Trospium

Summary

Trospium (CHEMBL1888176) is an approved small-molecule muscarinic antagonist (ATC G04BD09); indicated across 3 conditions including overactive bladder.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: G04BD09
• Indications: 3 conditions
• Clinical trials: 15
• Chemistry: 392.5 Da · C25H30NO3+

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1888176
Name	Trospium
Type	Small molecule
Max phase	4
FDA approved	no
PubChem CID	5284632
ChEBI	CHEBI:145791
ATC	G04BD09
Molecular formula	C25H30NO3+
Molecular weight	392.5
InChIKey	OYYDSUSKLWTMMQ-AIZNXBIQSA-N

SMILES: C1CC[N+]2(C1)[C@@H]3CC[C@H]2CC(C3)OC(=O)C(C4=CC=CC=C4)(C5=CC=CC=C5)O

IUPAC name: [(1R,5S)-spiro[8-azoniabicyclo[3.2.1]octane-8,1’-azolidin-1-ium]-3-yl] 2-hydroxy-2,2-diphenylacetate

ChEBI definition: A carboxylic ester resulting from the formal condensation of the carboxy group of hydroxy(diphenyl)acetic acid with the hydroxy group of (1S,3R,5R)-3-hydroxy-8λ5-azaspiro[bicyclo[3.2.1]octane-8,1’-pyrrolidin]-8-ylium. Its chloride salt is used to treat overactive bladder.

Pharmacological roles (ChEBI): muscarinic antagonist, antispasmodic drug.

Also known as: Trospium, Trospium cation, Trospium ion, trospium, SID50112692, TROSPIUM, Trospium chloride (Sanctura)

Parent form; salt/anhydrous children: CHEMBL3084748

Patent coverage: 12 distinct patent families (17 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 5 (assay-derived). Sample: Muscarinic acetylcholine receptor M2, Muscarinic acetylcholine receptor M1, Histamine H1 receptor, Voltage-gated inwardly rectifying potassium channel KCNH2, Muscarinic acetylcholine receptor M3.

Bioactivity

ChEMBL activities: 6 potent at pChembl ≥ 5 of 7 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
CHRM1	8.57	AC50	2.7	nM	CHEMBL_ACT_25210763
CHRM2	8.21	AC50	6.1	nM	CHEMBL_ACT_25213378
CHRM3	8.05	AC50	8.9	nM	CHEMBL_ACT_25136328
CHRM2	7.58	AC50	26	nM	CHEMBL_ACT_25195170
CHRM1	7.55	AC50	28	nM	CHEMBL_ACT_25135066
KCNH2	6.2	AC50	630	nM	CHEMBL_ACT_25117296

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

3 indications (2 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
overactive bladder	1	MONDO:0006624	EFO:1000781

2 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 15.

Phase distribution

Phase	Trials
PHASE4	4
Not specified	4
PHASE3	3
PHASE1/PHASE2	2
PHASE1	2

Top trials by phase / activity

NCT	Phase	Status	Title
NCT06923891	PHASE4	NOT_YET_RECRUITING	An Open-Label Study to Evaluate the Efficacy and Tolerability of Xanomeline/Trospium In First Episode/Early Phase Schizophrenia Patients
NCT00932022	PHASE4	COMPLETED	Trospium Chloride XR in Obese Female Patients With Overactive Bladder
NCT04090190	PHASE4	COMPLETED	Inflammation in Women With Urgency Urinary Incontinence Treated With Anticholinergics
NCT04227184	PHASE4	COMPLETED	Investigation of Brain Mechanisms Involved in Urgency Urinary Incontinence
NCT07011732	PHASE3	RECRUITING	A Phase 3 Study to Evaluate the Safety and Efficacy of KarXT + KarX-EC for the Treatment of Agitation Associated With Alzheimer’s Disease (ADAGIO-1)
NCT07011745	PHASE3	RECRUITING	A Phase 3 Study to Evaluate the Safety and Efficacy of KarXT + KarX-EC for the Treatment of Agitation Associated With Alzheimer’s Disease (ADAGIO-2)
NCT07084831	PHASE3	NOT_YET_RECRUITING	A Study Evaluating the Efficacy of Xanomeline/Trospium (XT) on Cognitive Impairment After 24 and 52 Weeks of Treatment in Adult Participants With Schizophrenia
NCT07423546	PHASE1/PHASE2	NOT_YET_RECRUITING	A PET/MRI Study of Cobenfy on Dopamine Transmission in Schizophrenia
NCT00465959	PHASE1/PHASE2	COMPLETED	Study of Trospium Chloride Inhalation Powder (TrIP) in Patients With Chronic Obstructive Pulmonary Disease
NCT07063342	PHASE1	RECRUITING	A Study to Evaluate Novel KarX and KarT Prototypes Versus the KarXT and KarX-EC Reference Following Single Doses, and to Explore the Effect of Food After Multiple Doses of Selected Prototypes in Healthy Adult Participants
NCT00986401	PHASE1	COMPLETED	Safety and Tolerability of Trospium Chloride and Metformin Hydrochloride in Healthy Subjects
NCT07379827	Not specified	RECRUITING	Effectiveness and Adverse-effect Switch Evaluation of Xanomeline and Trospium Chloride (KarXT)
NCT01499069	Not specified	COMPLETED	Urinary Nerve Growth Factor (NGF), Prostaglandin E2 (PGE2)and Adenosine Triphosphate (ATP): Potential Biomarkers in Overactive Bladder Patients
NCT03572231	Not specified	COMPLETED	A Registry Study of Patients Initiating a Course of Drug Therapy for Overactive Bladder in Taiwan, Korea and China
NCT03602508	Not specified	COMPLETED	Treatment Persistence Among Patients With Overactive Bladder: A Retrospective Secondary Data Analysis in Asia Oceania

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No PharmGKB pharmacogenomic data curated for this drug.

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).