Asenapine

Asenapine Brand Names- Saphris | SECUADO

What is Asenapine

Asenapine is an atypical antipsychotic agent of the dibenzo-oxepino pyrrole chemical class.

The sublingual tablet is used for the treatment of schizophrenia in adults, manic or mixed episodes associated with bipolar I disorder in adults, maintenance treatment of bipolar I disorder in adults, and as monotherapy treatment for acute bipolar I disorder in pediatric patients 10 years and older.

The asenapine transdermal system is used for the treatment of schizophrenia in adults.

Unlike some other antipsychotics, asenapine has not exhibited a significant effect on the QT interval; post-baseline QT prolongations of more than 500 msec were reported at comparable rates for typical doses of asenapine and placebo in short-term premarketing QT studies.

However, cardiac precautions similar to several other atypical antipsychotics are recommended.

As with all atypical antipsychotics, the labels include a boxed warning regarding an increased mortality risk in elderly patients with dementia-related psychosis.

Indications

1. behavioral or psychological symptoms of dementia
2. bipolar disorder
3. mania
4. schizophrenia

Side Effects

1. abdominal pain
2. agranulocytosis
3. akathisia
4. anaphylactoid reactions
5. anemia
6. angioedema
7. anxiety
8. appetite stimulation
9. arthralgia
10. blurred vision
11. bradycardia
12. bundle-branch block
13. constipation
14. contact dermatitis
15. dehydration
16. dental pain
17. depression
18. diabetic ketoacidosis
19. diarrhea
20. diplopia
21. dizziness
22. drowsiness
23. dysarthria
24. dysgeusia
25. dyskinesia
26. dysmenorrhea
27. dyspepsia
28. dysphagia
29. dyspnea
30. dystonic reaction
31. edema
32. elevated hepatic enzymes
33. erythema
34. fatigue
35. fever
36. gastroesophageal reflux
37. glossitis
38. headache
39. hypercholesterolemia
40. hyperglycemia
41. hyperinsulinemia
42. hyperlipidemia
43. hyperprolactinemia
44. hypersalivation
45. hypertension
46. hyperthermia
47. hypertriglyceridemia
48. hypoesthesia
49. hyponatremia
50. hypotension
51. hypothermia
52. infection
53. insomnia
54. irritability
55. leukopenia
56. maculopapular rash
57. musculoskeletal pain
58. myalgia
59. nasal congestion
60. nausea
61. neuroleptic malignant syndrome
62. neutropenia
63. oral ulceration
64. orthostatic hypotension
65. paresthesias
66. peripheral edema
67. pharyngitis
68. photosensitivity
69. polydipsia
70. pruritus
71. pseudoparkinsonism
72. QT prolongation
73. rash
74. seizures
75. SIADH
76. sinus tachycardia
77. skin discoloration
78. skin hyperpigmentation
79. skin irritation
80. stroke
81. suicidal ideation
82. syncope
83. tardive dyskinesia
84. thrombocytopenia
85. torticollis
86. tremor
87. urinary incontinence
88. visual impairment
89. vomiting
90. water intoxication
91. weight gain
92. wheezing
93. xerosis
94. xerostomia

Monitoring Parameters

• AIMS assessment
• blood glucose
• CBC
• glycosylated hemoglobin A1c (HbA1c)
• LFTs
• neurologic function
• pregnancy testing
• serum electrolytes
• serum lipid profile
• serum prolactin
• thyroid function tests (TFTs)
• weight

Contraindications

• abrupt discontinuation
• agranulocytosis
• alcoholism
• ambient temperature increase
• anticholinergic medications
• bradycardia
• breast cancer
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cerebrovascular disease
• children
• CNS depression
• coadministration with other CNS depressants
• coronary artery disease
• dehydration
• dementia
• diabetes mellitus
• diabetic ketoacidosis
• driving or operating machinery
• dysphagia
• ethanol ingestion
• females
• geriatric
• heart failure
• heating pad
• hematological disease
• hepatic disease
• hypercholesterolemia
• hyperglycemia
• hyperlipidemia
• hyperprolactinemia
• hypertension
• hyperthermia
• hypertriglyceridemia
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypotension
• hypothermia
• hypovolemia
• infants
• infertility
• leukopenia
• long QT syndrome
• malnutrition
• myocardial infarction
• neonates
• neurological disease
• neutropenia
• obesity
• orthostatic hypotension
• Parkinson’s disease
• pregnancy
• pregnancy testing
• QT prolongation
• seizure disorder
• seizures
• strenuous exercise
• stroke
• substance abuse
• suicidal ideation
• syncope
• tachycardia
• tardive dyskinesia
• thyroid disease

Interactions

• Acarbose
• Acebutolol
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Tramadol
• Aclidinium; Formoterol
• Albiglutide
• Albuterol
• Albuterol; Ipratropium
• Alfentanil
• Alfuzosin
• Aliskiren
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-blockers
• Alpha-glucosidase Inhibitors
• Alprazolam
• Ambrisentan
• Amifampridine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxapine
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Apomorphine
• Aprepitant, Fosaprepitant
• Arformoterol
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azilsartan
• Azilsartan; Chlorthalidone
• Azithromycin
• Barbiturates
• Bedaquiline
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzodiazepines
• Betaxolol
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bosentan
• Brexpiprazole
• Brimonidine; Timolol
• Bromocriptine
• Brompheniramine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Budesonide; Formoterol
• Bumetanide
• Buprenorphine
• Buprenorphine; Naloxone
• Bupropion
• Bupropion; Naltrexone
• Buspirone
• Butabarbital
• Butorphanol
• Cabergoline
• Calcium-channel blockers
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan
• Candesartan; Hydrochlorothiazide, HCTZ
• Cannabidiol
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbidopa
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carteolol
• Carvedilol
• Cenobamate
• Central-acting adrenergic agents
• Ceritinib
• Cetirizine
• Cetirizine; Pseudoephedrine
• Cetrorelix
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlorcyclizine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroquine
• Chlorothiazide
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Clemastine
• Clevidipine
• Clobazam
• Clofazimine
• Clomipramine
• Clonazepam
• Clorazepate
• Clozapine
• Cobicistat
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Crizotinib
• Cyproheptadine
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasatinib
• Degarelix
• Desflurane
• Desipramine
• Deutetrabenazine
• Dexchlorpheniramine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmethylphenidate
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diazepam
• Diazoxide
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Dimenhydrinate
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Dorzolamide; Timolol
• Doxazosin
• Doxepin
• Doxylamine
• Doxylamine; Pyridoxine
• Dronabinol
• Dronedarone
• Droperidol
• Dulaglutide
• Duloxetine
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elbasvir; Grazoprevir
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Encorafenib
• Enflurane
• Entacapone
• Entrectinib
• Eplerenone
• Epoprostenol
• Eprosartan
• Eprosartan; Hydrochlorothiazide, HCTZ
• Eribulin
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esketamine
• Esmolol
• Estazolam
• Eszopiclone
• Ethacrynic Acid
• Ethanol
• Exenatide
• Ezogabine
• Felodipine
• Fenoldopam
• Fentanyl
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurazepam
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• food
• Formoterol
• Formoterol; Mometasone
• Foscarnet
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Furosemide
• Gabapentin
• Ganirelix
• Gemifloxacin
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide; Metformin
• Glyburide; Metformin
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Halofantrine
• Halogenated Anesthetics
• Haloperidol
• Halothane
• Histrelin
• Homatropine; Hydrocodone
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hydroxychloroquine
• Hydroxyzine
• Ibuprofen; Oxycodone
• Ibutilide
• Idelalisib
• Iloperidone
• Iloprost
• Imipramine
• Incretin Mimetics
• Indacaterol
• Indacaterol; Glycopyrrolate
• Indapamide
• Inotuzumab Ozogamicin
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Irbesartan
• Isavuconazonium
• Isocarboxazid
• Isoflurane
• Isradipine
• Itraconazole
• Ivosidenib
• Ketoconazole
• Labetalol
• Lapatinib
• Lasmiditan
• Lefamulin
• Lemborexant
• Lenvatinib
• Leuprolide
• Leuprolide; Norethindrone
• Levalbuterol
• Levocetirizine
• Levodopa
• Levofloxacin
• Levorphanol
• Linagliptin
• Linagliptin; Metformin
• Liraglutide
• Lisinopril
• Lithium
• Lixisenatide
• Lofexidine
• Long-acting beta-agonists
• Loop diuretics
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Losartan
• Loxapine
• Lumateperone
• Lurasidone
• Macimorelin
• Maprotiline
• Mecamylamine
• Meclizine
• Mefloquine
• Meglitinides
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Meprobamate
• Mesoridazine
• Metaproterenol
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methadone
• Methohexital
• Methyclothiazide
• Methylphenidate
• Metoclopramide
• Metolazone
• Metoprolol
• Metronidazole
• Midazolam
• Midostaurin
• Mifepristone
• Miglitol
• Minoxidil
• Mirabegron
• Mirtazapine
• Mitotane
• Moexipril
• Molindone
• Monoamine oxidase inhibitors
• Morphine
• Morphine; Naltrexone
• Moxifloxacin
• Nabilone
• Nadolol
• Nafarelin
• Nalbuphine
• Nateglinide
• Nebivolol
• Nebivolol; Valsartan
• Nicardipine
• Nifedipine
• Nilotinib
• Nimodipine
• Nisoldipine
• Nitroprusside
• Non-Ionic Contrast Media
• Norfloxacin
• Nortriptyline
• Obeticholic Acid
• Octreotide
• Ofloxacin
• Olanzapine
• Olmesartan
• Olodaterol
• Ondansetron
• Oritavancin
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxazepam
• Oxycodone
• Oxymorphone
• Paliperidone
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Peginterferon Alfa-2b
• Penbutolol
• Pentamidine
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Pergolide
• Perindopril
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenelzine
• Phenobarbital
• Phenoxybenzamine
• Phentolamine
• Phenylephrine; Promethazine
• Pimavanserin
• Pimozide
• Pindolol
• Pioglitazone
• Pirbuterol
• Pitolisant
• Posaconazole
• Potassium-sparing diuretics
• Pramipexole
• Pramlintide
• Prazosin
• Pregabalin
• Primaquine
• Primidone
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Propranolol
• Protriptyline
• Quazepam
• Quetiapine
• Quinapril
• Quinidine
• Quinine
• Ramelteon
• Ramipril
• Ranolazine
• Rasagiline
• Remifentanil
• Repaglinide
• Reserpine
• Ribociclib
• Ribociclib; Letrozole
• Rilpivirine
• Risperidone
• Rolapitant
• Romidepsin
• Ropinirole
• Rosiglitazone
• Rotigotine
• Sacubitril; Valsartan
• Safinamide
• Salmeterol
• Saquinavir
• Saxagliptin
• Secobarbital
• Selegiline
• Semaglutide
• Sertraline
• Sevoflurane
• SGLT2 Inhibitors
• Short-acting beta-agonists
• Sibutramine
• Simeprevir
• Simvastatin; Sitagliptin
• Siponimod
• Sitagliptin
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Solifenacin
• Sorafenib
• Sotalol
• Sparfloxacin
• Spironolactone
• Sufentanil
• Sulfonylureas
• Sunitinib
• Suvorexant
• Tacrine
• Tacrolimus
• Tamoxifen
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• Telavancin
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• Telmisartan
• Temazepam
• Terazosin
• Terbutaline
• Tetrabenazine
• Thiabendazole
• Thiazide diuretics
• Thiopental
• Thioridazine
• Thiothixene
• Timolol
• Tiotropium; Olodaterol
• Tolcapone
• Tolterodine
• Toremifene
• Torsemide
• Tramadol
• Trandolapril
• Trandolapril; Verapamil
• Tranylcypromine
• Trazodone
• Treprostinil
• Triamterene
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Trimipramine
• Triprolidine
• Triptorelin
• Umeclidinium; Vilanterol
• Valsartan
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Verapamil
• Voriconazole
• Vorinostat
• Zaleplon
• Ziprasidone
• Zolpidem
• Zonisamide