RxCe - Asenapine Use in Antipsychotic Care Materials

ASENAPINE USE IN ANTIPSYCHOTIC CARE

Faculty:

L. Austin Fredrickson, MD, FACP

L. Austin Fredrickson is an Associate Professor of Internal Medicine at Northeast Ohio Medical University, where he serves as core faculty and teaches diagnostics, therapeutics, clinical skills, and health humanities. He is board-certified in general internal medicine and practices rural primary care. 

Sandra Rogers, MD

Sandra Rogers, MD, is a primary care physician in Texas. She is board-certified in Family Medicine and Internal Medicine by the American Board of Family Medicine and the American Board of Internal Medicine. She completed her dual residency at Eastern Virginia Medical School in Norfolk, Virginia. She has been practicing in Allen, Texas, for over 20 years.

Becca Resnik, RN

Becca Resnik received her nursing degree from Chattanooga State Community College. She has an MA in Translation Studies from the University of Birmingham, United Kingdom, and a BS in Nuclear Engineering Technology from Excelsior University, Albany, New York. Becca Resnik also has a Medical Writing Certificate from the University of Connecticut School of Pharmacy. Becca Resnik maintains an active Registered Nurse license.

Pamela Sardo, PharmD, BS

Pamela Sardo, PharmD, BS, is a licensed pharmacist and freelance medical writer. She is the founder and principal at Sardo Solutions in Texas. Pam received her BS from the University of Connecticut and her PharmD from the University of Rhode Island. Pam’s career spans many years in retail, clinics, hospitals, long-term care, Veterans Affairs, and managed health care responsibilities across a broad range of therapeutic classes and disease states.

Abstract

Asenapine is a second-generation, atypical antipsychotic medication. Its labeled uses include treating adults with schizophrenia and adults and children (age 10-17) with bipolar I disorder. Asenapine comes with labeled warnings and contraindications similar to other antipsychotics. This course discusses asenapine’s indications, pharmacological profile, mechanism of action, dosing, and labeled warnings and contraindications. This clinical knowledge promotes safe prescribing, improves patient monitoring, prevents adverse outcomes, and supports regulatory compliance, thereby optimizing therapeutic benefits and minimizing risks when prescribing asenapine.

Accreditation Statements

In support of improving patient care, RxCe.com LLC is jointly accredited by the Accreditation Council^TM for Continuing Medical Education (ACCME^®), the Accreditation Council for Pharmacy Education (ACPE^®), and the American Nurses Credentialing Center (ANCC^®), to provide continuing education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive 2 Interprofessional Continuing Education (IPCE) credits for learning and change.

Joint Universal Activity Number: The Joint Accreditation Universal Activity Numbers assigned to this activity are as follows:

Pharmacists: JA4008424-0000-26-022-H01-P

Pharmacy Technicians: JA4008424-0000-26-022-H01-T

Credits: 2 contact hour(s) (0.2 CEU(s)) of continuing education credit.

Credit Types:

IPCE Credits - 2 Credits

AAPA Category 1 Credit™️ - 2 Credits

AMA PRA Category 1 Credit™️ - 2 Credits

Pharmacy - 2 Credits

Type of Activity: Application

Media: Computer-Based Training (i.e., online courses)

Estimated time to complete activity: 2 contact hour(s) (0.2 CEU(s)), including Course Test and course evaluation.

Release Date: March 6, 2026 Expiration Date: March 6, 2029

Target Audience: This educational activity is for Physicians, Physician Assistants, Pharmacists, and Pharmacy Technicians

How to Earn Credit: From March 6, 2026, through March 6, 2029, participants must:

Read the “learning objectives” and “author and planning team disclosures;”

Take the “Educational Activity Pre-Test;”

Study the section entitled “Educational Activity;” and

Complete the Educational Activity Post-Test and Activity Evaluation. The Educational Activity Post-Test will be graded automatically. Following successful completion of the Educational Activity Post-Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)

CME Credit: Credit for this course will be uploaded to CPE Monitor^® for pharmacists. Physicians may receive AMA PRA Category 1 Credit™️ and use these credits toward Maintenance of Certification (MOC) requirements. Physician Assistants may earn AAPA Category 1 CME credit, reportable through PA Portfolio. All learners shall verify their individual licensing board’s specific requirements and eligibility criteria.

Statement of Need

Asenapine is a second-generation, atypical antipsychotic medication that is known to be effective in the treatment of schizophrenia in adults. Asenapine is also used for maintenance treatment in bipolar I disorder, as well as treatment for acute manic or mixed episodes associated with bipolar I disorder in adults and pediatric patients 10 years and older. The pharmacological profile and option of a sublingual route of administration with asenapine make it a unique antipsychotic drug of choice in emergency psychiatry cases, the pediatric population, and for maintenance treatment of mixed mood states. The specific effects of antipsychotics on hostility and aggression in patients with schizophrenia or bipolar disorder have received special attention from emergency physicians and healthcare team members.

Learning Objectives: Upon completion of this educational activity, participants should be able to:

Describe the basic pharmacological profile, use, and clinical outcomes of asenapine treatment

Identify the dosing and uses for asenapine

Compare the benefits and risks of asenapine use for patients with chronic mental illness compared to other antipsychotics

Identify the contraindications and potential side effects of asenapine

Disclosures

The following individuals were involved in developing this activity: L. Austin Fredrickson, MD, FACP; Sandra Rogers, MD; Becca Resnik, RN; Steven Malen, PharmD, MBA; and Pamela Sardo, PharmD, BS. None of the faculty members has a conflict of interest or financial relationship related to the subject matter of this activity, except that Becca Resnik discloses that she is an independent contractor (Translator/Engineer, 08/12/2024 to present) for Johnson & Johnson, Zuchwil, Switzerland, and DePuy Synthes. Any relevant financial relationships have been mitigated.

Educational Activity Pre-Test

For the treatment of bipolar I disorder, asenapine

can be used as a monotherapy.

is only approved as an adjunct treatment.

is recommended only for people 18 and older.

should never be used with lithium.

Asenapine has a high level of peripheral alpha-adrenergic receptor antagonism, which is most likely to be a concern for

tachycardia.

hypoglycemia.

vasoconstriction.

orthostatic hypotension.

Asenapine is approved for pediatric patients aged 10–17 years with

schizophrenia.

bipolar I disorder with manic or mixed episodes.

any psychosis due to a medical condition.

postural hypotension.

Educational Activity

Asenapine Use in Antipsychotic Care

Introduction

Asenapine is a second-generation, atypical antipsychotic medication. Its labeled uses include treating adults with schizophrenia and adults and children (age 10-17) with bipolar I disorder. Asenapine carries labeled warnings and contraindications comparable to those of other antipsychotics. Reviewing asenapine's approved indications, pharmacologic profile, receptor activity, dosing, and safety warnings facilitates healthcare professional decision-making. Promoting safe asenapine prescribing, enhancing patient monitoring, reducing the risk of adverse outcomes, and supporting regulatory compliance should optimize efficacy and minimize clinical risk.

Pharmacological Profile

Asenapine is classified as an atypical antipsychotic agent.^1-3 It is approved by the U.S. Food and Drug Administration (FDA) in a sublingual formulation for the treatment of adults with schizophrenia.^1-3 Asenapine is also available in a transdermal formulation that is currently approved and limited to treating adults with schizophrenia.^4,5 In 2020, the FDA approved generic forms of asenapine.^3,6

For adult patients and children (age 10-17) with bipolar I disorder, asenapine is FDA-approved as an acute monotherapy for manic or mixed episodes.^2,7-9 In addition, for adult patients, it is used as an adjunctive treatment to lithium or valproate and as a maintenance monotherapy treatment.^2,10

Retrospective reviews of asenapine administration in all age groups suggest that asenapine is a helpful psychotropic agent because of its ease of use as a dissolvable sublingual tablet.¹⁰ Pediatric patients diagnosed with severe mixed mood states who require antipsychotic treatment for symptom control may benefit from asenapine; however, more research is needed to determine the efficacy of asenapine as compared to other psychotropic medications in this patient population.¹¹

Mechanism of Action

The mechanism of action by which asenapine produces its therapeutic effects is unknown, but it is likely mediated by its ability to act as a dopamine and serotonin (5-HT_2A) receptor antagonist. It has high binding affinity for various serotonin and dopamine receptor subtypes, alpha₁- and alpha₂-adrenergic receptors, and histamine H₁ receptors.^2,12,13 Asenapine has a moderate binding affinity for H₂ receptors. It has no significant ability to bind to muscarinic receptors.^12,13

The sublingual and transdermal formulations of asenapine allow the drug to bypass first-pass metabolism, providing a bioavailability of approximately 35%.^10,14 Asenapine swallowed in tablet form has less than 2% bioavailability, so the oral formulation should be given sublingually for maximum benefit.^2,10,15

Contraindications

Asenapine is contraindicated in patients with severe hepatic impairment (Child-Pugh C).² Asenapine exposure is 7-fold higher in subjects with severe hepatic impairment than the exposure observed in subjects with normal hepatic function.²

Asenapine is contraindicated in patients with known hypersensitivity to asenapine or any component of the formulation.² Patients with a history of hypersensitivity reactions to asenapine have experienced anaphylaxis, angioedema, hypotension, tachycardia, swollen tongue, dyspnea, wheezing, and rash.²

Doses and Formulations

Asenapine is available in 2.5 mg, 5 mg, and 10 mg sublingual tablets. Patients should be counseled on the correct use of asenapine. Sublingual asenapine tablets should be placed under the tongue, allowed to dissolve, and then swallowed with saliva.^2,3 Sublingual tablets are fast-acting; they dissolve within seconds of being placed under the tongue.^2,3 Patients should be advised to peel back the medication packaging carefully and not push the tablet through it, as this may cause the tablet to crumble.^2,3 Hands should be completely dry during this process, to prevent the tablet from dissolving prematurely before actual administration.^2,3 The patient should not eat or drink for 10 minutes after taking the tablet. In a small study of 26 patients, eating immediately before taking a dose of asenapine reduced the exposure to asenapine by 20%, and eating 4 hours after a dose reduced exposure by 10%.^2,3 Patients may benefit from education and counseling from a healthcare team member on opening the cassettes that medication is dispensed in to avoid administration barriers.^2,3

The transdermal formulation of asenapine, marketed under the brand name Secuado^®, is available in strengths of 3.8 mg/24 hours, 5.7 mg/24 hours, and 7.6 mg/24 hours.⁵ A patch should be applied once daily (once during a 24-hour period).⁵ Patients should wear only one patch at a time, and patches should not be cut to fit or for different doses.⁵ Application sites include the upper arm, upper back, abdomen, or hip. It is recommended that the application site be rotated with each application to minimize skin reactions.⁵ It is appropriate to shower with the patch; however, swimming or bathing has not yet been evaluated. External heat sources, such as a heating pad, should be avoided because they may increase asenapine plasma concentrations and are not recommended.⁵

The Clinical Trials section of the prescribing information for the sublingual formulation mentions asenapine for hostility or uncooperativeness. Asenapine sublingual tablets were statistically superior to placebo in reducing hostility, agitation, uncooperativeness, or other psychotic behaviors in schizophrenia and bipolar I disorder.^2,10

Schizophrenia and Asenapine as a Treatment Option

Antipsychotics are the drug of choice for treating schizophrenia. Asenapine is an effective treatment for acute exacerbations of schizophrenia and prevents relapses when used as a long-term maintenance therapy.^1,16-18 However, there is insufficient evidence for recommending asenapine over other antipsychotic medications in the treatment of psychotic disorders.¹⁷

The onset of schizophrenia increases as a child gets older, with peak onset reportedly appearing from age 15 and thereafter.¹⁹ Asenapine is not currently approved for pediatric patients with schizophrenia.¹⁹ The results of the trial on the efficacy of asenapine in treating schizophrenia were not conclusive but did provide valuable information on the drug’s safety profile in pediatric patients.¹⁹

One 5 mg sublingual tablet of asenapine twice a day is the recommended starting dose for patients who are diagnosed with schizophrenia. After one week, the dose may be increased to 10 mg twice daily. The 24-hour maximum dose is 20 mg.^4,5 Asenapine 3.8 mg/24 hours is the initial dose for the transdermal formulation. The dose may be increased to either 5.7 mg/24 hours or 7.6 mg/24 hours after one week if needed. The maximum dose of the transdermal formulation is 7.6 mg/24 hours. If switching from oral to transdermal formulation is desired, it is suggested that the 3.8 mg/24 hours dose corresponds to 5 mg administered sublingually twice daily, and the 7.6 mg/24 hours dose corresponds to 10 mg administered sublingually twice daily. Use the lowest effective dose and periodically reevaluate across all formulations.

Bipolar I Disorder and Asenapine as a Treatment Option

Bipolar disorder is a psychiatric disorder characterized by episodes of mania, hypomania, and major depression.^11,12 There are two types of bipolar disorder, type I and type II. Manic episodes are a feature of type I but not type II, and patients who have type I almost always have major depressive and hypomanic episodes. Bipolar disorder can also present with mixed features, which are also called mixed episodes.¹² The onset of bipolar I disorder may occur during childhood or adolescence.¹³ Asenapine offers a treatment option for patients diagnosed with bipolar I disorder with manic or mixed episodes during childhood or adolescence.¹³

Early onset of bipolar I disorder is more common than other serious psychiatric conditions (e.g., schizophrenia).¹³ Studies indicate that the onset of bipolar disorder occurs before the age of 13 in 14–28% of patients and between 13 and 18 years of age in 36–38% of patients.¹³ As mentioned above, asenapine is approved in the US as a monotherapy to treat children and adolescents aged 10–17 years with this condition.¹⁰ Asenapine is not approved for pediatric use in patients with other forms of bipolar I disorder.¹³

The recommended dose is 2.5–10 mg administered sublingually twice a day.¹³ These patients should be closely monitored for treatment efficacy and adverse effects.¹³ In an acute manic or mixed episode in adults, asenapine may be used as monotherapy, 5 mg or 10 mg sublingually twice a day. The 24-hour maximum dose is 20 mg.⁵ Dosing recommendations for bipolar disorder are currently only given for the sublingual tablet.

Combination therapy (with lithium or valproate): Begin with 5 mg twice a day; if needed, 10 mg twice a day can be used.⁵ Combination therapy as a treatment for acute mania has been proven to be superior to a mood stabilizer plus a placebo and superior to monotherapy with lithium or valproic acid.^19-21 Case reports, one 12-week randomized controlled trial, and several case series found that asenapine and lithium or valproic acid could significantly reduce the severity of manic symptoms, decrease the frequency of manic episodes, and have an acceptable safety profile.^16,22-24

Maintenance therapy: 5 mg–10 mg twice a day.^2,3 Initially, it is recommended that the patient continue the dose needed for stabilization and then be reevaluated based on response and tolerability.^2,3

Dosing recommendations for children in states of acute manic or mixed episodes provide for an initial start of 2.5 mg twice daily, which can be increased to 5 mg twice daily after three days, then increased to 10 mg twice daily after an additional three days if indicated.^2,3 Pediatric patients are more susceptible to dystonia if a slower titration process is not followed. Currently, dosing is approved for children aged 10 and above, with safety and efficacy not yet established in younger children.^2.3

Studies comparing monotherapy with asenapine to haloperidol and olanzapine as a treatment for acute mania or mixed episodes found that asenapine reduced mania rating scores, sustained remission, and was equivalent or at times superior to these drugs for treating bipolar disorder.^25,26

Dosing Adjustments

Older Adults

There are no specific dosing adjustments for older adults taking asenapine.^2,3,5 Asenapine may cause orthostatic hypotension, which is an adverse effect that is more likely to be troublesome for the geriatric population.² Although exposure levels are higher in older patients than in younger adults (approximately 30–40%), no dosage adjustments are recommended based on age alone due to the insufficient number of older adult patients in clinical trials.^2,3,10,27 It remains unclear whether higher exposure levels to asenapine elicit a greater response in older adults than in younger adults.^10,27

Renal Impairment

Exposure levels of asenapine in patients with mild to severe renal impairment are similar to those with normal renal function, and no dose adjustments are required.^2,3,5

Hepatic Impairment

As mentioned above, asenapine is contraindicated in patients with severe hepatic impairment (Child-Pugh C). In patients with mild to moderate hepatic impairment (Child-Pugh Class A or B), the prescribing information for sublingual and transdermal asenapine states that no dosage adjustment is required, as asenapine exposure is similar to that in subjects with normal hepatic function.^2,3,5 Transient elevations in serum transaminases (primarily ALT) occurred in the short-term schizophrenia and bipolar mania adult trials, which were more common in treated patients.^2,3,5 The ALT elevations associated with asenapine resolve in several weeks, and discontinuing the use of the drug or changing the dose may not be needed.²⁸ However, dosing, discontinuation, and monitoring should be individualized based on the patient's clinical situation.

Drug-Drug Interactions

Concurrent use of asenapine and antihypertensive drugs may cause hypotension.^2,3 When prescribing paroxetine (a CYP2D6 substrate and inhibitor) with asenapine, reduce paroxetine by half.^2,3,5

Adverse Effects and Warnings

Adverse effects listed with an incidence of ≥5% or twice that of placebo include akathisia, dizziness, dysgeusia, fatigue, increased appetite, increased weight, nausea, oral hypoesthesia, oral paresthesia, and somnolence.^2,3

Adverse effects of asenapine, such as central nervous system (CNS) depression, motor and sensory instability, and orthostatic hypotension, can increase the risk for falls and subsequent fractures.^2,3 Asenapine may cause somnolence, postural hypotension, motor and sensory instability, which may lead to falls and, consequently, fractures or other injuries. For patients with diseases, conditions, or medications that could exacerbate these effects, complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy.

Older Adults and Dementia

Asenapine is not approved for the treatment of dementia-related psychosis.^2,3,29 According to the Centers for Medicare and Medicaid, an estimated 16% of older adults in nursing homes as of 2017 had been prescribed antipsychotics.³⁰ Except for in an emergency, the American Psychiatric Association (APA) has recommended that antipsychotics should “only be used for the treatment of agitation or psychosis in patients with dementia when symptoms are severe, are dangerous, and/or cause significant distress to the patient.”^30,31 The prescribing information for asenapine and other atypical antipsychotics includes a boxed warning that advises clinicians about the use of these drugs in older adult patients who have dementia and the corresponding increased risk of death.^2,3,5,30

Temperature Regulation

The antipsychotics have been associated with altered thermoregulation and can have anticholinergic effects, both of which can put the patient at risk for an elevated temperature.^2,3,5 The adverse effects as researched during pre-market clinical trials of asenapine suggest an incidence of elevated body temperature of ≤ 1% for the asenapine-treated group and 0.0% for the placebo group.^2,3,5 Dehydration, high ambient temperature, the concurrent use of anticholinergic drugs, and strenuous exercise may increase this risk.^2,3,5

Orthostatic Hypotension and Cardiovascular Conditions

Asenapine has a high level of peripheral alpha-adrenergic receptor antagonism and can cause orthostatic hypotension.^2,3,5 Older patients are more likely to have orthostatic hypotension, probably due to decreased baroreceptor sensitivity. Asenapine should be used cautiously if the patient has cardiovascular or cerebrovascular disease, takes medication that can cause hypotension, is dehydrated or hypovolemic, or cannot tolerate a sudden drop in blood pressure.^2,3,5 Cardiac concerns with asenapine use include QTc prolongation, which is a risk factor for potentially dangerous arrhythmias, especially in older patients or those with other cardiac risk factors.^2,3,5 As a consequence, blood pressure should be periodically monitored while on therapy, especially during dose changes.^2,3,5

The use of asenapine should be avoided if the patient has congenital long QT syndrome or is taking a medication that can prolong the QT interval.^2,3,5 The risk of QTc prolongation is magnified by hypokalemia and hypomagnesemia.^2,3,5 Drug-induced acquired QT prolongation is defined as a QTc interval that is > 500 milliseconds or a QTc interval increase ≥ 60 milliseconds from the patient’s baseline QTc interval.^2,3,5 In a dedicated adult QT study, no patients treated with asenapine sublingual tablets experienced QTc increases ≥60 msec from baseline measurements, nor did any patient experience a QTc of ≥500 msec. The risk of QT prolongation with asenapine is low.^32-36

Hematologic Effects

During clinical trials and post-marketing experience with asenapine, cases of leukopenia and neutropenia were reported. These blood dyscrasias, as well as agranulocytosis, have been associated with the use of other antipsychotics.^2,3,5 Patients who have a low white blood cell count (WBC) or a low absolute neutrophil count (ANC), or have had drug-induced leukopenia or neutropenia, may be susceptible to these hematologic adverse effects.^2,3,5 The complete blood count (CBC) should be closely monitored for the first few months of use, and if a blood dyscrasia develops or if the ANC is < 1,000/mm³, the patient should stop taking asenapine.^2,3,5

Central Nervous System Effects

Sedation and somnolence are common CNS adverse effects of asenapine.^2,3,5 The atypical antipsychotics may also lower the seizure threshold. During pre-marketing trials of asenapine, seizures were reported in 5/1953 (0.3%) of adult patients.^2,3,5 Asenapine should be used cautiously in patients who have a seizure disorder or may be at risk for seizures.^2,3,5

Atypical antipsychotics can cause movement disorders such as extrapyramidal symptoms (EPS), akathisia, dystonia, Parkinsonism, and tardive dyskinesia.^2,3,5 These adverse effects can occur with the use of typical and atypical antipsychotics, but the risk for EPS is lower for atypical antipsychotics, including asenapine, than with typical antipsychotics.^2,3,5 Drug-induced movement disorders are thought to be primarily caused by dopamine receptor antagonism and an imbalance between dopaminergic and cholinergic activity.^37-40

Akathisia is one of the more commonly reported adverse events from asenapine use, with a majority of these events being either mild or moderate in severity.⁴¹ Akathisia caused by asenapine has been reported to occur in 1.9%–8.3% of patients.^20,41,42 Parkinsonism caused by asenapine has been reported, but appears to be a rare adverse effect.⁴¹ The risk for, and incidence of, antipsychotic-induced tardive dyskinesia has been estimated to be from 20% to 32.4%.^42,43 Atypical antipsychotics are generally less likely to cause tardive dyskinesia.⁴⁴ Factors that increase the risk for developing tardive dyskinesia may include African American ethnicity, alcohol or substance use, cognitive disturbance, diabetes, development of other EPS, high dose, long duration of use, female sex, and older age.^45,46

Weight Gain, Hyperglycemia, and Dyslipidemia

Weight gain is a relatively common adverse effect of atypical antipsychotics, including asenapine.^2,3,5 In a 52-week controlled trial of asenapine, the mean weight gain from baseline was 0.9 kg, and at the end of the trial, 14.7% of patients had at least a 7% increase in body weight.^2,3,5

Asenapine is considered to have the potential for causing hyperglycemia. In short-term trials of 3 and 6 weeks' duration, the mean change in fasting glucose was -0.2 to 0.0 mg/dL in placebo-treated patients and 1.1 mg/dL to 4.1 mg/dL in asenapine-treated patients, depending on dose.^2,3,5 People who take an atypical antipsychotic are estimated to have a two to threefold increased prevalence of hyperglycemia and diabetes compared to the general population.³³

The incidence of dyslipidemias (including elevated total serum cholesterol, increased LDL cholesterol and decreased HDL cholesterol, and elevated fasting serum triglycerides) varies between the atypical antipsychotics. Asenapine is considered to have a low risk.³³ During short-term clinical trials for bipolar disorder, the number of patients who developed a serum cholesterol level >240 mg/dL was 7.8% of the asenapine-treated patients and 7.9% of the placebo-treated patients.^2,3,5 In these same trials, 13.1% of the asenapine-treated patients developed a serum triglyceride level > 200 mg/dL, compared with 8.6% of the placebo-treated patients.^2,3,5

Hyperprolactinemia

Atypical antipsychotics, including asenapine, may increase serum prolactin levels and have been associated with sexual and reproductive dysfunction.^2,3,5 The risk is thought to be highest with paliperidone and risperidone, and asenapine has been shown to have either no effect on serum prolactin or clinically insignificant elevations or to have a very low number of patients who develop clinically significant prolactin levels.^34,47 If the patient has an elevated prolactin level and is symptomatic, treatment with the drug can be discontinued, and the serum prolactin level should return to normal within several days.^2,3,5 In cases of hyperprolactinemia, an individualized approach should be followed: the dose can be reduced, a low-potency antipsychotic can be used as a replacement, a prolactin-sparing antipsychotic can be prescribed, women can be prescribed estrogen, or the patient can continue to take the offending drug.^48,49 In addition, a full or partial dopamine agonist can be prescribed.^48,49 Galactorrhea or dysmenorrhea were rare side effects reported in 2% or less of asenapine-treated patients compared to 1% in placebo-treated patients.^2,3,5

Gastrointestinal Effects

Antipsychotics, including asenapine, have been associated with esophageal dysmotility and aspiration.^2,3,5 Constipation, xerostomia, oral hypoesthesia, hypersalivation, abdominal discomfort, and vomiting are side effects associated with asenapine.^2,3,5 Although these side effects have a low incidence of less than 10%, they should be monitored in all patients taking asenapine.⁵⁰

Neuroleptic Malignant Syndrome

Cases of neuroleptic malignant syndrome (NMS) caused by asenapine have been reported.^2,3,5 The pathophysiology of NMS is not fully understood, but is believed to be partially due to dopamine receptor blockade.⁵¹ Factors that increase the risk for NMS may include male sex, a rapid dose titration, dehydration, and a prior episode of NMS.⁵² A high dose of an antipsychotic may increase the risk of developing NMS, but most cases are caused by doses that are within the prescribed therapeutic range.⁵³ The onset of signs and symptoms usually begins within two weeks of starting therapy with an antipsychotic, and almost all cases of NMS occur within 30 days of the first dose.⁵² Neuroleptic malignant syndrome can occur after the first dose or after years of taking the same drug at the same dose, and it can happen when the use of the drug is discontinued.⁵² Asenapine should be discontinued if NMS develops.⁵⁴

Suicidal Behavior

Suicidal ideation is an adverse reaction reported in the prescribing information.^2,3,5 Atypical antipsychotics may be prescribed for patients who have unipolar major depression; however, major depression is a strong risk factor for suicide.⁵⁵

Pregnancy and Breastfeeding

The use of antipsychotics during the third trimester has been associated with EPS and withdrawal signs and symptoms in neonates.⁵⁶ There is little information about asenapine and the risk for pregnancy and birth complications such as congenital malformations, low birth weight, premature birth, and stillbirth.⁵⁶ There are no controlled studies of its use in pregnant women.⁵⁶ Physicians should carefully assess the risks and benefits before prescribing, and shared decision-making with the patient is important. Participation in the national registry is an option.⁵⁶

Resources

National Pregnancy Registry for Atypical Antipsychotics

https://womensmentalhealth.org/research/pregnancyregistry/atypicalantipsychotic/

CALL TOLL-FREE: 1-866-961-2388

Asenapine’s Expanding Use in Treating Hostility and Agitation

Treatment with asenapine was superior to placebo in reducing hostility symptoms and agitation in patients with bipolar I disorder, suggesting that asenapine may be an effective and noninvasive treatment for hostility and agitation in this patient population. Improvement was at least partially independent of overall improvement in mania symptoms.⁵⁷

Apart from its efficacy in controlling hostility and agitation in schizophrenia and bipolar disorder,^2,10,58 it may have application off-label to treat hostility and agitation in patients with other conditions, such as severe abdominal pain and distension.⁵⁹

Asenapine Case Studies

The first case study discusses the use of asenapine in a 71-year-old female diagnosed with bipolar disorder and mania.³⁵ The second case study discusses the use of asenapine in a 44-year-old female diagnosed with bipolar disorder.⁴⁴

Case Study 1: Bipolar I Disorder with Mania

The authors reported a case of a 71-year-old female with a long history of bipolar disorder who was admitted with mania.³⁵ Prior medications for the treatment of bipolar disorder included sodium valproate and olanzapine; however, the patient was reportedly nonadherent with medications for 5 months prior to admission.³⁵

Pause and Ponder

How would you counsel and suggest support for a nonadherent patient?

The patient was administered olanzapine 10 mg twice daily when admitted. A course of electroconvulsive therapy (ECT) was planned a week later due to poor remission of symptoms, and the patient had a history of a successful response to ECT therapy in the past.³⁵ She had no significant comorbid medical conditions, and all laboratory testing was normal, including electrolytes. An electrocardiogram (ECG) was normal with a QTc of 383 ms. Two cycles of ECT were completed, and she was switched from olanzapine to asenapine 5 mg twice daily because she reported weight gain on olanzapine. Before a third ECT session, the patient reportedly developed ventricular trigeminy with a QTc of 459 ms.³⁵

Pause and Ponder

What actions are suggested that may reveal the cause of ventricular trigeminy?

Due to the change in her ECG, the ECT session was not pursued. The patient underwent repeated blood testing, including electrolytes and cardiac enzymes, which were normal. A repeat ECG 12 hours later also showed ventricular trigeminy and prolonged QTc.³⁵

Asenapine was stopped as it was suspected to be the cause of the onset of arrhythmia and QTc prolongation. The day following discontinuation, the ventricular trigeminy stopped, and the patient’s QTc shortened to 428 ms. The patient continued ECT and was discharged after 19 days of admission with a prescription for sodium valproate 600 mg twice daily.³⁵

Discussion

A prolonged QT interval placed the patient at risk of developing ventricular arrhythmias that included torsade de pointes, which could be fatal. The patient also developed ventricular trigeminy, which the authors described as a type of extrasystole that recent research suggests could lead to the possible development of nonischemic dilated cardiomyopathy, even in the absence of known cardiac disease.³⁵ Cardiac rhythm monitoring was recommended by the authors whenever starting, switching, or increasing the dose of antipsychotics, especially in older or other high-risk individuals. Significant cardiac changes can occur when starting or switching antipsychotics, even in an antipsychotic medication considered to have a lower risk profile for causing QTc changes that place a patient at risk of a dangerous cardiac arrhythmia.³⁵

Case Study 2: Bipolar I Disorder

In this case study, the authors report on a potential drug-drug interaction between asenapine and ciprofloxacin.⁶⁰ The patient was a 44-year-old single white female who did not smoke. The patient had a history of bipolar I disorder. The patient was admitted to the hospital because of a worsening depressed mood.⁶⁰

The patient had been taking asenapine 5 mg for 1.5 months prior to her admission in this case. Her medical history included a severe dystonic reaction to haloperidol. The patient’s prescribed medications were continued, and they “included baclofen 20mg/day, dexlansoprazole 60mg/day, fluoxetine 20mg/day, lorazepam 1mg/day, and divalproex 2250mg/day.”⁶⁰

The patient had a urinary tract infection (UTI) at admission, and she was administered ciprofloxacin 500 mg twice daily.⁵⁸ Within 33 hours of taking ciprofloxacin, the patient was unable to close her jaw, which was indicative of acute dystonia. The patient was administered 50 mg of diphenhydramine intramuscularly to treat her acute dystonia, and the condition resolved.⁶⁰

Pause and Ponder

What other actions should be considered for the patient in case study 2?

Ciprofloxacin was discontinued, and the patient was prescribed nitrofurantoin 100 mg twice daily in its place. Asenapine was continued with no complications thereafter.⁶⁰

Discussion

In this case, the authors stated that the potential drug-drug interaction between asenapine and ciprofloxacin had not been previously reported.⁵⁷ Asenapine is a second-generation antipsychotic that is primarily metabolized by uridine 5′-diphospho-glucuronosyltransferase 1A4 (UGT1A4) and cytochrome P450 (CYP)1A2.⁶⁰ Ciprofloxacin is a potent inhibitor of CYP1A2 but not of UGT1A4.⁶⁰ Ciprofloxacin has a half-life of 4 hours, and it reaches a steady state after 3 days.⁶⁰ Interactions between ciprofloxacin and second-generation antipsychotics that are metabolized through the CYP1A2 pathway have been published, such as a case involving elevated olanzapine serum levels when co-administered with ciprofloxacin.^60,61

In this case, the authors determined that ciprofloxacin precipitated the patient’s dystonia.⁶⁰ The patient’s UTI could have been an additional contributing factor, but the authors noted that the dystonia did not appear until after the initiation of ciprofloxacin, and given ciprofloxacin’s pharmacokinetics, it was considered the primary cause of the patient’s dystonia.⁶⁰

Summary

Asenapine is a second-generation, atypical antipsychotic medication. Its labeled uses include treating adults with schizophrenia and adults and children (age 10-17) with bipolar I disorder. It is approved by the FDA in a sublingual formulation for the treatment of adults with schizophrenia. Asenapine is also available in a transdermal formulation that is currently approved and limited to treating adults with schizophrenia.

Asenapine comes with labeled warnings and contraindications similar to other antipsychotics. Adverse effects listed with an incidence of ≥5% or twice that of placebo include akathisia, dizziness, dysgeusia, fatigue, increased appetite, increased weight, nausea, oral hypoesthesia, oral paresthesia, and somnolence. Clinical knowledge, individualized approach to care, and team collaboration promote safe prescribing and optimize therapeutic benefits while minimizing risks.

References

Minassian A, Young JW. Evaluation of the clinical efficacy of asenapine in schizophrenia. Expert Opin Pharmacother. 2010;11(12):2107-2115. doi:10.1517/14656566.2010.506188

ASENAPINE- asenapine maleate tablet. Prescribing Information. Breckenridge Pharmaceutical, Inc. Updated February 13, 2024. Accessed November 16, 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f5cd9abb-40e3-4cb5-a1b2-40cdba8a1c7e

SAPHRIS- asenapine maleate tablet. Prescribing Information. Allergan, Inc. Updated January 31, 2025. Accessed November 16, 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5429f134-839f-4ffc-9944-55f51238def8

Carrithers B, El-Mallakh RS. Transdermal Asenapine in Schizophrenia: A Systematic Review. Patient Prefer Adherence. 2020;14:1541-1551. Published 2020 Aug 25. doi:10.2147/PPA.S235104

SECUADO- asenapine film, extended release. Prescribing Information. Noven Therapeutics, LLC. Updated January 30, 2025. Accessed November 16, 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=685eaf44-5944-4f38-afba-0a4fc0b3462b

U. S. Food and Drug Administration. 2020 First Generic Drug Approvals. FDA. February 23, 2021. Accessed November 16, 2025. https://www.fda.gov/drugs/first-generic-drug-approvals/2020-first-generic-drug-approvals

Findling RL, Landbloom RL, Mackle M, et al. Long-term Safety of Asenapine in Pediatric Patients Diagnosed With Bipolar I Disorder: A 50-Week Open-Label, Flexible-Dose Trial. Paediatr Drugs. 2016;18(5):367-378. doi:10.1007/s40272-016-0184-2

Wozniak J, O'Connor H, Iorini M, Ambrose AJH. Pediatric Bipolar Disorder: Challenges in Diagnosis and Treatment. Paediatr Drugs. 2025;27(2):125-142. doi:10.1007/s40272-024-00669-z

Chwieduk CM, Scott LJ. Asenapine: a review of its use in the management of mania in adults with bipolar I disorder. CNS Drugs. 2011;25(3):251-267. doi:10.2165/11206700-000000000-00000

Musselman M, Faden J, Citrome L. Asenapine: an atypical antipsychotic with atypical formulations. Ther Adv Psychopharmacol. 2021;11:20451253211035269. Published 2021 Sep 11. doi:10.1177/20451253211035269

Alvarez-Herrera S, Escamilla R, Medina-Contreras O, et al. Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics. Front Endocrinol (Lausanne). 2020;11:195. Published 2020 Apr 21. doi:10.3389/fendo.2020.00195

Torrisi SA, Laudani S, Contarini G, et al. Dopamine, Cognitive Impairments and Second-Generation Antipsychotics: From Mechanistic Advances to More Personalized Treatments. Pharmaceuticals (Basel). 2020;13(11):365. Published 2020 Nov 5. doi:10.3390/ph13110365

Citrome L, Zeni CM, Correll CU. Patches: Established and Emerging Transdermal Treatments in Psychiatry. J Clin Psychiatry. 2019;80(4):18nr12554. Published 2019 Jul 16. doi:10.4088/JCP.18nr12554

Landbloom R, Mackle M, Wu X, et al. Asenapine for the treatment of adults with an acute exacerbation of schizophrenia: results from a randomized, double-blind, fixed-dose, placebo-controlled trial with olanzapine as an active control. CNS Spectr. 2017;22(4):333-341. doi:10.1017/S1092852916000377

Orr C, Deshpande S, Sawh S, Jones PM, Vasudev K. Asenapine for the Treatment of Psychotic Disorders. Can J Psychiatry. 2017;62(2):123-137. doi:10.1177/0706743716661324

Plosker GL, Deeks ED. Asenapine: A Review in Schizophrenia. CNS Drugs. 2016;30(7):655-666. doi:10.1007/s40263-016-0363-2

Stepanova E, Grant B, Findling RL. Asenapine Treatment in Pediatric Patients with Bipolar I Disorder or Schizophrenia: A Review. Paediatr Drugs. 2018;20(2):121-134. doi:10.1007/s40272-017-0274-9

Szegedi A, Durgam S, Mackle M, et al. Randomized, Double-Blind, Placebo-Controlled Trial of Asenapine Maintenance Therapy in Adults With an Acute Manic or Mixed Episode Associated With Bipolar I Disorder. Am J Psychiatry. 2018;175(1):71-79. doi:10.1176/appi.ajp.2017.16040419

Vieta E, Montes JM. A Review of Asenapine in the Treatment of Bipolar Disorder. Clin Drug Investig. 2018;38(2):87-99. doi:10.1007/s40261-017-0592-2

Marazziti D, Mucci F, Baroni S, Piccinni A. Asenapine augmentation in bipolar disorders: a case series. Clin Case Rep. 2016;4(5):499-504. Published 2016 Apr 7. doi:10.1002/ccr3.526

Dell'Osso B, Cremaschi L, Palazzo MC, et al. Use of asenapine as add-on therapy in the treatment of bipolar disorder: a comprehensive review and case series. Expert Opin Drug Saf. 2014;13(9):1199-1208. doi:10.1517/14740338.2014.938047

Szegedi A, Calabrese JR, Stet L, et al. Asenapine as adjunctive treatment for acute mania associated with bipolar disorder: results of a 12-week core study and 40-week extension. J Clin Psychopharmacol. 2012;32(1):46-55. doi:10.1097/JCP.0b013e31823f872f

Buoli M, Esposito CM, Godio M, Caldiroli A, Serati M, Altamura AC. Have antipsychotics a different speed of action in the acute treatment of mania? A single-blind comparative study. J Psychopharmacol. 2017;31(12):1537-1543. doi:10.1177/0269881117705098

Cazorla P, Zhao J, Mackle M, Szegedi A. Asenapine effects on individual Young Mania Rating Scale items in bipolar disorder patients with acute manic or mixed episodes: a pooled analysis. Neuropsychiatr Dis Treat. 2013;9:409-413. doi:10.2147/NDT.S38390

Sajatovic M, Dines P, Fuentes-Casiano E, et al. Asenapine in the treatment of older adults with bipolar disorder. Int J Geriatr Psychiatry. 2015;30(7):710-719. doi:10.1002/gps.4213

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Asenapine. [Updated 2023 Jun 5]. Accessed November 20, 2025. https://www.ncbi.nlm.nih.gov/books/NBK548092/

Rubino A, Sanon M, Ganz ML, et al. Association of the US Food and Drug Administration Antipsychotic Drug Boxed Warning With Medication Use and Health Outcomes in Elderly Patients With Dementia. JAMA Netw Open. 2020;3(4):e203630. Published 2020 Apr 1. doi:10.1001/jamanetworkopen.2020.3630

McKeirnan K. Preventing Unnecessary Antipsychotic Use in Patients With Dementia. Pharmacy Times. 2019. Accessed November 4, 2025. https://www.pharmacytimes.com/view/preventing-unnecessary-antipsychotic-use-in-patients-with-dementia

Reus VI, Fochtmann LJ, Eyler AE, et al. The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients With Dementia. Am J Psychiatry. 2016;173(5):543-546. doi:10.1176/appi.ajp.2015.173501

Beach SR, Celano CM, Sugrue AM, et al. QT Prolongation, Torsades de Pointes, and Psychotropic Medications: A 5-Year Update. Psychosomatics. 2018;59(2):105-122. doi:10.1016/j.psym.2017.10.009

Wei Xin Chong J, Hsien-Jie Tan E, Chong CE, Ng Y, Wijesinghe R. Atypical antipsychotics: A review on the prevalence, monitoring, and management of their metabolic and cardiovascular side effects. Ment Health Clin. 2016;6(4):178-184. Published 2016 Jun 29. doi:10.9740/mhc.2016.07.178

Citrome L. Asenapine review, part II: clinical efficacy, safety and tolerability. Expert Opin Drug Saf. 2014;13(6):803-830. doi:10.1517/14740338.2014.908183

Gıll JS, Sulaıman AH. QTc Prolongation and Ventricular Trigemini with Asenapine: A Case Report. Asenapin ile Düzeltilmiş QT Aralığında Uzama ve Ventriküler Trigeminal Ritim: Bir Olgu Sunumu. Turk Psikiyatri Derg. 2018;29(1):67-68.

Kotasek F, Tibrewal P, Dhillon R. QTc prolongation with asenapine. Aust N Z J Psychiatry. 2014;48(10):961. doi:10.1177/0004867414531832

Duma SR, Fung VS. Drug-induced movement disorders. Aust Prescr. 2019;42(2):56-61. doi:10.18773/austprescr.2019.014

Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013;382(9896):951-962. doi:10.1016/S0140-6736(13)60733-3

Stępnicki P, Kondej M, Kaczor AA. Current Concepts and Treatments of Schizophrenia. Molecules. 2018;23(8):2087. Published 2018 Aug 20. doi:10.3390/molecules23082087

Masiran R. Persistent oromandibular dystonia and angioedema secondary to haloperidol. BMJ Case Rep. 2017;2017:bcr2017220817. Published 2017 Oct 4. doi:10.1136/bcr-2017-220817

Durgam S, Landbloom RP, Mackle M, Wu X, Mathews M, Nasrallah HA. Exploring the long-term safety of asenapine in adults with schizophrenia in a double-blind, fixed-dose, extension study. Neuropsychiatr Dis Treat. 2017;13:2021-2035. Published 2017 Jul 31. doi:10.2147/NDT.S130211

Ketter TA, Durgam S, Landbloom R, Mackle M, Wu X, Mathews M. Long-term safety and tolerability of asenapine: A double-blind, uncontrolled, long-term extension trial in adults with an acute manic or mixed episode associated with bipolar I disorder. J Affect Disord. 2017;207:384-392. doi:10.1016/j.jad.2016.09.037

Ward KM, Citrome L. Antipsychotic-Related Movement Disorders: Drug-Induced Parkinsonism vs. Tardive Dyskinesia-Key Differences in Pathophysiology and Clinical Management. Neurol Ther. 2018;7(2):233-248. doi:10.1007/s40120-018-0105-0

Carbon M, Kane JM, Leucht S, Correll CU. Tardive dyskinesia risk with first- and second-generation antipsychotics in comparative randomized controlled trials: a meta-analysis. World Psychiatry. 2018;17(3):330-340. doi:10.1002/wps.20579

Salem H, Nagpal C, Pigott T, Teixeira AL. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges. Curr Neuropharmacol. 2017;15(5):789-798. doi:10.2174/1570159X14666161208153644

Tachere RO, Modirrousta M. Beyond anxiety and agitation: A clinical approach to akathisia. Aust Fam Physician. 2017;46(5):296-298.

Peuskens J, Pani L, Detraux J, De Hert M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs. 2014;28(5):421-453. doi:10.1007/s40263-014-0157-3

Mittal S, Prasad S, Ghosh A. Antipsychotic-induced hyperprolactinaemia: case studies and review. Postgrad Med J. 2018;94(1110):226-229. doi:10.1136/postgradmedj-2017-135221

Tewksbury A, Olander A. Management of antipsychotic-induced hyperprolactinemia. Ment Health Clin. 2016;6(4):185-190. Published 2016 Jun 29. doi:10.9740/mhc.2016.07.185

Jin L, Gu J, Wu Y, Xia H, Xie G, Zhu G. Safety assessment of asenapine in the FAERS database: real adverse event analysis and discussion on neurological and psychiatric side effects. BMC Pharmacol Toxicol. 2024;25(1):49. Published 2024 Aug 12. doi:10.1186/s40360-024-00772-4

Miyasaka K, Hirofuji S, Maezawa M, et al. Evaluation of Antipsychotic-Induced Neuroleptic Malignant Syndrome Using a Self-Organizing Map. Cureus. 2024;16(8):e68260. Published 2024 Aug 30. doi:10.7759/cureus.68260

Ware MR, Feller DB, Hall KL. Neuroleptic Malignant Syndrome: Diagnosis and Management. Prim Care Companion CNS Disord. 2018;20(1):17r02185. Published 2018 Jan 4. doi:10.4088/PCC.17r02185

Hirofuji S, Miyasaka K, Maezawa M, et al. Evaluation of neuroleptic malignant syndrome induced by antipsychotic drugs using spontaneous reporting system. Heliyon. 2023;9(11):e21891. Published 2023 Nov 7. doi:10.1016/j.heliyon.2023.e21891

Raja S. Neuroleptic malignant syndrome probably induced by asenapine. J Neuropsychiatry Clin Neurosci. 2014;26(4):E36. doi:10.1176/appi.neuropsych.13090224

Szegedi A, Zhao J, van Willigenburg A, Nations KR, Mackle M, Panagides J. Effects of asenapine on depressive symptoms in patients with bipolar I disorder experiencing acute manic or mixed episodes: a post hoc analysis of two 3-week clinical trials. BMC Psychiatry. 2011;11:101. Published 2011 Jun 20. doi:10.1186/1471-244X-11-101

Bergink V, Suleiman M, Hennen MA, Robakis T. Management of Bipolar Disorder in Pregnancy and Postpartum: A Clinicians' Guide. CNS Drugs. 2025;39(8):763-777. doi:10.1007/s40263-025-01202-7

Szegedi A, Verweij P, van Duijnhoven W, Mackle M, Cazorla P, Fennema H. Meta-analyses of the efficacy of asenapine for acute schizophrenia: comparisons with placebo and other antipsychotics. J Clin Psychiatry. 2012 Dec;73(12):1533-40. doi: 10.4088/JCP.11r07596

Citrome L, Landbloom R, Chang CT, Earley W. Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder. Neuropsychiatr Dis Treat. 2017;13:2955-2963. Published 2017 Dec 11. doi:10.2147/NDT.S149376

Citrome L, Komaroff M, Starling B, Byreddy S, Terahara T, Hasebe M. Efficacy of HP-3070, an Asenapine Transdermal System, on Symptoms of Hostility in Adults With Schizophrenia: A Post Hoc Analysis of a 6-Week Phase 3 Study. J Clin Psychiatry. 2022;83(4):21m14355. Published 2022 Jun 6. doi:10.4088/JCP.21m14355

Burk BG, Humphreys K, Waites J, Adams B, Birur B, Parker PE. Sublingual asenapine for agitation in malabsorptive states: three patient cases. Ther Adv Psychopharmacol. 2024;14:20451253241263714. Published 2024 Jul 25. doi:10.1177/20451253241263714

Ridout KK, Ridout SJ, Pirnie LF, Puttichanda SP. Sudden-onset dystonia in a patient taking asenapine: interaction between ciprofloxacin and asenapine metabolism. Am J Psychiatry. 2015;172(11):1162-1163. doi:10.1176/appi.ajp.2015.15030353

Letsas KP, Sideris A, Kounas SP, Efremidis M, Korantzopoulos P, Kardaras F. Drug-induced QT interval prolongation after ciprofloxacin administration in a patient receiving olanzapine. Int J Cardiol. 2006;109(2):273-274. doi:10.1016/j.ijcard.2005.04.031

DISCLAIMER

The information provided in this course is general in nature, and it is designed solely to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment, and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice.

Healthcare professionals must consult their employer, healthcare facility, hospital, or other organization for guidelines, protocols, and procedures to follow. The information provided in this course does not replace those guidelines, protocols, and procedures, but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits.

Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses is constantly changing. Any person taking this course understands that such a person must make an independent review of medication information before any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only, and such uses are not endorsed hereby.

Nothing contained in this course represents the opinions, views, judgments, or conclusions of RxCe.com LLC. RxCe.com LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course or course material.

RxCe.com

Back to Asenapine Use in Antipsychotic Care (Pharmacist, Pharmacy Tech, Physician Assistant, Physician)