- Asenapine Sublingual (Saphris)
- Generic in 2020
- Asenapine patch (Secuado)
- First Antipsychotic patch released at the same time Asenapine became generic in 2020
- Costs $1200/month
- Sublingual Tablet (Saphris)
- Start 5 mg SL twice daily
- May increase after 1 week to 10 mg SL twice daily
- Maximum: 20 mg/day
- Transdermal Patch (Secuado)
- Start 3.8 mg patch per 24 hours
- May increases after 1 week to 5.7 mg patch per 24 hours
- Maximum: 7.6 mg patch per 24 hours (no evidence of efficacy over 3.8 to 5.7 mg dose)
- Bipolar Disorder (including acute mania or mixed disorder)
- Adult
- Start 5 mg SL twice daily
- May increase after 1 week to 10 mg SL twice daily
- Maximum: 20 mg/day
- Child (10 to 17 years old)
- Start 2.5 mg SL twice daily
- May increase after 3 days to 5 mg SL twice daily
- May increase after another 3 days to 10 mg SL twice daily
- Maximum: 20 mg/day
- See Antipsychotic
- Weight gain (moderate risk)
- Extrapyramidal Side Effects (moderate risk)
- Diabetes Mellitus or Hyperglycemia (low risk)
- QT Prolongation (low risk)
- Hyperprolactinemia (moderate risk)
- Nausea or Vomiting
- Insomnia or Somnolence
-
Dystonic Reaction
- Avoid increasing dose too rapidly
- Unknown safety in pregnancy
- Withdrawal and Extrapyramidal Side Effects have been seen in newborns with third trimester exposure
- Avoid in Lactation
- Asenapine Sublingual (DailyMed)
- Asenapine Transdermal (DailyMed)
- (2016) Med Lett Drugs Ther 58(1510): 160-5
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 42-3
- Hamilton (2020) Tarascon Pocket Pharmacopoeia