Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- trospium / xanomeline
- cevimeline
Interactions between your drugs
cevimeline trospium
Applies to: cevimeline, trospium / xanomeline
GENERALLY AVOID: Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may antagonize the effects of direct-acting cholinergic agents such as bethanechol, carbachol, cevimeline, and pilocarpine. This interaction is sometimes desirable and is the basis for using atropine in the treatment of excessive muscarinic side effects and cholinergic crisis induced by cholinergic overdose. Conversely, cholinergic agents may also counteract the pharmacologic effects of anticholinergic agents and other agents that rely partially on their anticholinergic activity for therapeutic effects (e.g., some antiparkinsonian and antiemetic/antivertigo agents). The mechanism of interaction involves opposing pharmacodynamic action on muscarinic receptor sites.
MANAGEMENT: It may be appropriate to avoid concomitant use of anticholinergic agents and cholinergic agents, depending on the needs of the patient. If concurrent use is necessary, the patient should be monitored for reduced pharmacologic effects of both drugs.
References (2)
- Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
- "Product Information. Salagen (pilocarpine)." Boehringer-Ingelheim
Drug and food interactions
trospium food
Applies to: trospium / xanomeline
ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.
MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.
References (5)
- (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
- (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
- (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
- (2023) "Product Information. Trospium Chloride (trospium)." Padagis
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Cholinergics
Therapeutic duplication
The recommended maximum number of medicines in the 'cholinergics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'cholinergics' category:
- trospium / xanomeline
- cevimeline
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
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Further information
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