Avanafil and Xanomeline: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Avanafil
Xanomeline
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased oral sensitive CYP3A4 substrate exposure and an increased risk on severity and frequency of sensitive CYP3A4 substrate-related adverse reactions
Interaction Deep Dive
Xanomeline, transiently inhibits CYP3A4 locally in the gut but not systemically. Concomitant use of xanomeline with oral drugs that are sensitive substrates of CYP3A4 may increase exposure of the oral drugs that are sensitive substrates of CYP3A4. This may increase the frequency and/or severity of adverse reactions from such substrates. If concomitantly used, monitor patients for increased frequency and/or severity of adverse reactions related to oral drugs that are sensitive substrates of CYP3A41.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by xanomeline
Common questions
Can I take Avanafil and Xanomeline together?
Increased oral sensitive CYP3A4 substrate exposure and an increased risk on severity and frequency of sensitive CYP3A4 substrate-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Avanafil and Xanomeline interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Avanafil or Xanomeline need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: COBENFY(TM) oral capsules, xanomeline, trospium chloride oral capsules. Bristol-Myers Squibb Company (Per FDA), Princeton, NJ, 2024. DailyMed
Keep reading about Avanafil
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