Drug · FAERS side-effect profile with label screen

Xanomeline and Trospium side effects: what 2,007 FDA adverse event reports show

Xanomeline And Trospium Chloride · 33 reaction terms · 1,864 drug–reaction co-reports · data 2026-09-14

Drug class

Cholinergic Muscarinic Agonist

FDA label (Established Pharmacologic Class) of the closest related product

Label matched

Xanomeline And Trospium Chloride (Cobenfy)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

2,007 reports · 26% serious · 26 with death outcome · 41% female

openFDA FAERS counts, all years, deduplication not applied

Used for

COBENFY is indicated for the treatment of schizophrenia in adults. COBENFY is a combination of xanomeline, a muscarinic agonist, and trospium chloride, a muscarinic antagonist, indicated for the treatment of schizophrenia in adults. ( 1 )

FDA label, Indications and Usage

What it is

COBENFY is a combination of xanomeline, a muscarinic agonist, and trospium chloride, a muscarinic antagonist.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 28 strongest signals

Labeled adverse reaction 12Likely indication confounding 1Reporting / coding artifact 2Not in label — unassessed 13

What the badges mean

Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 5 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show: hide coding/lab/outcome terms hide indication terms unlabeled only hide PRR-only

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Urinary retention	130	39.4 33.3–46.5ROR 41.9 · χ² 4,810 / p <1e-300	39.0 EB05 33.7 · IC025 +4.8 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 103.3	no trial data cached
Hallucination, auditory	39	24.7 18.1–33.7ROR 25.1 · χ² 860 / p 2e-189	24.3 EB05 18.6 · IC025 +3.7 3/3 methods agree	Not in label — unassessed	serious PRR 66.6	no trial data cached
Salivary hypersecretion	22	22.1 14.6–33.6ROR 22.4 · χ² 423 / p 3e-94	21.7 EB05 15.0 · IC025 +3.2 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 16.0	no trial data cached
Schizophrenia	18	14.9 9.4–23.6ROR 15.0 · χ² 219 / p 7e-50	14.2 EB05 9.0 · IC025 +2.6 3/3 methods agree	Likely indication confounding term in indications; also in warnings	serious PRR 36.1	no trial data cached
Psychotic disorder	42	14.3 10.6–19.3ROR 14.6 · χ² 506 / p 2e-112	14.1 EB05 10.7 · IC025 +3.1 3/3 methods agree	Not in label — unassessed	serious PRR 30.3	no trial data cached
Mania	17	10.4 6.5–16.7ROR 10.5 · χ² 135 / p 2e-31	9.2 EB05 5.7 · IC025 +2.2 3/3 methods agree	Not in label — unassessed	serious PRR 30.0	no trial data cached
Treatment noncompliance	55	10.2 7.8–13.2ROR 10.4 · χ² 446 / p 2e-99	9.8 EB05 7.7 · IC025 +2.8 3/3 methods agree	Reporting / coding artifact	serious PRR 4.7	no trial data cached
Paranoia	16	9.3 5.7–15.1ROR 9.3 · χ² 110 / p 5e-26	8.0 EB05 5.0 · IC025 +2.0 3/3 methods agree	Not in label — unassessed	serious PRR 13.7	no trial data cached
Dyspepsia (indigestion)	81	8.3 6.7–10.3ROR 8.6 · χ² 514 / p 4e-114	8.0 EB05 6.6 · IC025 +2.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 4.8 · 78% consumer	no trial data cached
Constipation	157	7.3 6.3–8.5ROR 7.8 · χ² 854 / p 6e-188	7.2 EB05 6.3 · IC025 +2.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 7.2	no trial data cached
Vomiting	340	7.3 6.6–8.0ROR 8.5 · χ² 1,878 / p <1e-300	7.2 EB05 6.6 · IC025 +2.7 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 3.9	no trial data cached
Delusion	11	7.1 4.0–12.9ROR 7.2 · χ² 52 / p 3e-13	5.7 EB05 3.4 · IC025 +1.5 3/3 methods agree	Not in label — unassessed	serious PRR 16.5	no trial data cached
Dry mouth	57	7.1 5.5–9.1ROR 7.2 · χ² 292 / p 1e-65	6.7 EB05 5.4 · IC025 +2.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 6.3	no trial data cached
Hallucination, visual	13	6.2 3.6–10.7ROR 6.3 · χ² 52 / p 3e-13	5.2 EB05 3.2 · IC025 +1.4 3/3 methods agree	Not in label — unassessed	serious PRR 16.7	no trial data cached
Sedation	16	6.2 3.8–10.0ROR 6.2 · χ² 64 / p 6e-16	5.3 EB05 3.5 · IC025 +1.6 3/3 methods agree	Not in label — unassessed	serious PRR 3.7	no trial data cached
Dysuria (painful urination)	22	6.0 4.0–9.1ROR 6.0 · χ² 87 / p 6e-21	5.4 EB05 3.7 · IC025 +1.7 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 3.8 · 86% consumer	no trial data cached
Hyperhidrosis (excessive sweating)	75	5.8 4.7–7.3ROR 6.0 · χ² 298 / p 5e-67	5.6 EB05 4.7 · IC025 +2.1 3/3 methods agree	Not in label — unassessed	serious PRR 3.8	no trial data cached
Cold sweat	10	5.7 3.1–10.6ROR 5.7 · χ² 34 / p 3e-9	4.6 EB05 2.7 · IC025 +1.1 3/3 methods agree	Not in label — unassessed	serious PRR 2.0	no trial data cached
Nausea	441	5.6 5.2–6.1ROR 6.8 · χ² 1,732 / p <1e-300	5.6 EB05 5.2 · IC025 +2.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 3.7	no trial data cached
Vision blurred (blurred vision)	74	5.4 4.3–6.8ROR 5.6 · χ² 265 / p 6e-60	5.3 EB05 4.3 · IC025 +2.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 4.0	no trial data cached
Anger	16	4.7 2.9–7.7ROR 4.8 · χ² 43 / p 2e-11	4.2 EB05 2.8 · IC025 +1.2 3/3 methods agree	Not in label — unassessed	serious PRR 6.9	no trial data cached
Adverse event	41	4.5 3.3–6.0ROR 4.5 · χ² 107 / p 2e-25	4.3 EB05 3.3 · IC025 +1.6 3/3 methods agree	Reporting / coding artifact	serious PRR 1.2	no trial data cached
Heart rate increased	44	4.5 3.3–6.0ROR 4.5 · χ² 115 / p 4e-27	4.3 EB05 3.3 · IC025 +1.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 2.1	no trial data cached
Hallucination (hallucinations)	29	3.9 2.7–5.6ROR 3.9 · χ² 59 / p 6e-15	3.7 EB05 2.7 · IC025 +1.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 11.3	no trial data cached
Dyskinesia (involuntary movements)	14	3.5 2.1–5.8ROR 3.5 · χ² 22 / p 1e-6	3.2 EB05 2.0 · IC025 +0.8 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 2.4	no trial data cached
Abnormal behaviour	12	3.0 1.7–5.3ROR 3.0 · χ² 14 / p 8e-5	2.8 EB05 1.7 · IC025 +0.5	Not in label — unassessed	serious PRR 6.5	no trial data cached
Aggression	14	2.8 1.7–4.7ROR 2.8 · χ² 15 / p 7e-5	2.6 EB05 1.7 · IC025 +0.5	Not in label — unassessed	serious PRR 2.9	no trial data cached
Suicidal ideation (thoughts of suicide)	23	2.5 1.7–3.8ROR 2.5 · χ² 20 / p 5e-6	2.4 EB05 1.7 · IC025 +0.6	Not in label — unassessed	serious PRR 6.1	no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

Reaction	Reports	PRR 95% CI · ROR · χ²/p	EBGM EB05 · IC025	Label screen	Serious-only & strata	Trial cross-check
Nausea	441	5.6 5.2–6.1ROR 6.8 · χ² 1,732 / p <1e-300	5.6 EB05 5.2 · IC025 +2.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 3.7	no trial data cached
Vomiting	340	7.3 6.6–8.0ROR 8.5 · χ² 1,878 / p <1e-300	7.2 EB05 6.6 · IC025 +2.7 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 3.9	no trial data cached
Constipation	157	7.3 6.3–8.5ROR 7.8 · χ² 854 / p 6e-188	7.2 EB05 6.3 · IC025 +2.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 7.2	no trial data cached
Urinary retention	130	39.4 33.3–46.5ROR 41.9 · χ² 4,810 / p <1e-300	39.0 EB05 33.7 · IC025 +4.8 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 103.3	no trial data cached
Dyspepsia (indigestion)	81	8.3 6.7–10.3ROR 8.6 · χ² 514 / p 4e-114	8.0 EB05 6.6 · IC025 +2.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 4.8 · 78% consumer	no trial data cached
Hyperhidrosis (excessive sweating)	75	5.8 4.7–7.3ROR 6.0 · χ² 298 / p 5e-67	5.6 EB05 4.7 · IC025 +2.1 3/3 methods agree	Not in label — unassessed	serious PRR 3.8	no trial data cached
Vision blurred (blurred vision)	74	5.4 4.3–6.8ROR 5.6 · χ² 265 / p 6e-60	5.3 EB05 4.3 · IC025 +2.0 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 4.0	no trial data cached
Dry mouth	57	7.1 5.5–9.1ROR 7.2 · χ² 292 / p 1e-65	6.7 EB05 5.4 · IC025 +2.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 6.3	no trial data cached
Treatment noncompliance	55	10.2 7.8–13.2ROR 10.4 · χ² 446 / p 2e-99	9.8 EB05 7.7 · IC025 +2.8 3/3 methods agree	Reporting / coding artifact	serious PRR 4.7	no trial data cached
Heart rate increased	44	4.5 3.3–6.0ROR 4.5 · χ² 115 / p 4e-27	4.3 EB05 3.3 · IC025 +1.6 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 2.1	no trial data cached
Psychotic disorder	42	14.3 10.6–19.3ROR 14.6 · χ² 506 / p 2e-112	14.1 EB05 10.7 · IC025 +3.1 3/3 methods agree	Not in label — unassessed	serious PRR 30.3	no trial data cached
Adverse event	41	4.5 3.3–6.0ROR 4.5 · χ² 107 / p 2e-25	4.3 EB05 3.3 · IC025 +1.6 3/3 methods agree	Reporting / coding artifact	serious PRR 1.2	no trial data cached
Hallucination, auditory	39	24.7 18.1–33.7ROR 25.1 · χ² 860 / p 2e-189	24.3 EB05 18.6 · IC025 +3.7 3/3 methods agree	Not in label — unassessed	serious PRR 66.6	no trial data cached
Hallucination (hallucinations)	29	3.9 2.7–5.6ROR 3.9 · χ² 59 / p 6e-15	3.7 EB05 2.7 · IC025 +1.3 3/3 methods agree	Labeled adverse reaction exact term	serious PRR 11.3	no trial data cached
Suicidal ideation (thoughts of suicide)	23	2.5 1.7–3.8ROR 2.5 · χ² 20 / p 5e-6	2.4 EB05 1.7 · IC025 +0.6	Not in label — unassessed	serious PRR 6.1	no trial data cached

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Hallucination, auditory — n=39, PRR 24.7
Psychotic disorder — n=42, PRR 14.3
Hyperhidrosis — n=75, PRR 5.8
Suicidal ideation — n=23, PRR 2.5

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Xanomeline and Trospium?

In FDA FAERS, the most frequently co-reported reaction terms for Xanomeline and Trospium are nausea, vomiting, constipation, urinary retention, dyspepsia, hyperhidrosis. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Xanomeline and Trospium have an FDA boxed warning?

No. The FDA label retrieved for Xanomeline and Trospium has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Xanomeline and Trospium causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

FDA label via openFDA (set ID 8f0e73bf-6025-44f6-ab64-0983322de0df, effective 20260116; matched on openfda.generic_name.exact:"XANOMELINE AND TROSPIUM CHLORIDE")
Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA count= aggregation, field patient.drug.openfda.generic_name.exact, 33 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction
Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
Seriousness and sex counts from openFDA count=serious, patient.patientsex, seriousnessdeath

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.