I didn’t feel heard. I didn’t feel seen, like, what am I supposed to tell them? Another thing, they’re not going to believe me on?
If a doctor shuts you down, we should all be able to advocate for ourselves and say, “Hey, listen, you know, I disagree with this,” or “let’s have a discussion,” or “what are my options?” “I’m concerned about A, B, C or D.”
My name is Patricia Ares-Romero, and I’m a board-certified psychiatrist. Many times, not only the diagnosis is delayed, but the correct treatment, right, is delayed. And that’s the key.
I had a brother who was diagnosed with schizophrenia in his mid-20s. My brother’s diagnosis affected my family in a million ways. Trying to find the right treatment for him and to get him the help he needed, even when he didn’t want it, which was a really big part of the struggle.
The importance with patients, they really need to be honest with their symptoms. And only when we know about these symptoms are we able to treat them appropriately.
Because there’s such a broad range of symptoms, that schizophrenia is such an umbrella, meaning so many different things and manifesting in so many ways, that it’s hard also to explain your symptoms clearly because they are so challenging and so complicated.
This is why it’s so important for me to meet with a patient, meet with the family, and kind of really understand what other symptoms they may be experiencing that maybe they haven’t told me about.
I imagine it takes a lot of courage, but I also imagine it’s incredibly important to be able to have these really honest conversations with your health care providers.
If a family comes to my office and says, listen, you know, we found out about this medication or this is going on, I think it’s so important. It’s very easy to be isolated and withdrawn when you’re struggling with a disease that’s so complex. And having that connection, with family, with friends, with community, with providers inclusive really helps together with the right treatment.
We will now review Important Safety Information. Please see the top of this webpage for links to Patient Information and full Prescribing Information for COBENFY.
COBENFY™ (xanomeline and trospium chloride) is a prescription medicine used to treat schizophrenia in adults. It is not known if COBENFY is safe and effective in children.
IMPORTANT SAFETY INFORMATION
Do not take COBENFY if you:
- have urinary retention problems that cause your bladder to not empty completely or not empty at all
- have moderate or severe liver problems (impairment)
- have gastric retention problems that cause your stomach to empty slowly
- are allergic to COBENFY, xanomeline, or trospium chloride, or any of the ingredients in COBENFY
- have an eye problem called untreated narrow-angle glaucoma
Before taking COBENFY, tell your healthcare provider about all of your medical conditions, including if you:
- have an enlarged prostate, problems passing urine, or a blockage in your urinary bladder
- have liver problems
- have or have had gallstones or problems with your bile ducts or pancreas
- have stomach or intestinal problems, including constipation, ulcerative colitis, slow emptying of your stomach, or myasthenia gravis
- have an eye condition called narrow-angle glaucoma
- have kidney problems
- are pregnant or plan to become pregnant. It is not known if COBENFY may harm your unborn baby. Tell your healthcare provider if you become pregnant or think you are pregnant during treatment with COBENFY.
- There is a pregnancy exposure registry for women who take COBENFY during pregnancy. The purpose of this registry is to collect information about the health of women exposed to COBENFY and their baby. If you become pregnant during treatment with COBENFY, your healthcare provider will register you by calling 1-866-961-2388 or online at https://womensmentalhealth.org/research/pregnancyregistry/atypicalantipsychotic/
- are breastfeeding or plan to breastfeed. It is not known if COBENFY passes into your breast milk or if it can harm your baby
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking COBENFY with certain other medicines may increase your risk of side effects from COBENFY or the other medicine and may affect the way COBENFY or the other medicine works. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
What should I avoid while taking COBENFY?
Do not drive, operate heavy machinery, or do other dangerous activities until you know how COBENFY affects you. COBENFY may cause dizziness, confusion, seeing or hearing things that are not real (hallucinations), and sleepiness.
COBENFY may cause serious side effects, including:
- Problems with emptying your bladder (urinary retention). See “Do not take COBENFY if you:” COBENFY may cause your bladder to not empty completely or not empty at all. You are at increased risk for urinary retention if you are elderly, have a blockage in your bladder, have an enlarged prostate called benign prostatic hyperplasia (BPH), have bladder emptying problems from diabetes, or are taking higher doses of COBENFY. Urinary retention may increase your risk for getting a urinary tract infection. Call your healthcare provider or get emergency help right away if you get any signs or symptoms of urinary retention during treatment with COBENFY, including:
- difficulty urinating
- urination in a weak stream or drips
- urinating frequently
- full bladder and difficulty emptying your bladder
- pain when you urinate
- Risks in people with liver problems. See “Do not take COBENFY if you:” It is not recommended that people with mild liver problems (impairment) take COBENFY because they have an increased risk of getting side effects from COBENFY. Your healthcare provider will check the liver enzyme levels in your blood before starting treatment and as needed during treatment with COBENFY. Tell your healthcare provider if you get any signs or symptoms of liver problems during treatment with COBENFY, including:
- yellowing of your skin or the white part of your eyes
- dark urine
- pain and swelling in the upper right part of your stomach (abdomen)
- stomach pain that spreads to your back or to below your right shoulder
- itching
- nausea or vomiting
- loss of appetite
- fever
- chills
- light-colored stools
- tiredness
- Risks in people with bile duct and gallbladder problems (biliary disease). COBENFY may cause a blockage in your bile ducts that could lead to gallstones, pancreatitis, and increases in your liver enzymes. Your healthcare provider will check your liver enzyme and bilirubin levels in your blood before starting treatment and as needed during treatment with COBENFY. Tell your healthcare provider if you get any signs or symptoms of biliary disorders during treatment with COBENFY, including:
- stomach upset or burning (dyspepsia)
- nausea
- vomiting
- pain in the upper right part of your stomach
- Slow emptying of your stomach (decreased gastrointestinal motility). See “Do not take COBENFY if you:” You are at increased risk for getting decreased gastrointestinal motility if you have ulcerative colitis, already have problems with slow stomach emptying, and have myasthenia gravis. Tell your healthcare provider if you get any signs and symptoms of decreased gastrointestinal motility during treatment with COBENFY, including:
- constipation
- vomiting
- nausea
- stomach (abdominal) bloating
- stomach (abdominal) pain
- a feeling of fullness after eating just a few bites
- acid reflux
- Serious allergic reactions (angioedema). Angioedema may happen during treatment with COBENFY and can be life threatening. Stop taking COBENFY and call your healthcare provider or get emergency help right away if you get any of the following signs or symptoms of a serious allergic reaction during treatment with COBENFY, including:
- hives
- swelling of your face, lips, mouth, or tongue
- swelling of your throat
- hoarseness or difficulty speaking
- breathing problems
- An eye problem called narrow-angle glaucoma. See “Do not take COBENFY if you:” If you already have narrow angles in your eyes, COBENFY may cause a sudden attack (acute angle closure) of glaucoma. Tell your healthcare provider if you get any signs or symptoms of narrow-angle glaucoma during treatment with COBENFY, including:
- red eyes
- blurred vision
- seeing halos or bright colors around lights
- eye pain or discomfort
- nausea or vomiting
- severe headache
Increases in heart rate. COBENFY may increase your heart (pulse) rate. Your healthcare provider should check your heart rate before you start treatment and during treatment as needed. Tell your healthcare provider if you get a racing or pounding feeling in your chest during treatment with COBENFY.
Side effects in people with kidney problems. People with kidney problems may have an increased risk of getting dry mouth, constipation, stomach upset or burning, urinary tract infection, and urinary retention during treatment with COBENFY.
- Central nervous system problems. See “What should I avoid while taking COBENFY?”
The most common side effects of COBENFY include:
- nausea
- stomach upset or burning (dyspepsia)
- constipation
- vomiting
- high blood pressure
- stomach (abdominal) pain
- diarrhea
- increased heart rate
- dizziness
- heartburn (gastrointestinal reflux disease)
Your healthcare provider may lower your dose or stop treatment with COBENFY if you get certain side effects.
These are not all of the possible side effects of COBENFY.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Please see the Full Prescribing Information, including Patient Information at www.cobenfy.com or click the buttons at the top of this webpage.
