monitor/Modify Tx

trospium + pentobarbital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• perphenazine
Cobenfy (xanomeline/ trospium)

+

perphenazine

1 interaction

Monitor/Modify Tx

trospium + perphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• phendimetrazine
Cobenfy (xanomeline/ trospium)

+

phendimetrazine

1 interaction

Monitor/Modify Tx

trospium + phendimetrazine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• phenobarbital
Cobenfy (xanomeline/ trospium)

+

phenobarbital

1 interaction

Monitor/Modify Tx

trospium + phenobarbital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• phentermine
Cobenfy (xanomeline/ trospium)

+

phentermine

1 interaction

Monitor/Modify Tx

trospium + phentermine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• phenylephrine ophthalmic
Cobenfy (xanomeline/ trospium)

+

phenylephrine ophthalmic

1 interaction

Monitor/Modify Tx

trospium + phenylephrine ophthalmic

monitor HR; risk may be lower w/ phenylephrine ophthalmic 2.5%: combo may incr. risk of tachycardia (additive effects)

• pregabalin
Cobenfy (xanomeline/ trospium)

+

pregabalin

1 interaction

Monitor/Modify Tx

trospium + pregabalin

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• primidone
Cobenfy (xanomeline/ trospium)

+

primidone

1 interaction

Monitor/Modify Tx

trospium + primidone

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• propofol
Cobenfy (xanomeline/ trospium)

+

propofol

1 interaction

Monitor/Modify Tx

trospium + propofol

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• protriptyline
Cobenfy (xanomeline/ trospium)

+

protriptyline

1 interaction

Monitor/Modify Tx

trospium + protriptyline

monitor HR; consider decr. dose of one or both drugs: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, hyperthermia, anticholinergic adverse effects (additive effects)

• pseudoephedrine
Cobenfy (xanomeline/ trospium)

+

pseudoephedrine

1 interaction

Monitor/Modify Tx

trospium + pseudoephedrine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• quazepam
Cobenfy (xanomeline/ trospium)

+

quazepam

1 interaction

Monitor/Modify Tx

trospium + quazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• quinidine (antiarrhythmic)
Cobenfy (xanomeline/ trospium)

+

quinidine (antiarrhythmic)

2 interactions

Monitor/Modify Tx

xanomeline + quinidine (antiarrhythmic)

monitor quinidine levels, ECG: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism possibly inhibited, GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

Caution Advised

trospium + quinidine (antiarrhythmic)

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• ranolazine
Cobenfy (xanomeline/ trospium)

+

ranolazine

1 interaction

Monitor/Modify Tx

xanomeline + ranolazine

monitor ECG: combo may incr. ranolazine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• red yeast rice
Cobenfy (xanomeline/ trospium)

+

red yeast rice

1 interaction

Monitor/Modify Tx

xanomeline + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (GI metabolism possibly inhibited, red yeast rice contains varying amounts of lovastatin)

• remifentanil
Cobenfy (xanomeline/ trospium)

+

remifentanil

1 interaction

Monitor/Modify Tx

trospium + remifentanil

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• remimazolam
Cobenfy (xanomeline/ trospium)

+

remimazolam

1 interaction

Monitor/Modify Tx

trospium + remimazolam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ribociclib
Cobenfy (xanomeline/ trospium)

+

ribociclib

1 interaction

Monitor/Modify Tx

xanomeline + ribociclib

monitor ECG, electrolytes, CBC: combo may incr. ribociclib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (GI metabolism possibly inhibited)

• rotigotine transdermal
Cobenfy (xanomeline/ trospium)

+

rotigotine transdermal

1 interaction

Monitor/Modify Tx

trospium + rotigotine transdermal

monitor HR: combo may incr. risk of CNS depression, psychomotor impairment, tachycardia (additive effects)

• salmeterol inhaled
Cobenfy (xanomeline/ trospium)

+

salmeterol inhaled

1 interaction

Monitor/Modify Tx

trospium + salmeterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• selpercatinib
Cobenfy (xanomeline/ trospium)

+

selpercatinib

1 interaction

Monitor/Modify Tx

xanomeline + selpercatinib

monitor ECG, electrolytes: combo may incr. selpercatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• sevoflurane
Cobenfy (xanomeline/ trospium)

+

sevoflurane

1 interaction

Monitor/Modify Tx

trospium + sevoflurane

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• sirolimus
Cobenfy (xanomeline/ trospium)

+

sirolimus

1 interaction

Monitor/Modify Tx

xanomeline + sirolimus

monitor sirolimus levels: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• solriamfetol
Cobenfy (xanomeline/ trospium)

+

solriamfetol

1 interaction

Monitor/Modify Tx

trospium + solriamfetol

monitor HR: combo may incr. risk of tachycardia (additive effects)

• sufentanil
Cobenfy (xanomeline/ trospium)

+

sufentanil

1 interaction

Monitor/Modify Tx

trospium + sufentanil

monitor respiratory rate; decr. sufentanil start dose, consider decr. trospium dose, use lowest effective doses: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• suvorexant
Cobenfy (xanomeline/ trospium)

+

suvorexant

1 interaction

Monitor/Modify Tx

trospium + suvorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tacrolimus
Cobenfy (xanomeline/ trospium)

+

tacrolimus

1 interaction

Monitor/Modify Tx

xanomeline + tacrolimus

monitor oral tacrolimus levels, ECG, renal fxn: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, other adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• tadalafil
Cobenfy (xanomeline/ trospium)

+

tadalafil

1 interaction

Monitor/Modify Tx

xanomeline + tadalafil

monitor BP: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (GI metabolism possibly inhibited)

• talazoparib
Cobenfy (xanomeline/ trospium)

+

talazoparib

1 interaction

Monitor/Modify Tx

xanomeline + talazoparib

monitor CBC: combo may incr. talazoparib levels, risk of myelosuppression, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• taletrectinib
Cobenfy (xanomeline/ trospium)

+

taletrectinib

1 interaction

Monitor/Modify Tx

xanomeline + taletrectinib

monitor ECG: combo may incr. taletrectinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (GI metabolism possibly inhibited)

• tapentadol
Cobenfy (xanomeline/ trospium)

+

tapentadol

1 interaction

Monitor/Modify Tx

trospium + tapentadol

monitor respiratory rate, BP; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• temazepam
Cobenfy (xanomeline/ trospium)

+

temazepam

1 interaction

Monitor/Modify Tx

trospium + temazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• tenofovir alafenamide
Cobenfy (xanomeline/ trospium)

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

xanomeline + tenofovir alafenamide

if tenofovir alafenamide not admin. w/ cobicistat, monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• tenofovir disoproxil
Cobenfy (xanomeline/ trospium)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

xanomeline + tenofovir disoproxil

monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• terbutaline
Cobenfy (xanomeline/ trospium)

+

terbutaline

1 interaction

Monitor/Modify Tx

trospium + terbutaline

monitor HR: combo may incr. risk of tachycardia (additive effects)

• thioridazine
Cobenfy (xanomeline/ trospium)

+

thioridazine

1 interaction

Monitor/Modify Tx

trospium + thioridazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• thiothixene
Cobenfy (xanomeline/ trospium)

+

thiothixene

1 interaction

Monitor/Modify Tx

trospium + thiothixene

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• tolvaptan
Cobenfy (xanomeline/ trospium)

+

tolvaptan

1 interaction

Monitor/Modify Tx

xanomeline + tolvaptan

consider decr. tolvaptan dose: combo may incr. tolvaptan levels, risk of adverse effects (GI metabolism possibly inhibited)

• tramadol
Cobenfy (xanomeline/ trospium)

+

tramadol

1 interaction

Monitor/Modify Tx

trospium + tramadol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• triazolam
Cobenfy (xanomeline/ trospium)

+

triazolam

2 interactions

Monitor/Modify Tx

trospium + triazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

xanomeline + triazolam

monitor respiratory rate; consider decr. triazolam dose: combo may incr. triazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

• trimipramine
Cobenfy (xanomeline/ trospium)

+

trimipramine

1 interaction

Monitor/Modify Tx

trospium + trimipramine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• ubrogepant
Cobenfy (xanomeline/ trospium)

+

ubrogepant

1 interaction

Monitor/Modify Tx

xanomeline + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 2h if needed: combo may incr. ubrogepant levels, risk of adverse effects (GI metabolism possibly inhibited, gut P-gp-mediated transport possibly inhibited)

• vardenafil
Cobenfy (xanomeline/ trospium)

+

vardenafil

1 interaction

Monitor/Modify Tx

xanomeline + vardenafil

monitor ECG: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (GI metabolism possibly inhibited)

• vilanterol inhaled
Cobenfy (xanomeline/ trospium)

+

vilanterol inhaled

1 interaction

Monitor/Modify Tx

trospium + vilanterol inhaled

monitor HR: combo may incr. risk of tachycardia (additive effects)

• viloxazine
Cobenfy (xanomeline/ trospium)

+

viloxazine

1 interaction

Monitor/Modify Tx

trospium + viloxazine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment (additive effects)

• warfarin
Cobenfy (xanomeline/ trospium)

+

warfarin

1 interaction

Monitor/Modify Tx

xanomeline + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (GI metabolism possibly inhibited)

• yohimbe
Cobenfy (xanomeline/ trospium)

+

yohimbe

1 interaction

Monitor/Modify Tx

trospium + yohimbe

monitor HR: combo may incr. risk of tachycardia (additive effects)

• zaleplon
Cobenfy (xanomeline/ trospium)

+

zaleplon

1 interaction

Monitor/Modify Tx

trospium + zaleplon

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zanubrutinib
Cobenfy (xanomeline/ trospium)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

xanomeline + zanubrutinib

monitor CBC: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects (GI metabolism possibly inhibited)

• ziconotide
Cobenfy (xanomeline/ trospium)

+

ziconotide

1 interaction

Monitor/Modify Tx

trospium + ziconotide

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zolpidem
Cobenfy (xanomeline/ trospium)

+

zolpidem

1 interaction

Monitor/Modify Tx

trospium + zolpidem

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Caution Advised

• 5-HTP
Cobenfy (xanomeline/ trospium)

+

5-HTP

1 interaction

Caution Advised

trospium + 5-HTP

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• aceclidine ophthalmic
Cobenfy (xanomeline/ trospium)

+

aceclidine ophthalmic

1 interaction

Caution Advised

trospium + aceclidine ophthalmic

caution advised: combo may decr. aceclidine efficacy (antagonistic effects)

• allopurinol
Cobenfy (xanomeline/ trospium)

+

allopurinol

1 interaction

Caution Advised

trospium + allopurinol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• almotriptan
Cobenfy (xanomeline/ trospium)

+

almotriptan

1 interaction

Caution Advised

trospium + almotriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• alosetron
Cobenfy (xanomeline/ trospium)

+

alosetron

1 interaction

Caution Advised

trospium + alosetron

caution advised: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• amantadine
Cobenfy (xanomeline/ trospium)

+

amantadine

1 interaction

Caution Advised

trospium + amantadine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• apomorphine
Cobenfy (xanomeline/ trospium)

+

apomorphine

1 interaction

Caution Advised

trospium + apomorphine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• apraclonidine ophthalmic
Cobenfy (xanomeline/ trospium)

+

apraclonidine ophthalmic

1 interaction

Caution Advised

trospium + apraclonidine ophthalmic

caution advised if apraclonidine IOP adjunct use; postop use OK: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• aripiprazole bimonthly injection
Cobenfy (xanomeline/ trospium)

+

aripiprazole bimonthly injection

1 interaction

Caution Advised

trospium + aripiprazole bimonthly injection

caution advised: combo may incr. risk of hyperthermia, CNS depression, psychomotor impairment (additive effects)

• aripiprazole lauroxil
Cobenfy (xanomeline/ trospium)

+

aripiprazole lauroxil

1 interaction

Caution Advised

trospium + aripiprazole lauroxil

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• aripiprazole monthly injection
Cobenfy (xanomeline/ trospium)

+

aripiprazole monthly injection

1 interaction

Caution Advised

trospium + aripiprazole monthly injection

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• aripiprazole oral
Cobenfy (xanomeline/ trospium)

+

aripiprazole oral

1 interaction

Caution Advised

trospium + aripiprazole oral

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• asenapine
Cobenfy (xanomeline/ trospium)

+

asenapine

1 interaction

Caution Advised

trospium + asenapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• atropine ophthalmic
Cobenfy (xanomeline/ trospium)

+

atropine ophthalmic

1 interaction

Caution Advised

trospium + atropine ophthalmic

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• baclofen
Cobenfy (xanomeline/ trospium)

+

baclofen

1 interaction

Caution Advised

trospium + baclofen

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• barium
Cobenfy (xanomeline/ trospium)

+

barium

1 interaction

Caution Advised

trospium + barium

caution advised: combo may incr. risk of intestinal obstruction (additive effects)

• belladonna alkaloids
Cobenfy (xanomeline/ trospium)

+

belladonna alkaloids

1 interaction

Caution Advised

trospium + belladonna alkaloids

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• bethanechol
Cobenfy (xanomeline/ trospium)

+

bethanechol

1 interaction

Caution Advised

trospium + bethanechol

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• botulinum toxin
Cobenfy (xanomeline/ trospium)

+

botulinum toxin

1 interaction

Caution Advised

trospium + botulinum toxin

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• brexpiprazole
Cobenfy (xanomeline/ trospium)

+

brexpiprazole

1 interaction

Caution Advised

trospium + brexpiprazole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• brimonidine ophthalmic
Cobenfy (xanomeline/ trospium)

+

brimonidine ophthalmic

1 interaction

Caution Advised

trospium + brimonidine ophthalmic

caution advised if elevated IOP or presbyopia use; OTC ocular redness use OK: combo may increase risk of CNS depression, psychomotor impairment (additive effects)

• brimonidine topical
Cobenfy (xanomeline/ trospium)

+

brimonidine topical

1 interaction

Caution Advised

trospium + brimonidine topical

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• brivaracetam
Cobenfy (xanomeline/ trospium)

+

brivaracetam

1 interaction

Caution Advised

trospium + brivaracetam

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• bromocriptine
Cobenfy (xanomeline/ trospium)

+

bromocriptine

1 interaction

Caution Advised

trospium + bromocriptine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• brompheniramine
Cobenfy (xanomeline/ trospium)

+

brompheniramine

1 interaction

Caution Advised

trospium + brompheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• bupropion
Cobenfy (xanomeline/ trospium)

+

bupropion

1 interaction

Caution Advised

xanomeline + bupropion

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• buspirone
Cobenfy (xanomeline/ trospium)

+

buspirone

1 interaction

Caution Advised

trospium + buspirone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cannabidiol
Cobenfy (xanomeline/ trospium)

+

cannabidiol

1 interaction

Caution Advised

trospium + cannabidiol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• carbinoxamine
Cobenfy (xanomeline/ trospium)

+

carbinoxamine

1 interaction

Caution Advised

trospium + carbinoxamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• cariprazine
Cobenfy (xanomeline/ trospium)

+

cariprazine

2 interactions

Caution Advised

trospium + cariprazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

xanomeline + cariprazine

caution advised: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (GI metabolism possibly inhibited)

• carisoprodol
Cobenfy (xanomeline/ trospium)

+

carisoprodol

1 interaction

Caution Advised

trospium + carisoprodol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cenobamate
Cobenfy (xanomeline/ trospium)

+

cenobamate

1 interaction

Caution Advised

trospium + cenobamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cetirizine
Cobenfy (xanomeline/ trospium)

+

cetirizine

1 interaction

Caution Advised

trospium + cetirizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cevimeline
Cobenfy (xanomeline/ trospium)

+

cevimeline

1 interaction

Caution Advised

trospium + cevimeline

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• chamomile, German
Cobenfy (xanomeline/ trospium)

+

chamomile, German

1 interaction

Caution Advised

trospium + chamomile, German

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chlophedianol
Cobenfy (xanomeline/ trospium)

+

chlophedianol

1 interaction

Caution Advised

trospium + chlophedianol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• chlorcyclizine
Cobenfy (xanomeline/ trospium)

+

chlorcyclizine

1 interaction

Caution Advised

trospium + chlorcyclizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• chlorpheniramine
Cobenfy (xanomeline/ trospium)

+

chlorpheniramine

1 interaction

Caution Advised

trospium + chlorpheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• chlorzoxazone
Cobenfy (xanomeline/ trospium)

+

chlorzoxazone

1 interaction

Caution Advised

trospium + chlorzoxazone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• citalopram
Cobenfy (xanomeline/ trospium)

+

citalopram

1 interaction

Caution Advised

trospium + citalopram

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• clemastine
Cobenfy (xanomeline/ trospium)

+

clemastine

1 interaction

Caution Advised

trospium + clemastine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• clidinium
Cobenfy (xanomeline/ trospium)

+

clidinium

1 interaction

Caution Advised

trospium + clidinium

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• cobimetinib
Cobenfy (xanomeline/ trospium)

+

cobimetinib

1 interaction

Caution Advised

xanomeline + cobimetinib

caution advised: combo may incr. cobimetinib levels, risk of adverse effects (GI metabolism possibly inhibited)

• cyclobenzaprine
Cobenfy (xanomeline/ trospium)

+

cyclobenzaprine

1 interaction

Caution Advised

trospium + cyclobenzaprine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• cyclopentolate ophthalmic
Cobenfy (xanomeline/ trospium)

+

cyclopentolate ophthalmic

1 interaction

Caution Advised

trospium + cyclopentolate ophthalmic

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• cyclophosphamide
Cobenfy (xanomeline/ trospium)

+

cyclophosphamide

1 interaction

Caution Advised

xanomeline + cyclophosphamide

caution advised w/ oral cyclophosphamide: combo may decr. cyclophosphamide active metabolite levels, efficacy (GI metabolism possibly inhibited, decr. conversion to active metabolite)

• cyproheptadine
Cobenfy (xanomeline/ trospium)

+

cyproheptadine

1 interaction

Caution Advised

trospium + cyproheptadine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• dacomitinib
Cobenfy (xanomeline/ trospium)

+

dacomitinib

1 interaction

Caution Advised

xanomeline + dacomitinib

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• dantrolene
Cobenfy (xanomeline/ trospium)

+

dantrolene

1 interaction

Caution Advised

trospium + dantrolene

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• darifenacin
Cobenfy (xanomeline/ trospium)

+

darifenacin

1 interaction

Caution Advised

trospium + darifenacin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• darolutamide
Cobenfy (xanomeline/ trospium)

+

darolutamide

1 interaction

Caution Advised

xanomeline + darolutamide

if also combined w/ strong CYP3A4 inhibitor, caution advised: combo may incr. darolutamide levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• desvenlafaxine
Cobenfy (xanomeline/ trospium)

+

desvenlafaxine

1 interaction

Caution Advised

trospium + desvenlafaxine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• deutetrabenazine
Cobenfy (xanomeline/ trospium)

+

deutetrabenazine

1 interaction

Caution Advised

trospium + deutetrabenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexbrompheniramine
Cobenfy (xanomeline/ trospium)

+

dexbrompheniramine

1 interaction

Caution Advised

trospium + dexbrompheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• dexchlorpheniramine
Cobenfy (xanomeline/ trospium)

+

dexchlorpheniramine

1 interaction

Caution Advised

trospium + dexchlorpheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• dichlorphenamide
Cobenfy (xanomeline/ trospium)

+

dichlorphenamide

1 interaction

Caution Advised

trospium + dichlorphenamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• difelikefalin
Cobenfy (xanomeline/ trospium)

+

difelikefalin

1 interaction

Caution Advised

trospium + difelikefalin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• difenoxin
Cobenfy (xanomeline/ trospium)

+

difenoxin

1 interaction

Caution Advised

trospium + difenoxin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, severe constipation, paralytic ileus (additive effects)

• dimenhydrinate
Cobenfy (xanomeline/ trospium)

+

dimenhydrinate

1 interaction

Caution Advised

trospium + dimenhydrinate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• diphenhydramine
Cobenfy (xanomeline/ trospium)

+

diphenhydramine

1 interaction

Caution Advised

trospium + diphenhydramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• diphenoxylate
Cobenfy (xanomeline/ trospium)

+

diphenoxylate

1 interaction

Caution Advised

trospium + diphenoxylate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, severe constipation, paralytic ileus (additive effects)

• donepezil
Cobenfy (xanomeline/ trospium)

+

donepezil

1 interaction

Caution Advised

trospium + donepezil

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• doxazosin
Cobenfy (xanomeline/ trospium)

+

doxazosin

1 interaction

Caution Advised

trospium + doxazosin

caution advised w/ doxazosin ER dosage form: combo may incr. doxazosin levels, risk of adverse effects (absorption increased)

• doxepin topical
Cobenfy (xanomeline/ trospium)

+

doxepin topical

1 interaction

Caution Advised

trospium + doxepin topical

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• duloxetine
Cobenfy (xanomeline/ trospium)

+

duloxetine

1 interaction

Caution Advised

trospium + duloxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• efavirenz
Cobenfy (xanomeline/ trospium)

+

efavirenz

1 interaction

Caution Advised

trospium + efavirenz

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• eletriptan
Cobenfy (xanomeline/ trospium)

+

eletriptan

1 interaction

Caution Advised

trospium + eletriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• elinzanetant
Cobenfy (xanomeline/ trospium)

+

elinzanetant

2 interactions

Caution Advised

trospium + elinzanetant

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

xanomeline + elinzanetant

caution advised: combo may incr. elinzanetant levels, risk of CNS depression, psychomotor impairment, other adverse effects (GI metabolism possibly inhibited)

• entacapone
Cobenfy (xanomeline/ trospium)

+

entacapone

1 interaction

Caution Advised

trospium + entacapone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• erenumab
Cobenfy (xanomeline/ trospium)

+

erenumab

1 interaction

Caution Advised

trospium + erenumab

caution advised: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• ergotamine
Cobenfy (xanomeline/ trospium)

+

ergotamine

1 interaction

Caution Advised

xanomeline + ergotamine

caution advised w/ oral ergotamine: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (GI metabolism possibly inhibited)

• escitalopram
Cobenfy (xanomeline/ trospium)

+

escitalopram

1 interaction

Caution Advised

trospium + escitalopram

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• eslicarbazepine acetate
Cobenfy (xanomeline/ trospium)

+

eslicarbazepine acetate

1 interaction

Caution Advised

trospium + eslicarbazepine acetate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ethosuximide
Cobenfy (xanomeline/ trospium)

+

ethosuximide

1 interaction

Caution Advised

trospium + ethosuximide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• felbamate
Cobenfy (xanomeline/ trospium)

+

felbamate

1 interaction

Caution Advised

trospium + felbamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fenfluramine
Cobenfy (xanomeline/ trospium)

+

fenfluramine

1 interaction

Caution Advised

trospium + fenfluramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fesoterodine
Cobenfy (xanomeline/ trospium)

+

fesoterodine

1 interaction

Caution Advised

trospium + fesoterodine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• fexinidazole
Cobenfy (xanomeline/ trospium)

+

fexinidazole

1 interaction

Caution Advised

xanomeline + fexinidazole

caution advised: combo may decr. fexinidazole active metabolite levels, efficacy (GI metabolism possibly inhibited, decr. conversion to active metabolites)

• flavoxate
Cobenfy (xanomeline/ trospium)

+

flavoxate

1 interaction

Caution Advised

trospium + flavoxate

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• fluoxetine
Cobenfy (xanomeline/ trospium)

+

fluoxetine

2 interactions

Caution Advised

trospium + fluoxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

xanomeline + fluoxetine

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• fluvoxamine
Cobenfy (xanomeline/ trospium)

+

fluvoxamine

1 interaction

Caution Advised

trospium + fluvoxamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• foslevodopa
Cobenfy (xanomeline/ trospium)

+

foslevodopa

1 interaction

Caution Advised

trospium + foslevodopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fosphenytoin
Cobenfy (xanomeline/ trospium)

+

fosphenytoin

1 interaction

Caution Advised

trospium + fosphenytoin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• frovatriptan
Cobenfy (xanomeline/ trospium)

+

frovatriptan

1 interaction

Caution Advised

trospium + frovatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• galantamine
Cobenfy (xanomeline/ trospium)

+

galantamine

1 interaction

Caution Advised

trospium + galantamine

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• ganaxolone
Cobenfy (xanomeline/ trospium)

+

ganaxolone

1 interaction

Caution Advised

trospium + ganaxolone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• gepotidacin
Cobenfy (xanomeline/ trospium)

+

gepotidacin

1 interaction

Caution Advised

trospium + gepotidacin

caution advised: combo may decr. trospium efficacy (antagonistic effects, gepotidacin reversibly inhibits acetylcholinesterase)

• glecaprevir
Cobenfy (xanomeline/ trospium)

+

glecaprevir

1 interaction

Caution Advised

xanomeline + glecaprevir

caution advised: combo may incr. glecaprevir levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• glofitamab
Cobenfy (xanomeline/ trospium)

+

glofitamab

1 interaction

Caution Advised

trospium + glofitamab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• guanfacine
Cobenfy (xanomeline/ trospium)

+

guanfacine

1 interaction

Caution Advised

trospium + guanfacine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• homatropine
Cobenfy (xanomeline/ trospium)

+

homatropine

1 interaction

Caution Advised

trospium + homatropine

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• hydrochlorothiazide
Cobenfy (xanomeline/ trospium)

+

hydrochlorothiazide

1 interaction

Caution Advised

trospium + hydrochlorothiazide

caution advised: combo may incr. hydrochlorothiazide levels, risk of adverse effects (absorption increased)

• iloperidone
Cobenfy (xanomeline/ trospium)

+

iloperidone

1 interaction

Caution Advised

trospium + iloperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• ipratropium nasal
Cobenfy (xanomeline/ trospium)

+

ipratropium nasal

1 interaction

Caution Advised

trospium + ipratropium nasal

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• lacosamide
Cobenfy (xanomeline/ trospium)

+

lacosamide

1 interaction

Caution Advised

trospium + lacosamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lamotrigine
Cobenfy (xanomeline/ trospium)

+

lamotrigine

1 interaction

Caution Advised

trospium + lamotrigine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levetiracetam
Cobenfy (xanomeline/ trospium)

+

levetiracetam

1 interaction

Caution Advised

trospium + levetiracetam

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levocetirizine
Cobenfy (xanomeline/ trospium)

+

levocetirizine

1 interaction

Caution Advised

trospium + levocetirizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levodopa
Cobenfy (xanomeline/ trospium)

+

levodopa

1 interaction

Caution Advised

trospium + levodopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• linvoseltamab
Cobenfy (xanomeline/ trospium)

+

linvoseltamab

1 interaction

Caution Advised

trospium + linvoseltamab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lofexidine
Cobenfy (xanomeline/ trospium)

+

lofexidine

1 interaction

Caution Advised

trospium + lofexidine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• loperamide
Cobenfy (xanomeline/ trospium)

+

loperamide

1 interaction

Caution Advised

trospium + loperamide

caution advised: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• loxapine
Cobenfy (xanomeline/ trospium)

+

loxapine

1 interaction

Caution Advised

trospium + loxapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• meclizine
Cobenfy (xanomeline/ trospium)

+

meclizine

1 interaction

Caution Advised

trospium + meclizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• melatonin
Cobenfy (xanomeline/ trospium)

+

melatonin

1 interaction

Caution Advised

trospium + melatonin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• meprobamate
Cobenfy (xanomeline/ trospium)

+

meprobamate

1 interaction

Caution Advised

trospium + meprobamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• metformin
Cobenfy (xanomeline/ trospium)

+

metformin

1 interaction

Caution Advised

trospium + metformin

caution advised: combo may decr. trospium levels, efficacy (mechanism unknown)

• methacholine inhaled
Cobenfy (xanomeline/ trospium)

+

methacholine inhaled

1 interaction

Caution Advised

trospium + methacholine inhaled

caution advised: combo may interfere with test results (antagonistic effects)

• methocarbamol
Cobenfy (xanomeline/ trospium)

+

methocarbamol

1 interaction

Caution Advised

trospium + methocarbamol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• methsuximide
Cobenfy (xanomeline/ trospium)

+

methsuximide

1 interaction

Caution Advised

trospium + methsuximide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• methyldopa
Cobenfy (xanomeline/ trospium)

+

methyldopa

1 interaction

Caution Advised

trospium + methyldopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• methylergonovine
Cobenfy (xanomeline/ trospium)

+

methylergonovine

1 interaction

Caution Advised

xanomeline + methylergonovine

caution advised w/ oral methylergonovine: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (GI metabolism possibly inhibited)

• metyrapone
Cobenfy (xanomeline/ trospium)

+

metyrapone

1 interaction

Caution Advised

trospium + metyrapone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• metyrosine
Cobenfy (xanomeline/ trospium)

+

metyrosine

1 interaction

Caution Advised

trospium + metyrosine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• mexiletine
Cobenfy (xanomeline/ trospium)

+

mexiletine

1 interaction

Caution Advised

trospium + mexiletine

caution advised: combo may decr. peak mexiletine levels, delay antiarrhythmic onset (absorption delayed)

• milsaperidone
Cobenfy (xanomeline/ trospium)

+

milsaperidone

1 interaction

Caution Advised

trospium + milsaperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• mirabegron
Cobenfy (xanomeline/ trospium)

+

mirabegron

1 interaction

Caution Advised

trospium + mirabegron

caution advised: combo may incr. risk of urinary retention (additive effects)

• mitotane
Cobenfy (xanomeline/ trospium)

+

mitotane

1 interaction

Caution Advised

trospium + mitotane

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• molindone
Cobenfy (xanomeline/ trospium)

+

molindone

1 interaction

Caution Advised

trospium + molindone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• mosunetuzumab
Cobenfy (xanomeline/ trospium)

+

mosunetuzumab

1 interaction

Caution Advised

trospium + mosunetuzumab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• mycophenolate mofetil
Cobenfy (xanomeline/ trospium)

+

mycophenolate mofetil

1 interaction

Caution Advised

trospium + mycophenolate mofetil

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• naldemedine
Cobenfy (xanomeline/ trospium)

+

naldemedine

1 interaction

Caution Advised

xanomeline + naldemedine

caution advised: combo may incr. naldemedine levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• naltrexone
Cobenfy (xanomeline/ trospium)

+

naltrexone

1 interaction

Caution Advised

trospium + naltrexone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• naphazoline ophthalmic
Cobenfy (xanomeline/ trospium)

+

naphazoline ophthalmic

1 interaction

Caution Advised

trospium + naphazoline ophthalmic

caution advised: combo with anticholinergics may incr. risk of exaggerated adrenergic effects of ophthalmic decongestants (mechanism unknown)

• naratriptan
Cobenfy (xanomeline/ trospium)

+

naratriptan

1 interaction

Caution Advised

trospium + naratriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• nefazodone
Cobenfy (xanomeline/ trospium)

+

nefazodone

1 interaction

Caution Advised

trospium + nefazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• neostigmine
Cobenfy (xanomeline/ trospium)

+

neostigmine

1 interaction

Caution Advised

trospium + neostigmine

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• oxcarbazepine
Cobenfy (xanomeline/ trospium)

+

oxcarbazepine

1 interaction

Caution Advised

trospium + oxcarbazepine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• paliperidone
Cobenfy (xanomeline/ trospium)

+

paliperidone

1 interaction

Caution Advised

trospium + paliperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• palovarotene
Cobenfy (xanomeline/ trospium)

+

palovarotene

1 interaction

Caution Advised

xanomeline + palovarotene

caution advised: combo may incr. palovarotene levels, risk of adverse effects (GI metabolism possibly inhibited)

• paroxetine
Cobenfy (xanomeline/ trospium)

+

paroxetine

2 interactions

Caution Advised

trospium + paroxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

xanomeline + paroxetine

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• passion flower
Cobenfy (xanomeline/ trospium)

+

passion flower

1 interaction

Caution Advised

trospium + passion flower

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• perampanel
Cobenfy (xanomeline/ trospium)

+

perampanel

1 interaction

Caution Advised

trospium + perampanel

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• pexidartinib
Cobenfy (xanomeline/ trospium)

+

pexidartinib

1 interaction

Caution Advised

xanomeline + pexidartinib

caution advised: combo may incr. pexidartinib levels, risk of hepatotoxicity, other adverse effects (GI metabolism possibly inhibited)

• pheniramine
Cobenfy (xanomeline/ trospium)

+

pheniramine

1 interaction

Caution Advised

trospium + pheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• phenytoin
Cobenfy (xanomeline/ trospium)

+

phenytoin

1 interaction

Caution Advised

trospium + phenytoin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• pibrentasvir
Cobenfy (xanomeline/ trospium)

+

pibrentasvir

1 interaction

Caution Advised

xanomeline + pibrentasvir

caution advised: combo may incr. pibrentasvir levels, risk of adverse effects (gut P-gp-mediated transport possibly inhibited)

• pilocarpine
Cobenfy (xanomeline/ trospium)

+

pilocarpine

1 interaction

Caution Advised

trospium + pilocarpine

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• pilocarpine ophthalmic
Cobenfy (xanomeline/ trospium)

+

pilocarpine ophthalmic

1 interaction

Caution Advised

trospium + pilocarpine ophthalmic

caution advised: combo may decr. pilocarpine efficacy (antagonistic effects)

• potassium acid phosphate
Cobenfy (xanomeline/ trospium)

+

potassium acid phosphate

1 interaction

Caution Advised

trospium + potassium acid phosphate

caution advised w/ solid potassium formulations; liquid potassium formulations OK: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• potassium gluconate
Cobenfy (xanomeline/ trospium)

+

potassium gluconate

1 interaction

Caution Advised

trospium + potassium gluconate

caution advised w/ solid potassium formulations; liquid potassium formulations OK: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• potassium phosphate
Cobenfy (xanomeline/ trospium)

+

potassium phosphate

1 interaction

Caution Advised

trospium + potassium phosphate

caution advised w/ solid potassium formulations; liquid potassium formulations OK: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• pramipexole
Cobenfy (xanomeline/ trospium)

+

pramipexole

1 interaction

Caution Advised

trospium + pramipexole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• procainamide
Cobenfy (xanomeline/ trospium)

+

procainamide

1 interaction

Caution Advised

trospium + procainamide

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• procarbazine
Cobenfy (xanomeline/ trospium)

+

procarbazine

1 interaction

Caution Advised

trospium + procarbazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• prochlorperazine
Cobenfy (xanomeline/ trospium)

+

prochlorperazine

1 interaction

Caution Advised

trospium + prochlorperazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• pyridostigmine
Cobenfy (xanomeline/ trospium)

+

pyridostigmine

1 interaction

Caution Advised

trospium + pyridostigmine

caution advised: combo may decr. efficacy of both drugs (antagonistic effects)

• pyrilamine
Cobenfy (xanomeline/ trospium)

+

pyrilamine

1 interaction

Caution Advised

trospium + pyrilamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• quetiapine
Cobenfy (xanomeline/ trospium)

+

quetiapine

1 interaction

Caution Advised

trospium + quetiapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia, anticholinergic adverse effects (additive effects)

• quinidine (CYP2D6 inhibitor)
Cobenfy (xanomeline/ trospium)

+

quinidine (CYP2D6 inhibitor)

2 interactions

Caution Advised

trospium + quinidine (CYP2D6 inhibitor)

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

xanomeline + quinidine (CYP2D6 inhibitor)

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• ramelteon
Cobenfy (xanomeline/ trospium)

+

ramelteon

1 interaction

Caution Advised

trospium + ramelteon

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rasagiline
Cobenfy (xanomeline/ trospium)

+

rasagiline

1 interaction

Caution Advised

trospium + rasagiline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rilzabrutinib
Cobenfy (xanomeline/ trospium)

+

rilzabrutinib

1 interaction

Caution Advised

xanomeline + rilzabrutinib

caution advised: combo may incr. rilzabrutinib levels, risk of adverse effects (GI metabolism possibly inhibited)

• risperidone
Cobenfy (xanomeline/ trospium)

+

risperidone

1 interaction

Caution Advised

trospium + risperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• rizatriptan
Cobenfy (xanomeline/ trospium)

+

rizatriptan

1 interaction

Caution Advised

trospium + rizatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• roflumilast
Cobenfy (xanomeline/ trospium)

+

roflumilast

1 interaction

Caution Advised

xanomeline + roflumilast

caution advised: combo may incr. roflumilast levels, risk of adverse effects (GI metabolism possibly inhibited)

• ropinirole
Cobenfy (xanomeline/ trospium)

+

ropinirole

1 interaction

Caution Advised

trospium + ropinirole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rufinamide
Cobenfy (xanomeline/ trospium)

+

rufinamide

1 interaction

Caution Advised

trospium + rufinamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• safinamide
Cobenfy (xanomeline/ trospium)

+

safinamide

1 interaction

Caution Advised

trospium + safinamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• selegiline
Cobenfy (xanomeline/ trospium)

+

selegiline

1 interaction

Caution Advised

trospium + selegiline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• selegiline transdermal
Cobenfy (xanomeline/ trospium)

+

selegiline transdermal

1 interaction

Caution Advised

trospium + selegiline transdermal

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• selinexor
Cobenfy (xanomeline/ trospium)

+

selinexor

1 interaction

Caution Advised

trospium + selinexor

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• sertraline
Cobenfy (xanomeline/ trospium)

+

sertraline

1 interaction

Caution Advised

trospium + sertraline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• solifenacin
Cobenfy (xanomeline/ trospium)

+

solifenacin

1 interaction

Caution Advised

trospium + solifenacin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• stiripentol
Cobenfy (xanomeline/ trospium)

+

stiripentol

1 interaction

Caution Advised

trospium + stiripentol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• sumatriptan
Cobenfy (xanomeline/ trospium)

+

sumatriptan

1 interaction

Caution Advised

trospium + sumatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tasimelteon
Cobenfy (xanomeline/ trospium)

+

tasimelteon

1 interaction

Caution Advised

trospium + tasimelteon

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• terbinafine
Cobenfy (xanomeline/ trospium)

+

terbinafine

1 interaction

Caution Advised

xanomeline + terbinafine

caution advised: combo may incr. xanomeline levels, risk of adverse effects (hepatic metabolism possibly inhibited)

• tetrabenazine
Cobenfy (xanomeline/ trospium)

+

tetrabenazine

1 interaction

Caution Advised

trospium + tetrabenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tetrahydrozoline ophthalmic
Cobenfy (xanomeline/ trospium)

+

tetrahydrozoline ophthalmic

1 interaction

Caution Advised

trospium + tetrahydrozoline ophthalmic

caution advised: combo with anticholinergics may incr. risk of exaggerated adrenergic effects of ophthalmic decongestants (mechanism unknown)

• thiotepa
Cobenfy (xanomeline/ trospium)

+

thiotepa

1 interaction

Caution Advised

trospium + thiotepa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tiagabine
Cobenfy (xanomeline/ trospium)

+

tiagabine

1 interaction

Caution Advised

trospium + tiagabine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tizanidine
Cobenfy (xanomeline/ trospium)

+

tizanidine

1 interaction

Caution Advised

trospium + tizanidine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tolcapone
Cobenfy (xanomeline/ trospium)

+

tolcapone

1 interaction

Caution Advised

trospium + tolcapone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tolterodine
Cobenfy (xanomeline/ trospium)

+

tolterodine

1 interaction

Caution Advised

trospium + tolterodine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• topiramate
Cobenfy (xanomeline/ trospium)

+

topiramate

1 interaction

Caution Advised

trospium + topiramate

caution advised, especially in Peds pts: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• trazodone
Cobenfy (xanomeline/ trospium)

+

trazodone

1 interaction

Caution Advised

trospium + trazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• trifluoperazine
Cobenfy (xanomeline/ trospium)

+

trifluoperazine

1 interaction

Caution Advised

trospium + trifluoperazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects; may decr. phenothiazine efficacy (additive effects; antagonistic effects)

• trihexyphenidyl
Cobenfy (xanomeline/ trospium)

+

trihexyphenidyl

1 interaction

Caution Advised

trospium + trihexyphenidyl

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia, anticholinergic adverse effects (additive effects)

• triprolidine
Cobenfy (xanomeline/ trospium)

+

triprolidine

1 interaction

Caution Advised

trospium + triprolidine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, anticholinergic adverse effects (additive effects)

• tropicamide ophthalmic
Cobenfy (xanomeline/ trospium)

+

tropicamide ophthalmic

1 interaction

Caution Advised

trospium + tropicamide ophthalmic

caution advised: combo may incr. risk of anticholinergic adverse effects (additive effects)

• valbenazine
Cobenfy (xanomeline/ trospium)

+

valbenazine

1 interaction

Caution Advised

trospium + valbenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• valerian
Cobenfy (xanomeline/ trospium)

+

valerian

1 interaction

Caution Advised

trospium + valerian

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• valproic acid
Cobenfy (xanomeline/ trospium)

+

valproic acid

1 interaction

Caution Advised

trospium + valproic acid

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• venlafaxine
Cobenfy (xanomeline/ trospium)

+

venlafaxine

1 interaction

Caution Advised

trospium + venlafaxine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• verapamil
Cobenfy (xanomeline/ trospium)

+

verapamil

1 interaction

Caution Advised

xanomeline + verapamil

caution advised w/ oral verapamil: combo may incr. verapamil levels, risk of hypotension, bradycardia, AV block, other adverse effects (GI metabolism possibly inhibited)

• vibegron
Cobenfy (xanomeline/ trospium)

+

vibegron

1 interaction

Caution Advised

trospium + vibegron

caution advised: combo may incr. risk of urinary retention (additive effects)

• vigabatrin
Cobenfy (xanomeline/ trospium)

+

vigabatrin

1 interaction

Caution Advised

trospium + vigabatrin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• vilazodone
Cobenfy (xanomeline/ trospium)

+

vilazodone

1 interaction

Caution Advised

trospium + vilazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ziprasidone
Cobenfy (xanomeline/ trospium)

+

ziprasidone

1 interaction

Caution Advised

trospium + ziprasidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment, hyperthermia (additive effects)

• zolmitriptan
Cobenfy (xanomeline/ trospium)

+

zolmitriptan

1 interaction

Caution Advised

trospium + zolmitriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zonisamide
Cobenfy (xanomeline/ trospium)

+

zonisamide

1 interaction

Caution Advised

trospium + zonisamide

caution advised: combo may incr. risk of hyperthermia, CNS depression, psychomotor impairment (additive effects)