II. Indications
III. Preparations
- 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
IV. Dosing: Schizophrenia
- 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)
V. Dosing: 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
VI. Adverse Effects
- 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
VII. Safety
- Unknown safety in pregnancy
- Withdrawal and Extrapyramidal Side Effects have been seen in newborns with third trimester exposure
- Avoid in Lactation
VIII. Resources
- Asenapine Sublingual (DailyMed)
- Asenapine Transdermal (DailyMed)
IX. References
- (2016) Med Lett Drugs Ther 58(1510): 160-5
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 42-3
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
| asenapine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ASENAPINE 10 MG TABLET SL | Generic | $2.87 each |
| ASENAPINE 2.5 MG TABLET SL | Generic | $3.46 each |
| ASENAPINE 5 MG TABLET SL | Generic | $3.63 each |
| saphris (on 3/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| SAPHRIS 10 MG TAB SUBLINGUAL | Generic | $2.87 each |
| SAPHRIS 2.5 MG TAB SUBLINGUAL | Generic | $3.46 each |
| SAPHRIS 5 MG TAB SUBLINGUAL | Generic | $3.63 each |