Asenapine
Bipolar Disorder, Schizophrenia
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Atypical Antipsychotic
Controlled Drug Substance
NO
Asenapine
Summary
Asenapine is used to treat schizophrenia and bipolar I disorder in adults, and manic or mixed episodes in bipolar I disorder in children aged 10 years and older.
Asenapine works by blocking certain receptors in the brain, including dopamine D2 and serotonin 5HT2A receptors. This helps to balance neurotransmitters and reduce symptoms such as hallucinations, mood swings, and disorganized thinking.
For adults, the usual dose for schizophrenia is 5 mg twice daily. For bipolar I disorder, the dose ranges from 5 mg to 10 mg twice daily. In children aged 10 to 17 years, the starting dose is 2.5 mg twice daily. Asenapine is taken as a sublingual tablet, placed under the tongue to dissolve.
Common side effects of Asenapine include drowsiness, weight gain, and oral numbness. Serious adverse effects can include neuroleptic malignant syndrome, tardive dyskinesia, and metabolic changes like high blood sugar.
Asenapine carries a risk of increased mortality in elderly patients with dementia-related psychosis and is not approved for treating this condition. It should not be used in patients with severe liver impairment or those with a history of hypersensitivity to the drug.
Indications and Purpose
How does Asenapine work?
Asenapine works by altering the activity of neurotransmitters in the brain, particularly dopamine and serotonin. It acts as an antagonist at various receptors, helping to stabilize mood and reduce symptoms of schizophrenia and bipolar disorder.
Is Asenapine effective?
Asenapine's effectiveness is supported by clinical trials showing its superiority to placebo in reducing symptoms of schizophrenia and bipolar I disorder. In trials, it improved scores on the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Young Mania Rating Scale (YMRS) for bipolar disorder.
What is Asenapine?
Asenapine is used to treat schizophrenia and bipolar I disorder. It works by altering the activity of certain natural substances in the brain, helping to control symptoms like unusual thinking and mood swings. Asenapine is an atypical antipsychotic that targets dopamine and serotonin receptors.
Directions for Use
For how long do I take Asenapine?
Asenapine is used for long-term management of schizophrenia and bipolar I disorder. The duration of use depends on the individual's response and the doctor's recommendation. It is important to continue taking asenapine even if you feel well, unless advised otherwise by your doctor.
How do I take Asenapine?
Asenapine is taken as a sublingual tablet, placed under the tongue to dissolve completely. Do not eat or drink for 10 minutes after taking the tablet. There are no specific food restrictions, but avoid alcohol as it can worsen side effects.
How long does it take for Asenapine to start working?
Asenapine may start to show effects within a few days, but it can take several weeks to experience the full benefits. It's important to continue taking the medication as prescribed and discuss any concerns with your doctor.
How should I store Asenapine?
Store asenapine in its original container, tightly closed, at room temperature away from excess heat and moisture. Keep it out of reach of children. Do not store it in the bathroom. Dispose of unneeded medication through a take-back program.
What is the usual dose of Asenapine?
For adults with schizophrenia, the recommended dose of asenapine is 5 mg taken twice daily. For bipolar I disorder, the starting dose is 5 mg to 10 mg twice daily. In children aged 10 to 17 years with bipolar I disorder, the starting dose is 2.5 mg twice daily, which can be increased to 5 mg and then to 10 mg twice daily based on response and tolerability.
Warnings and Precautions
Can Asenapine be taken safely while breastfeeding?
Asenapine is excreted in rat milk, and it is unknown if it is excreted in human milk. Breastfeeding is not recommended during treatment with asenapine. Discuss with your doctor the potential risks and benefits before using asenapine while breastfeeding.
Can Asenapine be taken safely while pregnant?
There is limited data on the use of asenapine during pregnancy. It should only be used if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotics during the third trimester are at risk for withdrawal symptoms. Consult your doctor for personalized advice.
Can I take Asenapine with other prescription drugs?
Asenapine may interact with antihypertensive drugs, enhancing their effects. It should be used cautiously with strong CYP1A2 inhibitors like fluvoxamine, which can increase asenapine levels. It may also interact with CYP2D6 substrates and inhibitors, such as paroxetine, affecting their metabolism.
Is Asenapine safe for the elderly?
Elderly patients with dementia-related psychosis have an increased risk of death when treated with antipsychotic drugs like asenapine. It is not approved for this use. Elderly patients should be monitored carefully for side effects, and dosage adjustments may be necessary based on individual tolerance.
Is it safe to drink alcohol while taking Asenapine?
Drinking alcohol while taking asenapine can worsen its side effects, such as drowsiness and dizziness. It is advised to avoid alcohol to ensure the medication's safety and effectiveness.
Is it safe to exercise while taking Asenapine?
Asenapine may cause dizziness, drowsiness, and difficulty maintaining balance, which could affect your ability to exercise safely. If you experience these symptoms, it is advisable to avoid strenuous activities and consult your doctor for guidance.
Who should avoid taking Asenapine?
Key warnings for asenapine include increased mortality in elderly patients with dementia-related psychosis, risk of neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, and orthostatic hypotension. It is contraindicated in patients with severe hepatic impairment and those with hypersensitivity to asenapine.
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