Zukaria

Indications

Asenapine Maleate is an antipsychotic medicine used in adults to treat:

• Schizophrenia, a mental illness that can cause hearing or seeing things that are not there, fixed false beliefs and confused thinking.
• Moderate to severe manic episodes of bipolar I disorder, either alone or together with a mood stabiliser such as Lithium or Valproate.

How It Works

Asenapine is an atypical (second generation) antipsychotic. It blocks certain receptors for the brain chemicals dopamine and serotonin. This helps rebalance brain signalling, which reduces symptoms such as hallucinations, agitation, racing thoughts and overexcitement.

Dosage and Administration

Take exactly as prescribed by your psychiatrist; the dose is set and adjusted for each person. The tablet is placed under the tongue (sublingual) and left to dissolve completely, which takes a few seconds. Do not swallow, chew or crush it, because it does not work well if swallowed. Do not eat or drink for 10 minutes after taking it. It is usually taken twice a day. Do not stop suddenly; your doctor will lower the dose gradually if needed.

Interactions

• Alcohol, sleeping tablets, strong painkillers and other sedating medicines can increase drowsiness.
• Fluvoxamine can raise Asenapine levels.
• Asenapine can raise levels of Paroxetine and some other medicines broken down by the same liver enzyme.
• Blood pressure medicines may cause a larger fall in blood pressure.
• Medicines that affect heart rhythm (for example some antiarrhythmics, Moxifloxacin or other antipsychotics) may add to heart rhythm risk.
• Levodopa and similar Parkinson medicines may work less well.

Contraindications

Do not take if you are allergic to Asenapine or any ingredient, or if you have severe liver disease.

Side Effects

Common side effects include sleepiness, numbness or tingling of the mouth or tongue soon after a dose, changed taste, dizziness, weight gain, increased appetite, restlessness or an urge to keep moving, stiffness or shaking, and anxiety. It may raise blood sugar and cholesterol, and can cause dizziness on standing.

Get urgent medical help if you have swelling of the tongue, lips or throat, difficulty breathing or a severe rash; high fever with stiff muscles, sweating and confusion (neuroleptic malignant syndrome); fast or irregular heartbeat or fainting; fits; or uncontrolled movements of the face, tongue or limbs.

Pregnancy and Lactation

Use in pregnancy only if your doctor decides it is needed. Babies exposed in the last 3 months of pregnancy may have shaking, stiffness, sleepiness, breathing or feeding problems after birth. Do not stop the medicine on your own if you become pregnant; talk to your doctor. Breastfeeding is not recommended during treatment.

Precautions and Warnings

• Elderly people with dementia have a higher risk of stroke and death with antipsychotics; Asenapine is not approved for dementia related behaviour.
• It may cause drowsiness; do not drive or operate machines until you know how it affects you.
• Tell your doctor about diabetes, heart disease, low blood pressure, epilepsy, liver disease or Parkinson disease.
• Your doctor may check weight, blood sugar, cholesterol and blood counts.
• Avoid overheating and dehydration.
• Report any thoughts of self harm or worsening mood to your doctor at once.

Overdose

Too much may cause severe sleepiness, agitation, confusion, abnormal movements, fast heartbeat or low blood pressure. Get emergency medical help straight away.

Therapeutic Class

Atypical (second generation) antipsychotic.

Storage

Store below 30°C in a dry place, in the original pack to protect from light and moisture, and out of the reach of children.