atomoxetine + oxybutynin + acetazolamide

SAS0421c is an experimental triple-combination pharmacological therapy comprising **atomoxetine**, **oxybutynin**, and **acetazolamide**, currently under investigation by **Brigham and Women's Hospital** for the treatment of **obstructive sleep apnea (OSA)**. The therapy utilizes a multi-mechanistic approach to address the pathophysiological drivers of OSA: atomoxetine (a norepinephrine reuptake inhibitor) and oxybutynin (an antimuscarinic) act synergistically to enhance pharyngeal dilator muscle activity (specifically the genioglossus) during sleep, while acetazolamide (a carbonic anhydrase inhibitor) serves as a respiratory stimulant that reduces ventilatory instability, known as loop gain. This combination is being evaluated in the **ComboPlus** clinical trial (NCT04213300) to determine if targeting multiple non-anatomical traits can significantly reduce the apnea-hypopnea index (AHI) compared to single-agent or dual-agent therapies, potentially offering a pharmacological alternative to continuous positive airway pressure (CPAP).

Other names

Ato-Oxy-AceComboPlus triple therapy