or Use Alternate Drug.oxazepamMonitor Closely (1)asenapine transdermal and oxazepam both increase sedation. Use Caution/Monitor.oxycodoneSerious - Use Alternative (1)asenapine transdermal and oxycodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequateoxymorphoneSerious - Use Alternative (1)asenapine transdermal and oxymorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequateozanimodMonitor Closely (1)asenapine transdermal and ozanimod both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidoneMonitor Closely (1)asenapine transdermal and paliperidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.panobinostatSerious - Use Alternative (1)asenapine transdermal and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.paroxetineSerious - Use Alternative (1)asenapine transdermal and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)asenapine transdermal and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibSerious - Use Alternative (1)asenapine transdermal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.pentamidineSerious - Use Alternative (1)asenapine transdermal and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)asenapine transdermal and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)asenapine transdermal and pentobarbital both increase sedation. Use Caution/Monitor.perampanelMonitor Closely (1)asenapine transdermal and perampanel both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (2)asenapine transdermal and perphenazine both increase QTc interval. Use Caution/Monitor. asenapine transdermal and perphenazine both increase sedation. Use Caution/Monitor.pheniramineMonitor Closely (1)asenapine transdermal and pheniramine both increase sedation. Use Caution/Monitor.phenobarbitalMonitor Closely (1)asenapine transdermal and phenobarbital both increase sedation. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)asenapine transdermal and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.pimozideMonitor Closely (1)asenapine transdermal and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and pimozide both increase QTc interval. Contraindicated.pitolisantSerious - Use Alternative (1)asenapine transdermal and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pomalidomideMonitor Closely (1)asenapine transdermal and pomalidomide both increase sedation. Use Caution/Monitor.ponesimodSerious - Use Alternative (1)asenapine transdermal and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleSerious - Use Alternative (1)asenapine transdermal and posaconazole both increase QTc interval. Contraindicated.pregabalinMonitor Closely (1)asenapine transdermal and pregabalin both increase sedation. Use Caution/Monitor.primaquineSerious - Use Alternative (1)asenapine transdermal and primaquine both increase QTc interval. Avoid or Use Alternate Drug.primidoneMonitor Closely (1)asenapine transdermal and primidone both increase sedation. Use Caution/Monitor.procainamideSerious - Use Alternative (1)asenapine transdermal and procainamide both increase QTc interval. Avoid or Use Alternate Drug.prochlorperazineMonitor Closely (2)asenapine transdermal and prochlorperazine both decrease QTc interval. Use Caution/Monitor. asenapine transdermal and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)asenapine transdermal and promethazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and promethazine both decrease QTc interval. Avoid or Use Alternate Drug.propafenoneSerious - Use Alternative (1)asenapine transdermal and propafenone both increase QTc interval. Avoid or Use Alternate Drug.propofolMonitor Closely (1)asenapine transdermal and propofol both increase sedation. Use Caution/Monitor.protriptylineMonitor Closely (2)asenapine transdermal and protriptyline both increase QTc interval. Use Caution/Monitor. asenapine transdermal and protriptyline both increase sedation. Use Caution/Monitor.pyrilamineMonitor Closely (1)asenapine transdermal and pyrilamine both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)asenapine transdermal and quazepam both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)asenapine transdermal and quetiapine both increase QTc interval. Use Caution/Monitor. asenapine transdermal and quetiapine both increase sedation. Use Caution/Monitor.quinidineSerious - Use Alternative (1)asenapine transdermal and quinidine both increase QTc interval. Avoid or Use Alternate Drug.quinineSerious - Use Alternative (1)asenapine transdermal and quinine both increase QTc interval. Avoid or Use Alternate Drug.ramelteonMonitor Closely (1)asenapine transdermal and ramelteon both increase sedation. Use Caution/Monitor.ranolazineSerious - Use Alternative (1)asenapine transdermal and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.remifentanilMonitor Closely (1)asenapine transdermal and remifentanil both increase sedation. Use Caution/Monitor.remimazolamMonitor Closely (1)remimazolam, asenapine transdermal. 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.reserpineMonitor Closely (1)asenapine transdermal and reserpine both increase sedation. Use Caution/Monitor.ribociclibSerious - Use Alternative (1)asenapine transdermal and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.rilpivirineMonitor Closely (1)asenapine transdermal and rilpivirine both increase QTc interval. Use Caution/Monitor.risperidoneMonitor Closely (1)asenapine transdermal and risperidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and risperidone both increase QTc interval. Avoid or Use Alternate Drug.romidepsinSerious - Use Alternative (1)asenapine transdermal and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.saquinavirSerious - Use Alternative (1)asenapine transdermal and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.scopolamineMonitor Closely (1)asenapine transdermal and scopolamine both increase sedation. Use Caution/Monitor.selinexorSerious - Use Alternative (1)selinexor, asenapine transdermal. 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)asenapine transdermal and selpercatinib both increase QTc interval. Use Caution/Monitor.sertralineSerious - Use Alternative (1)asenapine transdermal and sertraline both increase QTc interval. Avoid or Use Alternate Drug.sevofluraneMonitor Closely (1)asenapine transdermal and sevoflurane both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.siponimodSerious - Use Alternative (1)asenapine transdermal and siponimod both increase QTc interval. Avoid or Use Alternate Drug.sodium oxybateMonitor Closely (1)asenapine transdermal and sodium oxybate both increase sedation. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chlorideMonitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases effects of asenapine transdermal 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 (1)sodium sulfate/potassium sulfate/magnesium sulfate increases effects of asenapine transdermal 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)asenapine transdermal and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.sorafenibMonitor Closely (1)asenapine transdermal and sorafenib both increase QTc interval. Use Caution/Monitor.sotalolSerious - Use Alternative (1)asenapine transdermal and sotalol both increase QTc interval. Avoid or Use Alternate Drug.stiripentolMonitor Closely (1)asenapine transdermal and stiripentol both increase sedation. Use Caution/Monitor.sufentanilMonitor Closely (1)asenapine transdermal and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLMonitor Closely (1)asenapine transdermal and sufentanil SL both increase sedation. Use Caution/Monitor.sunitinibSerious - Use Alternative (1)asenapine transdermal and sunitinib both increase QTc interval. Avoid or Use Alternate Drug.suvorexantMonitor Closely (1)asenapine transdermal and suvorexant both increase sedation. Use Caution/Monitor.tacrolimusSerious - Use Alternative (1)asenapine transdermal and tacrolimus both increase QTc interval. Avoid or Use Alternate Drug.tapentadolMonitor Closely (1)asenapine transdermal and tapentadol both increase sedation. Use Caution/Monitor.tasimelteonMonitor Closely (1)asenapine transdermal and tasimelteon both increase sedation. Use Caution/Monitor.telavancinSerious - Use Alternative (1)asenapine transdermal and telavancin both increase QTc interval. Avoid or Use Alternate Drug.temazepamMonitor Closely (1)asenapine transdermal and temazepam both increase sedation. Use Caution/Monitor.tetrabenazineMonitor Closely (1)asenapine transdermal and tetrabenazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.thalidomideContraindicated (1)asenapine transdermal and thalidomide both increase sedation. Contraindicated.thioridazineContraindicated (1)asenapine transdermal and thioridazine both increase QTc interval. Contraindicated.Monitor Closely (1)asenapine transdermal and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneMonitor Closely (1)asenapine transdermal and thiothixene both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.tiagabineMonitor Closely (1)asenapine transdermal and tiagabine both increase sedation. Use Caution/Monitor.tizanidineMonitor Closely (1)asenapine transdermal and tizanidine both increase sedation. Use Caution/Monitor.tolcaponeMonitor Closely (1)asenapine transdermal and tolcapone both increase sedation. Use Caution/Monitor.topiramateMonitor Closely (1)asenapine transdermal and topiramate both increase sedation. Use Caution/Monitor.toremifeneSerious - Use Alternative (1)asenapine transdermal and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.tramadolSerious - Use Alternative (1)asenapine transdermal and tramadol both increase sedation. Avoid or Use Alternate Drug.trazodoneMonitor Closely (1)asenapine transdermal and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.triazolamSerious - Use Alternative (1)asenapine transdermal and triazolam both increase sedation. Avoid or Use Alternate Drug.triclabendazoleMonitor Closely (1)asenapine transdermal and triclabendazole both increase QTc interval. Use Caution/Monitor.trifluoperazineMonitor Closely (1)asenapine transdermal and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)asenapine transdermal and trimipramine both increase QTc interval. Use Caution/Monitor.triprolidineMonitor Closely (1)asenapine transdermal and triprolidine both increase sedation. Use Caution/Monitor.triptorelinSerious - Use Alternative (1)asenapine transdermal and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.umeclidinium bromide/vilanterol inhaledSerious - Use Alternative (1)asenapine transdermal and umeclidinium bromide/vilanterol inhaled both decrease QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiatedvalproic acidMonitor Closely (1)asenapine transdermal and valproic acid both increase sedation. Use Caution/Monitor.vandetanibSerious - Use Alternative (1)asenapine transdermal and vandetanib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommendedvardenafilSerious - Use Alternative (1)asenapine transdermal and vardenafil both increase QTc interval. Avoid or Use Alternate Drug.vemurafenibSerious - Use Alternative (1)asenapine transdermal and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.venlafaxineSerious - Use Alternative (1)asenapine transdermal and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.vigabatrinMonitor Closely (1)asenapine transdermal and vigabatrin both increase sedation. Use Caution/Monitor.vilanterol/fluticasone furoate inhaledSerious - Use Alternative (1)asenapine transdermal and vilanterol/fluticasone furoate inhaled both increase QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiatedvoclosporinMonitor Closely (1)voclosporin, asenapine transdermal. Either increases effects of the other by QTc interval. Use Caution/Monitor.voriconazoleSerious - Use Alternative (1)asenapine transdermal and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.vorinostatSerious - Use Alternative (1)asenapine transdermal and vorinostat both increase QTc interval. Avoid or Use Alternate Drug.zaleplonMonitor Closely (1)asenapine transdermal and zaleplon both increase sedation. Use Caution/Monitor.ziconotideMonitor Closely (1)asenapine transdermal and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)asenapine transdermal and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.zolpidemMonitor Closely (1)asenapine transdermal and zolpidem both increase sedation. Use Caution/Monitor.zonisamideMonitor Closely (1)asenapine transdermal and zonisamide both increase sedation. Use Caution/Monitor. >10% Application site reactions (14-15%) Extrapyramidal symptoms (8-13%) 1-10% Headache (9%) Increased weight (4-6%) Constipation (4-5%) Akathisia (4%) Somnolence (3-4%) Increased hepatic transaminases >3x ULN (1.6-3.1%) Dyspepsia (1-3%) Diarrhea (1-3%) Blood glucose increased (1-3%) Dystonia (1-3%) Nasopharyngitis (1-3%) Upper respiratory tract infection (1-3%) Creatine kinase elevations ≥3 x ULN at any time (1.6-2.1%) Hypertension (2%) Vomiting (<2%) Dry mouth (<2%) Asthenia (<2%) Myalgia (<2%) Increased prolactin levels (1.3%) <1% Anemia Temporary bundle-branch block Accommodation disorder Swollen tongue Hyponatremia Dysarthria Thrombocytopenia Postmarketing Reports Choking Increased mortality and dementia-related psychosis Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death Not approved for treatment of dementia-related psychosisContraindications Severe hepatic impairment (Child-Pugh C) Hypersensitivity to asenapine or any components of the transdermal system Cautions Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; in placebo-controlled trials, patients, especially those taking atypical antipsychotic drugs, showed an increased risk of death in treated patients (1.6-1.7x) compared with placebo patients Neuroleptic malignant syndrome associated with use; monitor for symptoms; discontinue if suspected, and provide intensive symptomatic treatment and monitoring In placebo-controlled trials in elderly subjects with dementia, patients randomized to risperidone, aripiprazole, and olanzapine had a higher incidence of stroke and transient ischemic attack, including fatal stroke Not approved for treatment of dementia-related psychosis Atypical antipsychotic drugs, including asenapine transdermal, have caused metabolic changes, including hyperglycemia, diabetes mellitus, dyslipidemia, and body weight gain Hypersensitivity reactions have been observed Atypical antipsychotics cause orthostatic hypotension and syncope; risk is greatest during initial dose titration and when increasing the dose May cause somnolence, postural hypotension, motor instability, and sensory instability, which may lead to falls and, consequently, fractures or other injuries; complete fall risk assessments in