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Asenapine

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Asenapine, Saphris, Secuado

  • See Also
  1. Antipsychotic Medication
  2. Psychosis
  • Indications
  1. Schizophrenia
  2. Bipolar Disorder
  3. Mania
  • Preparations
  1. Asenapine Sublingual (Saphris)
    1. Generic in 2020
  2. Asenapine patch (Secuado)
    1. First Antipsychotic patch released at the same time Asenapine became generic in 2020
    2. Costs $1200/month
  1. Sublingual Tablet (Saphris)
    1. Start 5 mg SL twice daily
    2. May increase after 1 week to 10 mg SL twice daily
    3. Maximum: 20 mg/day
  2. Transdermal Patch (Secuado)
    1. Start 3.8 mg patch per 24 hours
    2. May increases after 1 week to 5.7 mg patch per 24 hours
    3. Maximum: 7.6 mg patch per 24 hours (no evidence of efficacy over 3.8 to 5.7 mg dose)
  1. Adult
    1. Start 5 mg SL twice daily
    2. May increase after 1 week to 10 mg SL twice daily
    3. Maximum: 20 mg/day
  2. Child (10 to 17 years old)
    1. Start 2.5 mg SL twice daily
    2. May increase after 3 days to 5 mg SL twice daily
    3. May increase after another 3 days to 10 mg SL twice daily
    4. Maximum: 20 mg/day
  • Adverse Effects
  1. See Antipsychotic
  2. Weight gain (moderate risk)
  3. Extrapyramidal Side Effects (moderate risk)
  4. Diabetes Mellitus or Hyperglycemia (low risk)
  5. QT Prolongation (low risk)
  6. Hyperprolactinemia (moderate risk)
  7. Nausea or Vomiting
  8. Insomnia or Somnolence
  9. Dystonic Reaction
    1. Avoid increasing dose too rapidly
  • Safety
  1. Unknown safety in pregnancy
    1. Withdrawal and Extrapyramidal Side Effects have been seen in newborns with third trimester exposure
  2. Avoid in Lactation
  • Resources
  1. Asenapine Sublingual (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=16e1cc9f-7699-49ea-b179-acb65e162304
  2. Asenapine Transdermal (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=685eaf44-5944-4f38-afba-0a4fc0b3462b
  • References
  1. (2016) Med Lett Drugs Ther 58(1510): 160-5
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 42-3
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia