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Secuado
Secuado (generic name: asenapine transdermal system) is a prescription antipsychotic medication used for the treatment of schizophrenia in adults. It belongs to the class of atypical antipsychotics and works by affecting the balance of certain neurotransmitters in the brain, particularly dopamine and serotonin. Secuado is a unique formulation because it is delivered through a transdermal patch, which provides continuous, controlled release of medication over 24 hours. This helps manage symptoms of schizophrenia, such as hallucinations, delusions, and disorganized thinking, with the convenience of once-daily application.
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Frequently Asked Questions
How long does it take for Secuado to work?
Secuado may start improving symptoms within a few days to weeks of starting treatment, but it may take several weeks to see the full effect. Continue using the medication as prescribed by your healthcare provider.
Can I shower or swim while wearing the Secuado patch?
Yes, you can shower or swim while wearing the patch, as it is designed to stay on even with water exposure. However, avoid exposing the patch to excessive heat, such as hot tubs or prolonged sunlight.
What should I do if the Secuado patch falls off?
If the patch falls off, apply a new patch to a different area of clean, dry skin. Do not attempt to reapply the old patch.
Can Secuado cause weight gain?
Yes, weight gain is a possible side effect of Secuado, as it is with many atypical antipsychotics. Regular monitoring of weight and metabolic health is recommended during treatment.
Is Secuado safe for elderly patients with dementia?
No, Secuado is not approved for treating behavioral problems in elderly patients with dementia-related psychosis due to an increased risk of death in this population.
Comprehensive Drug Guide
How Does Secuado Work?
Secuado works by modulating the activity of certain neurotransmitters in the brain, specifically dopamine and serotonin receptors. It acts as an antagonist at dopamine D2 and serotonin 5-HT2A receptors, helping to reduce psychotic symptoms such as hallucinations, delusions, and thought disturbances. The transdermal system delivers a steady amount of asenapine through the skin over a 24-hour period, ensuring consistent blood levels of the drug.
Common Dosages
- 3.8 mg/24 hours
- 5.7 mg/24 hours
- 7.6 mg/24 hours
The appropriate dosage will depend on the patient's condition and response to treatment.
Typical Dosing
- The recommended starting dose of Secuado is 3.8 mg/24 hours, applied once daily to the upper body, such as the upper arm or upper back.
- The dose may be increased to 5.7 mg/24 hours or 7.6 mg/24 hours depending on the patient’s response and tolerability.
- The patch should be applied to a clean, dry, and intact skin area, and the application site should be rotated to avoid skin irritation.
Typical Dosing
FDA Approved Indications
- Schizophrenia in adults.
Who Shouldn't Take Secuado?
- Known hypersensitivity to asenapine or any components of the patch, including a history of severe allergic reactions to the medication.
Advice From The Pharmacist
- Apply Secuado patch once daily to a clean, dry area on the upper body. Do not apply to broken or irritated skin.
- Rotate the site of application to avoid skin irritation. Do not place the patch in the same spot for at least 14 days.
- Avoid direct exposure of the patch to heat sources, such as heating pads or prolonged sunlight, as this can increase drug absorption and the risk of side effects.
- If the patch comes loose or falls off, apply a new one to a different area of skin.
- Remove the old patch before applying a new one, and discard it properly by folding it in half with the sticky sides together.
- Store the patches at room temperature, away from moisture and heat.
Side Effects of Secuado
Common Side Effects
- Drowsiness
- Weight gain
- Application site reactions (such as redness or irritation)
- Dizziness
- Dry mouth
Uncommon/Severe Side Effects
- Neuroleptic malignant syndrome (a rare but serious condition characterized by fever, muscle stiffness, and altered mental status)
- Tardive dyskinesia (involuntary muscle movements, which can become permanent)
- Orthostatic hypotension (low blood pressure when standing up)
- Hyperglycemia or diabetes (elevated blood sugar levels)
Risks and Warnings of Secuado
- Increased mortality in elderly patients with dementia-related psychosis: Secuado, like other antipsychotics, is associated with an increased risk of death in elderly patients with dementia-related psychosis and should not be used in this population for this purpose.
- Neuroleptic malignant syndrome (NMS): This rare but potentially fatal condition can occur with antipsychotics. Symptoms include high fever, muscle stiffness, confusion, and irregular heartbeats. If you experience these symptoms, seek immediate medical attention.
- Tardive Dyskinesia: Long-term use of Secuado can cause tardive dyskinesia, which involves involuntary movements, especially in the face and tongue. This condition may be irreversible.
- Metabolic Changes: Secuado may cause weight gain, increases in blood sugar, and changes in cholesterol levels. Monitoring for these changes is important, especially in patients with pre-existing diabetes or cardiovascular risk factors.
Interactions with Secuado
Common Drug Interactions
- CYP2D6 inhibitors (e.g., paroxetine, fluoxetine): These medications may increase blood levels of asenapine, leading to a higher risk of side effects.
- CYP1A2 inducers (e.g., smoking, rifampin): These may decrease the effectiveness of Secuado by lowering its concentration in the bloodstream.
- Other central nervous system depressants (e.g., alcohol, benzodiazepines): Combining these with Secuado can increase the risk of sedation, drowsiness, and respiratory depression.
- Antihypertensives: Secuado may enhance the effects of blood pressure-lowering medications, increasing the risk of hypotension.
Alternatives to Secuado
- Abilify (aripiprazole): An atypical antipsychotic used to treat schizophrenia, bipolar disorder, and major depressive disorder.
- Zyprexa (olanzapine): Another atypical antipsychotic used for schizophrenia and bipolar disorder, available in oral and injectable forms.
- Risperdal (risperidone): An atypical antipsychotic used for schizophrenia, bipolar disorder, and irritability associated with autism.
- Invega (paliperidone): An extended-release antipsychotic used for schizophrenia and schizoaffective disorder.
