Saphris (asenapine)

Saphris (asenapine)

Brand name: Saphris®.
Active ingredient name: Asenapine.
Type of medication: Atypical antipsychotic.
Available in Canada from: Merk  Canada Inc.
Form: Oral tablets.
Generic: No.
Listed on Ontario formulary: Yes (with suggested criteria for coverage*).
*This product has a therapeutic note which suggests that physicians should prescribe it for the acute treatment of manic or mixed episodes associated with bipolar I disorder as either: Monotherapy, after a trial of lithium or divalproex sodium has failed, and trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response; OR co-therapy with lithium or divalproex sodium, after trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response.
OHIP+ coverage: Yes (with suggested criteria for coverage).
*This product has a therapeutic note which suggests that physicians should prescribe it for the acute treatment of manic or mixed episodes associated with bipolar I disorder as either: Monotherapy, after a trial of lithium or divalproex sodium has failed, and trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response; OR co-therapy with lithium or divalproex sodium, after trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response.

What is Saphris used for?

Saphris is used to treat the symptoms of schizophrenia in adults. It is also used to treat adults with bipolar disorder. Saphris is sometimes used to treat other conditions. Talk to your doctor to understand why you are taking Saphris.

 
How should I take Saphris?

  • Saphris is a sublingual tablet that must dissolve under your tongue. Place the tablet under your tongue and let it dissolve completely. Do not swallow, crush or chew. Do not eat or drink for at least 10 minutes after taking this medication. This medication is most often taken two times per day. 
  • Saphris is available in 5 mg and 10 mg sublingual tablets in Canada. 
  • Adults: The dose range for Saphris is 5 mg - 10 mg twice daily. The maximum daily dose is 20 mg. Your doctor may prescribe doses that are higher than 20 mg based on your individual situation.

What are the most common side effects seen with Saphris? 

The most common side effects of Saphris include:

  • Drowsiness

  • Restlessness (akathisia)

  • Headache
  • Abnormal movements (extrapyramidal side effects)
  • Nausea, vomiting, upset stomach
  • Insomnia
  • Dizziness
  • Weight gain

What are rare but potentially serious side effects seen with Saphris?

  • A decrease in white blood cell count (agranulocytosis)
  • Cerebrovascular event (stroke)
  • Anaphylactic reaction (severe allergy)
  • Diabetic ketoacidosis (DKA)
  • Neuroleptic malignant syndrome (NMS)

Warnings/Precautions

Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics. Most deaths appear to be either cardiovascular or infectious. Saphris is not approved for the treatment of dementia-related psychosis. Some individuals with dementia may, however, be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.

What medications interact with Saphris?

Tell all your doctors, pharmacists and dentist that you are taking Saphris. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription. At this time there appears to be only a handful of clinically-important medication interactions with Saphris.

The following types of medications may interact with Saphris

  • Certain medications for allergies [e.g., Benadryl (diphenhydramine)]
  • Certain medications for sleep (e.g., lorazepam, zopiclone)

  • Certain medications for pain (e.g., fentanyl)

  • Fluvoxamine (may increase levels of Saphris)

Avoid drinking alcohol or using illegal drugs while taking Saphris.