The Kingsley Clinic

Asenapine Medication: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

Asenapine is an atypical antipsychotic used to manage mental health conditions such as schizophrenia, bipolar disorder, and other mood disorders. It works by balancing certain chemicals in the brain, which helps improve mood, thinking, and behavior. Asenapine is available as sublingual tablets and is typically prescribed for long-term treatment. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with your treatment plan.

Names of Medication

US Brand Name: Saphris

Generic Name: Asenapine

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will be used in parentheses.

Pharmacologic Category

Asenapine belongs to the class of medications known as atypical antipsychotics. Other medications in this category include:

  1. Risperidone (Risperdal)
  2. Olanzapine (Zyprexa)
  3. Quetiapine (Seroquel)
  4. Aripiprazole (Abilify)

Asenapine Dosage

Asenapine is prescribed for various mental health conditions. The dosage and frequency depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. If you need assistance, our telemedicine services are available for immediate consultation.

Schizophrenia (Adults)

Initial Dose: 5 mg sublingually twice daily

Maintenance Dose: 5-10 mg sublingually twice daily

Duration: Long-term treatment, as directed by your healthcare provider

Bipolar Disorder (Adults)

Initial Dose: 5 mg sublingually twice daily

Maintenance Dose: 5-10 mg sublingually twice daily

Duration: Long-term treatment, as directed by your healthcare provider

Agitation Associated with Schizophrenia or Bipolar Disorder (Adults)

Initial Dose: 10 mg sublingually once

Maintenance Dose: 5-10 mg sublingually twice daily

Duration: As needed for acute episodes, followed by long-term management

Major Depressive Disorder (Adults, adjunctive therapy)

Initial Dose: 5 mg sublingually twice daily

Maintenance Dose: 5-10 mg sublingually twice daily

Duration: Long-term treatment, as directed by your healthcare provider

Anxiety Disorders, Psychotic Disorders, Depression, Mood Disorders, Schizoaffective Disorder (Adults)

Initial Dose: 5 mg sublingually twice daily

Maintenance Dose: 5-10 mg sublingually twice daily

Duration: Long-term treatment, as directed by your healthcare provider

Dosage Forms and Strengths

Asenapine is available in the following forms and strengths:

  1. Sublingual tablets: 5 mg, 10 mg

Administration Instructions for Asenapine

Asenapine is taken sublingually, meaning it dissolves under the tongue. Do not chew, crush, or swallow the tablet. To ensure full absorption, avoid eating or drinking for at least 10 minutes after taking the medication. Follow your healthcare provider’s instructions carefully, and if you have any questions, consult your doctor or one of our telemedicine providers.

Asenapine Side Effects and Adverse Reactions

Like all medications, Asenapine may cause side effects. Some are common and mild, while others can be more serious. If you experience any side effects, contact your healthcare provider immediately. Below are some potential side effects:

Common Side Effects (affecting more than 1 in 10 people)

  1. Drowsiness: Feeling unusually sleepy or fatigued.
  2. Weight gain: Some patients may notice an increase in weight.
  3. Dry mouth: A sensation of dryness in the mouth.

Less Common Side Effects (affecting 1 in 100 people)

  1. Restlessness: A feeling of being unable to sit still or relax.
  2. Increased heart rate: A faster-than-normal heartbeat.
  3. Dizziness: Feeling lightheaded or unsteady.

Serious Side Effects (rare, but require immediate medical attention)

  1. Severe allergic reactions: Swelling of the face, tongue, or throat, and difficulty breathing.
  2. Tardive dyskinesia: Uncontrollable movements, particularly in the face or limbs.
  3. Neuroleptic malignant syndrome: A rare but life-threatening reaction characterized by fever, muscle stiffness, and confusion.

If you experience any of these side effects or have concerns about your medication, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Contraindications for Asenapine

A contraindication is a specific condition where a medication should not be used due to potential harm. For Asenapine, contraindications include:

  1. Severe liver impairment: Asenapine is metabolized in the liver, and impaired liver function may increase the risk of side effects or toxicity.
  2. Allergic reaction to Asenapine: If you’ve had an allergic reaction to Asenapine, such as hives, swelling, or difficulty breathing, avoid taking it again as it could be life-threatening.
  3. Heart problems: Asenapine can affect the heart’s electrical activity, potentially leading to arrhythmias. If you have a history of heart disease, particularly heart rhythm disorders, this medication may not be suitable for you.
  4. Severe hypotension (low blood pressure): Asenapine can lower blood pressure, which may be dangerous for individuals with low blood pressure or those prone to fainting.

If you have any of these conditions, discuss them with your healthcare provider. Our telemedicine providers are available to help you find the right treatment options for your health needs.

Drug to Drug Interactions

Asenapine can interact with other medications, potentially increasing side effects or reducing the effectiveness of one or both drugs. Some medications that may interact with Asenapine include:

  1. Fluoxetine (Prozac): This antidepressant can raise Asenapine levels in your body, increasing the risk of side effects.
  2. Paroxetine (Paxil): Another antidepressant that can elevate Asenapine levels, potentially leading to more side effects.
  3. Ketoconazole (Nizoral): This antifungal can interfere with Asenapine metabolism, raising its concentration in the bloodstream.
  4. Carbamazepine (Tegretol): This anticonvulsant can lower Asenapine levels, reducing its effectiveness.
  5. Quinidine (Quinidex): This heart medication can increase the risk of heart rhythm issues when taken with Asenapine.

Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Our telemedicine team can review your medication list to help you avoid potential interactions.

Asenapine in Pregnancy

Is it Safe to Take Asenapine During Pregnancy?

Asenapine is classified as a pregnancy category C drug by the FDA, meaning there is insufficient well-controlled research in humans to determine its safety during pregnancy. Animal studies have shown potential risks to the fetus, but the benefits of using the medication may outweigh the risks in certain cases. If you are pregnant or planning to become pregnant, discuss the risks and benefits of continuing Asenapine with your healthcare provider. Our telemedicine providers can help you evaluate your options and make an informed decision about your treatment during pregnancy.

Asenapine While Breastfeeding

Is it Safe to Take Asenapine While Breastfeeding?

It is unclear whether Asenapine passes into breast milk. Due to the potential for serious side effects in a nursing infant, using Asenapine while breastfeeding is generally not recommended. If you are breastfeeding or planning to breastfeed, consult your healthcare provider about alternative treatments. Our telemedicine providers can help you explore safer options for both you and your baby.

Estimated Cost of Asenapine Medication

The cost of a 30-day supply of Asenapine (5 mg or 10 mg tablets) without insurance can range from $200 to $400, depending on the pharmacy. However, using a GoodRx coupon, you may reduce the cost to approximately $100 to $150. Prices vary, so it’s advisable to check with your local pharmacy or use a coupon service like GoodRx to find the best price.

Possible Alternatives to Asenapine

If you are taking Asenapine for any of the following conditions, alternative treatments or lifestyle changes may help. Always discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these alternatives.

  1. Schizophrenia: Other antipsychotic medications, such as Risperidone (Risperdal) or Aripiprazole (Abilify), may be used. Cognitive behavioral therapy (CBT) and family support can also be beneficial.
  2. Bipolar disorder: Mood stabilizers like Lithium or anticonvulsants like Valproate (Depakote) are commonly used. Lifestyle changes, such as maintaining regular sleep patterns and managing stress, can also help manage symptoms.
  3. Major depressive disorder: Antidepressants like Sertraline (Zoloft) or Escitalopram (Lexapro) may be alternatives. Psychotherapy and regular exercise have also been shown to improve mood.
  4. Anxiety disorders: Medications like Buspirone (Buspar) or selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine (Prozac) may be considered. Mindfulness techniques and relaxation exercises can also help reduce anxiety.
  5. Psychotic disorders: Other antipsychotic medications, such as Olanzapine (Zyprexa) or Quetiapine (Seroquel), may be used. Psychotherapy and social support are also important components of treatment.
  6. Agitation associated with schizophrenia or bipolar disorder: Short-term use of medications like Lorazepam (Ativan) or Haloperidol (Haldol) may help manage acute agitation. Behavioral interventions can also be helpful.
  7. Depression: In addition to antidepressants, lifestyle changes such as regular exercise, a healthy diet, and adequate sleep can improve symptoms. Cognitive behavioral therapy (CBT) is also an effective treatment.
  8. Mood disorders: Medications like Lamotrigine (Lamictal) or Quetiapine (Seroquel) may be considered. Regular physical activity and stress management techniques can also help stabilize mood.
  9. Schizoaffective disorder: A combination of antipsychotic medications and mood stabilizers may be used. Psychotherapy and support groups can also be beneficial.

Recent Updates on Asenapine Research

Recent studies have focused on the long-term safety and efficacy of Asenapine for treating schizophrenia and bipolar disorder. A 2022 study found that Asenapine effectively reduced symptom severity in patients with bipolar I disorder over a 12-month period, with a relatively low risk of weight gain compared to other antipsychotics. Another ongoing study is examining the use of Asenapine in combination with other medications to treat treatment-resistant schizophrenia, with early results suggesting it may improve outcomes in patients who have not responded to other treatments.

As research continues, staying informed about new developments is crucial. Our telemedicine providers can help you understand the latest findings and how they may impact your treatment plan.

James Kingsley
James Kingsley

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