What is this medication?

ASENAPINE (a SEN a peen) treats schizophrenia. It works by balancing the levels of dopamine and serotonin in your brain, substances that help regulate mood, behaviors, and thoughts. It belongs to a group of medications called antipsychotics. Antipsychotic medications can be used to treat several kinds of mental health conditions.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): SECUADO

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Dementia
• Diabetes
• Difficulty swallowing
• Have trouble controlling your muscles
• Heart disease
• High cholesterol
• History of breast cancer
• History of irregular heartbeat
• History of stroke
• Liver disease
• Low blood counts, like low white cell, platelet, or red cell counts
• Low blood pressure
• Parkinson's disease
• Seizures
• An unusual or allergic reaction to asenapine, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for external use only. Follow the directions on the prescription label. Do not cut or trim the patch. Apply the patch to an area of the upper arm, upper back, abdomen, or hip that is clean, dry and hairless. Avoid injured, irritated, or oily areas. Follow package instructions carefully. Do not apply to waistline where clothing may cause the patch to rub off. Wash hands after applying this medication. Change your patch at the same time each day. Use a different site each time to prevent skin irritation. Do not use more often than directed. Do not stop using except on your care team's advice.

After removing a used patch, fold the patch so it sticks to itself. Throw away the patch right away in a lidded trash can, away from the reach of children and pets. Do not flush down the toilet.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you forget to replace your patch, take off the old patch and put on a new patch as soon as you can. Do not apply an extra patch to your skin. Do not wear more than one patch at the same time.

What may interact with this medication?

Do not take this medication with any of the following:

• Cisapride
• Dronedarone
• Metoclopramide
• Pimozide
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Antihistamines for allergy, cough, and cold
• Certain antibiotics like gatifloxacin, moxifloxacin
• Certain medications for fungal infections like fluconazole, itraconazole, ketoconazole, posaconazole
• Certain medications for irregular heart beat like amiodarone, dofetilide, procainamide, quinidine, sotalol
• Certain medications for sleep or anxiety
• Certain medications for depression like amitriptyline, fluoxetine, paroxetine, sertraline
• Fluvoxamine
• General anesthetics like halothane, isoflurane, methoxyflurane, propofol
• Levodopa or other medications for Parkinson's disease
• Medications for blood pressure
• Medications for seizures
• Medications that relax muscles for surgery
• Narcotic medications for pain
• Other medications that prolong the QT interval (cause an abnormal heart rhythm)
• Phenothiazines like chlorpromazine, prochlorperazine
• Ziprasidone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if symptoms do not start to get better or if they get worse. Do not stop taking except on your care team's advice. You may develop a severe reaction. Your care team will tell you how much medication to take.

You may get dizzy or drowsy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks.

This medication may increase blood sugar. Ask your care team if changes in diet or medications are needed if you have diabetes.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

This medication can cause problems with controlling your body temperature. It can lower the response of your body to cold temperatures. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. It can also lower the response of your body to heat. Do not overheat. Do not over-exercise. Stay out of the sun when possible. If you must be in the sun, wear cool clothing. Drink plenty of water. If you have trouble controlling your body temperature, call your care team right away.

This medication patch is sensitive to certain body heat changes. If your skin gets too hot, more medication will come out of the patch. Call your care team if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hair dryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not do exercise that increases your body temperature.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
• High prolactin level—unexpected breast tissue growth, discharge from the nipple, change in sex drive or performance, irregular menstrual cycle
• Infection—fever, chills, cough, or sore throat
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Pain or trouble swallowing
• Seizures
• Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
• Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Drowsiness
• Headache
• Irritation at application site
• Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep patches in the package until ready to use. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.