Asenapine

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

(EMEA/H/C/001177; 01/09/2010)

Malta: Sycrest; Poland: Sycrest; Portugal: Sycrest; Slovakia: Sycrest; Slovenia: Sycrest; Sweden: Sycrest.

North America

USA: Saphris.

Drug combinations

Chemistry

Asenapine Maleate: C~21~H~20~ClNO~5~ Mw: 401.84. (3aRS,12bRS)-5-Chloro-2-methyl-2,3,3a,12btetrahydro-1Hdibenzo[2,3:6,7]oxepino[4,5-c]pyrrole (2Z)-2-butenedioate, trans-5-Chloro-2,3,3a,12b-tetrahydro-2-methyl-1H-dibenz(2,3:6,7)oxepino(4,5-c)pyrrole maleate. CAS-85650-56-2.

Pharmacologic Category

Antimanic Agents. Atypical Antipsychotics; 5-HT (5-HT~1A~, 5-HT~1B~, 5-HT~2A~, 5-HT~B~, 5-HT~2C~, 5-HT~5A~, 5-HT~6~ and 5-HT~7~) and D~2~ Receptor Antagonists. (ATC-Code: N05AH05).

Mechanism of action

Unknown. It has been suggested that the efficacy of asenapine in schizophrenia is mediated through a combination of antagonist activity at D~2~ and 5-HT~2A~ receptors.

Therapeutic use

Treatment of schizophrenia. Acute treatment, as monotherapy or adjunctive therapy, of manic or mixed episodes associated with bipolar I disorder.

Pregnancy and lactiation implications

Use during pregnancy only if benefit to mother outweighs potential risk to fetus. Breast feeding not recommended.

Unlabeled use

Contraindications

None known to date.

Warnings and precautions

Not approved for the treatment of dementia-related psychosis and not recommended for use in this particular group of patients (increased risk of death and cerebrovascular adverse events). Neuroleptic malignant syndrome has been reported. May cause tardive dyskinesia. Hyperglycemia or exacerbation of pre-existing diabetes has occasionally been reported during treatment. Patients should receive regular monitoring of weight. May induce orthostatic hypotension and syncope, especially early in treatment. Should be used with caution in the elderly and in known cardiovascular disease (e.g. heart failure, myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose to hypotension (e.g. dehydration and hypovolemia). Leukopenia, neutropenia, and agranulocytosis have been reported with antipsychotics. Caution should be exercised when drug is prescribed in known cardiovascular disease or family history of QT prolongation, and in concomitant use with other medicinal products thought to prolong the QT interval. Use cautiously in patients with history of seizures or with conditions that lower the seizure threshold. The possibility of a suicide attempt is inherent in schizophrenia and bipolar disorder. Use with caution in Parkinson’s disease or dementia with Lewy bodies (increased risk of neuroleptic malignant syndrome, and increased sensitivity to antipsychotics). Not recommended in severe hepatic impairment. Cases of dysphagia were occasionally reported. May cause somnolence and sedation.

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