Trospium / Xanomeline Dosage

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

Applies to the following strengths: 20 mg-50 mg; 30 mg-125 mg; 20 mg-100 mg; (20 mg-50 mg)-(20 mg-100 mg)

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.