Asenapine transdermal
SECUADO
Pronunciation: a-SEN-a-peen (se-kyoo-A-doe)
“Ass Seen caudally”
What it isOnce-daily asenapine transdermal system; schizophrenia in adults.
Why this oneThe only antipsychotic patch: no sublingual technique or ten-minute food and drink restriction, and concentrations hold steady through each 24-hour wear.
What limits itApplication-site reactions, so rotate the site daily. External heat raises absorption: no heating pads, electric blankets or hair dryers over the patch.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Schizophrenia | Adults | 3.8 mg/24h patch QD | 3.8 mg/24h; may titrate to 5.7 or 7.6 mg/24h | 7.6 mg/24h |
Titration May increase after 1 week
Renal No adjustment needed
Hepatic Contraindicated in severe (Child-Pugh C); no adjustment in mild–moderate (Child-Pugh A/B)
Instructions
- Transdermal: apply one patch every 24 h to hip, abdomen, upper arm, or upper back
- Apply to clean, dry, intact skin; rotate application site daily; do not cut the patch
- Avoid external heat sources over the patch (increases absorption)
Available strengths
- patch 3.8, 5.7, 7.6 mg/24 hr
- SL tab 2.5, 5, 10 mg
Contraindications
- Severe hepatic impairment (Child-Pugh C)
Cautions
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Metabolic changes (hyperglycemia/diabetes, dyslipidemia, weight gain)
- Orthostatic hypotension/syncope
- Leukopenia, neutropenia, agranulocytosis
- QT prolongation
- Hyperprolactinemia
- Seizures
- Application site reactions
- Cerebrovascular reactions/stroke in elderly with dementia
Adverse reactions
- Extrapyramidal symptoms
- Application site reactions
- Weight gain
- Headache
- Akathisia
- Somnolence
Pregnancy Third-trimester exposure: risk of neonatal extrapyramidal/withdrawal symptoms; no human data. Registry available.
Lactation No human milk data; asenapine excreted in rat milk.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 3.8 mg/24 hr | patch | per unit | — | $49.07/ea | not offered |
| 5.7 mg/24 hr | patch | per unit | — | $49.05/ea | not offered |
| 7.6 mg/24 hr | patch | per unit | — | $48.83/ea | not offered |
Other forms: Asenapine (SAPHRIS)
⚠ BOXED WARNING
- Increased mortality in elderly patients with dementia-related psychosis
Classes and tags
Clinical profile
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