Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.parecoxibMonitor Closely (1)parecoxib decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.paroxetineMonitor Closely (2)paroxetine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). asenapine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)asenapine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibSerious - Use Alternative (1)asenapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.pefloxacinMonitor Closely (1)pefloxacin will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.peginterferon alfa 2aMinor (1)peginterferon alfa 2a will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.penbutololMonitor Closely (1)asenapine and penbutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.pentamidineSerious - Use Alternative (1)asenapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)asenapine and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)asenapine and pentobarbital both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.perampanelMonitor Closely (1)asenapine and perampanel both increase sedation. Use Caution/Monitor.perhexilineMinor (1)asenapine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.perindoprilMonitor Closely (1)perindopril, asenapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.perphenazineMonitor Closely (2)asenapine and perphenazine both increase QTc interval. Use Caution/Monitor. asenapine and perphenazine both increase sedation. Use Caution/Monitor.Minor (1)asenapine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.phenelzineMonitor Closely (1)phenelzine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).pheniramineMonitor Closely (1)asenapine and pheniramine both increase sedation. Use Caution/Monitor.phenobarbitalMonitor Closely (1)asenapine and phenobarbital both increase sedation. Use Caution/Monitor.Minor (1)phenobarbital will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.phenoxybenzamineMonitor Closely (1)asenapine and phenoxybenzamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.phentolamineMonitor Closely (1)asenapine and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.phenylephrineMinor (1)asenapine, phenylephrine. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.phenylephrine POMinor (1)asenapine, phenylephrine PO. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.pimavanserinSerious - Use Alternative (1)pimavanserin and asenapine both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.pimozideMonitor Closely (1)asenapine and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and pimozide both increase QTc interval. Contraindicated.pindololMonitor Closely (1)asenapine and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.pioglitazoneMonitor Closely (1)asenapine, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.pipemidic acidMinor (1)pipemidic acid will increase the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.piroxicamMonitor Closely (1)piroxicam decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.pitolisantSerious - Use Alternative (1)asenapine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pomalidomideMonitor Closely (1)asenapine and pomalidomide both increase sedation. Use Caution/Monitor.ponesimodSerious - Use Alternative (1)asenapine and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleContraindicated (1)asenapine and posaconazole both increase QTc interval. Contraindicated.pramlintideMonitor Closely (1)asenapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.prazosinMonitor Closely (1)asenapine and prazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.pregabalinMonitor Closely (1)asenapine and pregabalin both increase sedation. Use Caution/Monitor.primaquineSerious - Use Alternative (1)primaquine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.primidoneMonitor Closely (1)asenapine and primidone both increase sedation. Use Caution/Monitor.Minor (1)primidone will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.procainamideSerious - Use Alternative (1)asenapine and procainamide both increase QTc interval. Avoid or Use Alternate Drug.procarbazineMonitor Closely (1)procarbazine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).prochlorperazineMonitor Closely (2)asenapine and prochlorperazine both decrease QTc interval. Use Caution/Monitor. asenapine and prochlorperazine both increase sedation. Use Caution/Monitor.Minor (1)asenapine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.promazineMinor (1)asenapine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.promethazineMonitor Closely (2)promethazine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). asenapine and promethazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and promethazine both decrease QTc interval. Avoid or Use Alternate Drug.Minor (1)asenapine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.propafenoneMonitor Closely (1)asenapine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and propafenone both increase QTc interval. Avoid or Use Alternate Drug.propofolMonitor Closely (1)asenapine and propofol both increase sedation. Use Caution/Monitor.propranololMonitor Closely (2)asenapine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. asenapine and propranolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.protriptylineMonitor Closely (2)asenapine and protriptyline both increase QTc interval. Use Caution/Monitor. asenapine and protriptyline both increase sedation. Use Caution/Monitor.pyrilamineMonitor Closely (1)asenapine and pyrilamine both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)asenapine and quazepam both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)asenapine and quetiapine both increase sedation. Use Caution/Monitor. quetiapine, asenapine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.quinaprilMonitor Closely (1)quinapril, asenapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.quinidineSerious - Use Alternative (1)asenapine and quinidine both increase QTc interval. Avoid or Use Alternate Drug.quinineMonitor Closely (1)asenapine and quinine both increase QTc interval. Use Caution/Monitor.ramelteonMonitor Closely (1)asenapine and ramelteon both increase sedation. Use Caution/Monitor.ramiprilMonitor Closely (1)ramipril, asenapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.ranolazineSerious - Use Alternative (1)asenapine and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.remifentanilSerious - Use Alternative (1)asenapine and remifentanil both increase sedation. Avoid or Use Alternate Drug.remimazolamMonitor Closely (1)remimazolam, asenapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.repaglinideMonitor Closely (1)asenapine, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.reserpineMonitor Closely (1)asenapine and reserpine both increase sedation. Use Caution/Monitor.ribociclibSerious - Use Alternative (1)ribociclib and asenapine both increase QTc interval. Avoid or Use Alternate Drug.rifampinMonitor Closely (1)rifampin will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.rilpivirineMonitor Closely (1)rilpivirine increases toxicity of asenapine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.risperidoneMonitor Closely (1)asenapine and risperidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)asenapine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.romidepsinSerious - Use Alternative (1)asenapine and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.rosiglitazoneMonitor Closely (1)asenapine, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.safinamideSerious - Use Alternative (1)asenapine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.salicylates (non-asa)Monitor Closely (1)salicylates (non-asa) decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.salsalateMonitor Closely (1)salsalate decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.saquinavirSerious - Use Alternative (2)saquinavir, asenapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of QT prolongation and cardiac arrhythmias. asenapine and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.saxagliptinMonitor Closely (1)asenapine, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.scopolamineMonitor Closely (1)asenapine and scopolamine both increase sedation. Use Caution/Monitor.secobarbitalMinor (1)secobarbital will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.selegilineMonitor Closely (1)selegiline, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).selinexorSerious - Use Alternative (1)selinexor, asenapine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.selpercatinibMonitor Closely (1)selpercatinib increases toxicity of asenapine by QTc interval. Use Caution/Monitor.sertralineSerious - Use Alternative (1)sertraline and asenapine both increase QTc interval. Avoid or Use Alternate Drug.sevofluraneMonitor Closely (1)asenapine and sevoflurane both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)sevoflurane and asenapine both increase QTc interval. Avoid or Use Alternate Drug.sildenafilSerious - Use Alternative (1)sildenafil increases effects of asenapine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypotension; separate sildenafil >25mg from alpha blocker by 4hr.silodosinMonitor Closely (1)asenapine and silodosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.siponimodSerious - Use Alternative (1)siponimod and asenapine both increase QTc interval. Avoid or Use Alternate Drug.sitagliptinMonitor Closely (1)asenapine, sitagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.smokingMinor (1)smoking will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.sodium oxybateMonitor Closely (1)asenapine and sodium oxybate both increase sedation. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chlorideMonitor Closely (2)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of asenapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. sodium sulfate/?magnesium sulfate/potassium chloride increases effects of asenapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.sodium sulfate/potassium sulfate/magnesium sulfateMonitor Closely (2)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of asenapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. sodium sulfate/potassium sulfate/magnesium sulfate increases effects of asenapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.solifenacinSerious - Use Alternative (1)solifenacin and asenapine both increase QTc interval. Avoid or Use Alternate Drug.sorafenibMonitor Closely (1)sorafenib and asenapine both increase QTc interval. Use Caution/Monitor.sotalolMonitor Closely (1)asenapine and sotalol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)asenapine and sotalol both increase QTc interval. Avoid or Use Alternate Drug.stiripentolMonitor Closely (1)stiripentol, asenapine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol,