Asenapine

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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
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  • Amlodipine
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  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
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  • Aspirin, ASA; Caffeine; Dihydrocodeine
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  • Aspirin, ASA; Oxycodone
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  • Chlordiazepoxide; Clidinium
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  • 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
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  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
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  • food
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