asenapine maleate at a glance
Medicine class
Atypical antipsychotic
Licensed role
Moderate to severe manic episodes associated with bipolar I disorder in adults
Administration
Placed under the tongue to dissolve completely; avoid eating and drinking for 10 minutes afterwards
Current eMC status
The selected Sycrest sublingual tablets are marked as discontinued
What is asenapine maleate used for?
The selected UK product is licensed in adults for:
Moderate to severe manic episodes associated with bipolar I disorder.
How does asenapine maleate work?
Its precise mechanism is not fully established. Asenapine blocks several brain receptors, particularly dopamine D2 and serotonin 5-HT2A receptors; this is thought to reduce manic symptoms.
How to take asenapine maleate
Follow the prescriber's instructions and use the tablet only under the tongue.
Keep it in the blister until needed and handle with dry hands.
Peel back the coloured tab and remove it gently. Do not push it through, crush it, chew it or swallow it.
Place it under the tongue and allow it to dissolve completely.
Do not eat or drink for 10 minutes afterwards.
When taking other medicines at the same time, take asenapine last.
asenapine maleate side effects
Common or expected effects
- Sleepiness, sedation or fatigue
- Anxiety
- Weight gain or increased appetite
- Restlessness, tremor, slowed movement or abnormal muscle contractions
- Dizziness
- Nausea
- Changed taste or temporary mouth numbness
- Increased saliva
- Raised liver enzymes
Get urgent medical advice
- Swelling of the face, tongue or throat, or difficulty breathing or swallowing
- High temperature, marked muscle stiffness, confusion, sweating or cardiovascular instability
- Seizures or fainting
- New persistent involuntary movements, particularly of the tongue, mouth or face
- Marked thirst, frequent urination or other symptoms of high blood glucose
asenapine maleate in pregnancy
Human pregnancy data are inadequate. Use only when the woman's clinical need justifies the potential fetal risk. Discuss pregnancy or plans for pregnancy promptly with the specialist prescriber rather than stopping independently. Third-trimester exposure can cause movement or withdrawal symptoms, breathing difficulty or feeding problems in the newborn, requiring monitoring after birth.
asenapine maleate while breastfeeding
It is unknown whether asenapine enters human milk. The selected UK product information advises stopping breastfeeding during treatment; discuss feeding options with the specialist team.
asenapine maleate interactions
Check prescribed, non-prescribed and recreational substances with a pharmacist or prescriber. Important examples include:
Alcohol and other centrally acting or sedating substances
May increase sleepiness and other effects on brain function; avoid alcohol.
Fluvoxamine
Can increase asenapine exposure, so combined use requires caution.
Paroxetine and medicines that are both CYP2D6 substrates and inhibitors
Asenapine may increase exposure or enhance CYP2D6 inhibition, requiring clinical review.
Common questions about asenapine maleate
Answers are fully visible for fast scanning and source review.
Is asenapine maleate licensed for schizophrenia in the UK?
Schizophrenia is not an indication in the selected UK product information; its licensed role is adult bipolar I mania.
Why must it be placed under the tongue?
It is absorbed through tissues beneath the tongue. If swallowed, very little reaches the bloodstream and treatment may be ineffective.
What if I accidentally swallow it?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.