Medical Information

The contraindications of Cobenfy (KarXT) involve specific populations, food interactions, and clinical limitations, and must be strictly followed to ensure medication safety. The following provides a systematic explanation from three aspects: absolute contraindications, dietary taboos, and special restrictions, to provide clear basis for clinical decision-making.

1. Absolute taboo group

(1) Severe liver dysfunction

Child Pugh Class C patients are contraindicated as significant inhibition of drug metabolism may lead to toxicity accumulation.

(2) Severe renal dysfunction

If the creatinine clearance rate is less than 30ml/min, it is contraindicated. Impaired renal excretion function can easily lead to adverse reactions.

(3) Pregnant women

Animal studies have shown embryotoxicity, and human data is limited, but it is recommended to completely ban it.

2. Dietary taboos

(1) Grapefruit products

Do not eat together, as the furan coumarin it contains can inhibit CYP3A4 enzyme, leading to a blood drug concentration increase of over 200%.

(2) High-fat diet

Avoid excessive intake of fat (>60g/meal) during medication, as it may delay drug absorption by up to 2 hours.

3. Special Restrictions

(1) Cardiovascular disease

Patients with a history of QT interval prolongation require electrocardiographic monitoring as medication may increase the risk of arrhythmia.

(2) History of epilepsy

Neurological evaluation is required before use, and clinical trial reports indicate that 0.5% of patients experienced epileptic seizures.

(3) Drug combination restrictions

Do not use in combination with potent CYP3A4 inhibitors (such as clarithromycin), and use in combination with moderate inhibitors should be reduced by 50%.