Mechanism of action: Asenapine transdermal balliculeVisual mnemonic: Asenapine transdermal mascot “Ass Seen caudally”
What it isOnce-daily asenapine transdermal system; schizophrenia in adults.
Why this oneOnly antipsychotic patch: no sublingual technique or ten-minute food and drink restriction, and concentrations hold steady through each 24-hour wear.
What limits itApplication-site reactions, so rotate the site daily. External heat raises absorption: no heating pads, electric blankets or hair dryers over the patch.
BOXED WARNING Increased mortality in elderly patients with dementia-related psychosis treated with antipsychotics; not approved for dementia-related psychosis.
FDA dosing
Population
Start
Target
Max
Schizophrenia
Adults
3.8 mg/24h patch QD
3.8 mg/24h; may titrate to 5.7 or 7.6 mg/24h
7.6 mg/24h
Titration May increase after 1 week
Renal No adjustment needed
Hepatic Contraindicated in severe (Child-Pugh C); no adjustment in mild–moderate (Child-Pugh A/B)
Instructions
Transdermal: apply one patch every 24 h to hip, abdomen, upper arm, or upper back
Apply to clean, dry, intact skin; rotate application site daily; do not cut the patch
Avoid external heat sources over the patch (increases absorption)