Cobenfy (xanomeline/trospium) is used for the treatment of schizophrenia, but patients with severe hepatic impairment, glaucoma, and urinary retention belong to the population requiring contraindication or cautious use, and must be clearly assessed before medication.

I. Patients with Severe Hepatic Impairment

1. Reasons for Contraindication

The drug components are mainly metabolized by the liver, and clearance is reduced in patients with severe hepatic impairment, which may lead to drug accumulation.

Accumulation increases the risk of adverse reactions, including gastrointestinal reactions and central nervous system symptoms.

2. Medication Recommendations

Patients with severe hepatic impairment should avoid use.

Patients with mild to moderate hepatic impairment should use cautiously after physician evaluation and strengthen liver function monitoring.

II. Patients with Glaucoma

1. Risk Mechanism

The anticholinergic component in the drug may cause pupil dilation and increased intraocular pressure.

Use in patients with angle-closure glaucoma may induce acute glaucoma attacks, with eye pain, blurred vision, and headache.

2. Medication Recommendations

Patients with angle-closure glaucoma should not use the drug.

Patients with a history of glaucoma should inform the doctor before medication, and ophthalmological evaluation should be performed first if necessary.

III. Patients with Urinary Retention

1. Risk Mechanism

Anticholinergic effects can weaken detrusor contraction and worsen difficulty urinating.

Symptoms may worsen in patients with existing urinary retention or benign prostatic hyperplasia with voiding dysfunction.

2. Medication Recommendations

Patients with urinary retention should avoid use.

Elderly men with benign prostatic hyperplasia should be evaluated for voiding status before medication and observed for voiding changes during treatment.

IV. Key Points for Pre-Medication Assessment

1. Medical History Inquiry

Before medication, patients should proactively inform the doctor of liver disease history, glaucoma history, and difficulty urinating.

2. Attention to Concomitant Medication

Avoid concomitant use with other anticholinergic drugs to prevent worsening of increased intraocular pressure and difficulty urinating.

3. Seek Medical Attention Promptly for Abnormalities

If symptoms such as eye pain, vision changes, worsening difficulty urinating, or jaundice occur, discontinue the drug immediately and seek medical attention.

Cobenfy (xanomeline/trospium) is used for the treatment of schizophrenia, but patients with severe hepatic impairment, glaucoma, and urinary retention belong to the population requiring contraindication or cautious use, and must be clearly assessed before medication.

I. Patients with Severe Hepatic Impairment

1. Reasons for Contraindication

The drug components are mainly metabolized by the liver, and clearance is reduced in patients with severe hepatic impairment, which may lead to drug accumulation.

Accumulation increases the risk of adverse reactions, including gastrointestinal reactions and central nervous system symptoms.

2. Medication Recommendations

Patients with severe hepatic impairment should avoid use.

Patients with mild to moderate hepatic impairment should use cautiously after physician evaluation and strengthen liver function monitoring.

II. Patients with Glaucoma

1. Risk Mechanism

The anticholinergic component in the drug may cause pupil dilation and increased intraocular pressure.

Use in patients with angle-closure glaucoma may induce acute glaucoma attacks, with eye pain, blurred vision, and headache.

2. Medication Recommendations

Patients with angle-closure glaucoma should not use the drug.

Patients with a history of glaucoma should inform the doctor before medication, and ophthalmological evaluation should be performed first if necessary.

III. Patients with Urinary Retention

1. Risk Mechanism

Anticholinergic effects can weaken detrusor contraction and worsen difficulty urinating.

Symptoms may worsen in patients with existing urinary retention or benign prostatic hyperplasia with voiding dysfunction.

2. Medication Recommendations

Patients with urinary retention should avoid use.

Elderly men with benign prostatic hyperplasia should be evaluated for voiding status before medication and observed for voiding changes during treatment.

IV. Key Points for Pre-Medication Assessment

1. Medical History Inquiry

Before medication, patients should proactively inform the doctor of liver disease history, glaucoma history, and difficulty urinating.

2. Attention to Concomitant Medication

Avoid concomitant use with other anticholinergic drugs to prevent worsening of increased intraocular pressure and difficulty urinating.

3. Seek Medical Attention Promptly for Abnormalities

If symptoms such as eye pain, vision changes, worsening difficulty urinating, or jaundice occur, discontinue the drug immediately and seek medical attention.