Trospium / Xanomeline Dosage

Medically reviewed by Drugs.com. Last updated on Dec 3, 2024.

Usual Adult Dose for Schizophrenia

Initial dose: Xanomeline 50 mg-trospium 20 mg orally twice a day for at least 2 days.

• Then, increase to xanomeline 100 mg-trospium 20 mg orally twice a day for at least 5 days

Maintenance dose: May titrate to xanomeline 125 mg-trospium 30 mg orally twice a day based on patient tolerability/response.
Maximum dose: Xanomeline 125 mg-trospium 30 mg orally twice a day

Comments:

• It is recommended to assess hepatic and cardiac function prior to treatment initiation.
• Avoid administration with food; give dose at least 1 hour before a meal or 2 hours after a meal.

Use: For the treatment of schizophrenia

Usual Geriatric Dose for Schizophrenia

Initial dose: Xanomeline 50 mg-trospium 20 mg orally twice a day.
Maintenance dose: Consider a slower titration for older adults. May increase up to xanomeline 100 mg-trospium 20 mg orally twice a day based on patient tolerability/response.
Maximum dose: Xanomeline 100 mg-trospium 20 mg orally twice a day

Comments:

• It is recommended to assess hepatic and cardiac function prior to treatment initiation.
• Avoid administration with food; give dose at least 1 hour before a meal or 2 hours after a meal.

Use: For the treatment of schizophrenia

Renal Dose Adjustments

Mild renal dysfunction (estimated GFR 60 to less than 90 mL/min): No adjustment recommended.
Moderate or severe renal dysfunction (estimated GFR less than 60 mL/min): Use is not recommended.

Liver Dose Adjustments

Mild liver dysfunction (Child-Pugh A): Use is not recommended.
Moderate or severe liver dysfunction (Child-Pugh B or C): Contraindicated

Precautions

CONTRAINDICATIONS:

• Urinary retention
• Moderate (Child-Pugh B) or severe (Child-Pugh B) hepatic impairment
• A history of hypersensitivity to this drug or trospium chloride; angioedema has been reported.
• Gastric retention
• Untreated narrow-angle glaucoma

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For oral use
• Prior to treatment initiation, assess liver enzymes and bilirubin, and establish baseline heart rate.
• Administer this drug at least 1 hour before a meal or at least 2 hours after a meal.

Storage requirements:

• Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F).

General:

• Use of this drug can increase the risk of urinary retention in older patients, including males with bladder outlet obstruction due to benign prostatic hyperplasia.

Monitoring:

• Cardiovascular: Heart rate (at baseline and as clinically indicated)
• Genitourinary: For signs/symptoms of urinary retention (during therapy)
• Hepatic: Liver enzymes and bilirubin (at baseline and as clinically indicated)
• Neurologic: For anticholinergic CNS effects (especially after beginning therapy or with dose increases)
• Ocular: If used in patients with narrow-angle glaucoma, monitor carefully (during therapy)
• Pregnancy: Monitoring via an exposure registry is available for pregnant patients exposed to this drug.

Patient advice:

• Read the US FDA-approved patient labeling (Patient Information).
• Avoid administration of this drug with food; do not open capsules.
• Tell your healthcare provider about all of the medicines you take.
• Seek immediate medical attention if unable to urinate. Monitor for symptoms of urinary retention.
• Report any signs of hepatic impairment or symptoms of hepatic injury to your health care provider.
• Notify a health care provider of signs/symptoms of abdominal pain, stomach upset, or gastrointestinal obstructive disorders.
• This drug may cause hypersensitivity reactions. Seek immediate medical attention if tongue/throat swelling or difficulty breathing occurs.
• Understand that this drug may increase heart rate.
• Use caution when performing activities requiring mental alertness until effects of this drug are known.
• Patients of childbearing potential: A pregnancy exposure registry is available.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer