Asenapine is used to treat schizophrenia (long-term mental disorder that causes changes in thoughts, feelings, and behaviour). It helps relieve symptoms common in schizophrenia, such as distorted thinking and emotional instability.
This medicine is also used on its own or together with other medicines to treat bipolar disorder (mental condition that causes extreme mood changes between feeling very high [mania] and very low [depression]).
Take Asenapine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it on an empty stomach. Avoid eating and drinking for at least 10 minutes after taking this medicine. Try to take it at the same time each day.
This medicine must be placed under your tongue to be effective. It is absorbed into your body through the lining of your mouth. Do not swallow, chew, or crush the tablet.
Asenapine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition. Your doctor will gradually reduce the dose before stopping it completely. Follow your doctor's instructions carefully.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have severe liver disease as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- current or history of fits or seizure disorder
- Parkinson’s disease (disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement, and impaired balance or walking)
- dementia with Lewy bodies (protein deposits develop in nerve cells in the brain affecting thinking, memory, and social abilities)
- heart diseases e.g. heart failure, ischaemia, prolonged QT interval, recent heart attack
- blood disorders e.g. neutropenia or leucopenia (low white blood cell count)
- disorders affecting the blood vessels and blood supply to the brain e.g. stroke
- risk for aspiration pneumonia (a lung infection that may occur when oral or stomach contents are breathed into the lungs or airways leading to the lungs instead of being swallowed)
- dehydration
- low blood volume
- risk for fall e.g. poor balance
- diabetes
- moderate liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to a child or the elderly. They may be more sensitive to the side effects.
Asenapine is not recommended in elderly patients with mood disorders related to dementia (a group of symptoms affecting thinking, memory, and social abilities).
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and kidney function, complete blood count, levels of blood electrolyte, thyroid, glucose) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring of mental status and for signs of extrapyramidal symptoms (e.g. uncontrollable twitching movements of the mouth, tongue, and limbs, inability to stay still or restlessness) may also be needed.
What lifestyle changes should I make?
Asenapine may affect the ability of your body to adjust to temperature changes in the environment. Avoid exposure to very cold or very hot environments. Avoid strenuous exercise and activities like going to the sauna. Drink more water to prevent dehydration.
Asenapine may cause dizziness or cause you to suddenly fall asleep during your daily activities such as eating and watching television. Do not drive or take part in any activity in which you need to be alert.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Other side effects include any of the following: nausea, vomiting, abdominal pain, constipation, diarrhoea, indigestion, increased salivation, change in taste sensation, difficulty swallowing, increased appetite, weight gain, tiredness, and anxiety.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the deep layers of the skin usually around the face, throat, and lips
- fever, sweating, muscle rigidity, confusion, irregular pulse, or blood pressure
- having thoughts of self-harm
- uncontrollable twitching movements of the mouth, tongue, and limbs, inability to stay still or restlessness
- fits or seizures
- signs and symptoms of high sugar level in the blood e.g. thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and a fruity breath odour
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
This medicine may cause the level of your white blood cells to drop. White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds, and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for irregular heartbeat e.g. quinidine, procainamide, amiodarone, sotalol
- medicines for mood disorders e.g. ziprasidone, chlorpromazine, thioridazine
- certain antibiotics e.g. gatifloxacin, moxifloxacin, ciprofloxacin
- medicines to treat depression e.g. fluvoxamine
- medicines for high blood pressure
- levodopa (medicine for Parkinson’s disease)
This list does not include all medicines that may interact with Asenapine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Asenapine.
Store in a cool, dry place away from the reach of children. Protect from light.
Medicines must not be used past the expiry date.
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