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Overview: Secuado is a patch that is applied once daily to treat schizophrenia. Common side effects include movement problems, skin reactions where the patch is applied, and weight gain. Secuado can affect your alertness or coordination. It can also affect your body’s ability to regulate temperature. Try to avoid getting overheated, stay hydrated, and wear light and breathable clothing while you are using Secuado.

Uses

What is Secuado used for?

Secuado (asenapine) is commonly used for schizophrenia, which is a mental health condition.

Secuado may also be used for other conditions as determined by your health care provider.

Asenapine is also available as a tablet that dissolves under the tongue. See Asenapine (Saphris) for more information.

How does Secuado work (mechanism of action)?

Secuado belongs to a group of medicines called second-generation (atypical) antipsychotics. It is thought to work by balancing brain chemicals called serotonin and dopamine. These chemicals are known to affect thoughts and mood.

How is Secuado supplied (dosage forms)?

Brands and other names

  • Secuado

Dosage forms and strengths

  • 3.8 mg/24-hour transdermal system (patches)
  • 5.7 mg/24-hour transdermal system (patches)
  • 7.6 mg/24-hour transdermal system (patches)

How should I store Secuado?

Secuado should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store it in a cool, dry place.

Side Effects

What are the most common side effects of Secuado?

The most common side effects of Secuado are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Movement problems
  • Skin reactions where the patch is applied (see below)
  • Weight gain

There may be other side effects of Secuado that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Secuado?

While less common, the most serious side effects of Secuado are described below, along with what to do if they happen.

Severe Allergic Reactions. Secuado may cause allergic reactions, which can be serious. Stop using Secuado and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • A racing heart
  • A fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Skin Reactions. Secuado may cause skin reactions where the patch is applied. These reactions may happen while you’re wearing Secuado or right after you remove it. The risk of a skin reaction may be higher if you apply Secuado for longer than recommended or if you apply it to the same area. Stop using Secuado and call your health care provider if you have any of the following symptoms.

  • Skin redness, itching, bumps, or swelling
  • Skin discomfort, pain, or irritation 
  • Discolored skin

Heart Rhythm Changes. Secuado may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Metabolism Changes. Secuado can cause high blood sugar levels or diabetes, high cholesterol levels, and weight gain. Keep all appointments with your health care provider to check your bloodwork and weight. Call your health care provider if you gain weight or have the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Your breath smelling fruity

Low Blood Pressure Upon Standing (Orthostatic Hypotension) and Falls. Secuado may cause a sudden drop in blood pressure when standing up from a seated or lying position. Some people faint or even fall when this happens, which may cause bone fractures or other injuries. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your health care provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Uncontrolled Movements.  Secuado can cause some people to have movements that they cannot control. This condition, called tardive dyskinesia (TD), can cause jerky movements of the face, tongue, or body. TD can be permanent. Call your health care provider right away if you have any of the following symptoms of TD.

  • Tongue sticking out
  • Lip smacking or puckering
  • Grimacing
  • Rapid eye blinking
  • Jerking or twisting motion of the arms, legs, or trunk

Seizures. Some people who have used Secuado have reported having seizures. There are many types of seizures, and some of them are not easy to recognize. Stop using Secuado and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Decreased Alertness or Coordination. Secuado can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Secuado affects you.

Blood Disorders. Secuado can cause blood disorders, such as low white blood cell levels (leukopenia,  neutropenia, or agranulocytosis). Keep all appointments with your health care provider to check your bloodwork. Stop using Secuado and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Body Temperature Regulation. Secuado can affect your ability to regulate your body temperature. This could make you become very hot, especially in hot weather or after exercising a lot. You should drink water and avoid overheating and dehydration. Call your health care provider right away if you are severely ill and have the following symptoms of dehydration.

  • Excessive or no sweating
  • Dry mouth
  • Feeling very hot
  • Feeling thirsty 
  • Not able to pee

Trouble Swallowing. Secuado can cause trouble swallowing (dysphagia), which can increase your risk of choking while eating or drinking. Eat small amounts of food, and chew your food well. Get emergency help if you are choking or have food stuck in your esophagus that is not passing.

Neuroleptic Malignant Syndrome (NMS). Antipsychotic medicines, like Secuado, may cause a rare but serious condition called neuroleptic malignant syndrome. NMS can lead to death. Stop using Secuado and contact your health care provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Confusion 
  • Changes in your breathing or heart rate
  • Increased sweating

High Prolactin Level (Hyperprolactinemia). Secuado may cause an increased level of the hormone prolactin in your blood. High levels of prolactin could lead to fertility or bone problems. Contact your health care provider if you have any of the following symptoms.

  •  Vaginal dryness
  •  Irregular or no periods
  •  Production of breast milk when not pregnant or nursing
  •  Inability to get or keep an erection
  • Enlarged breast size (gynecomastia)
  • Decreased muscle and body hair

Warnings & Precautions

Who should not use Secuado?

Allergies to Ingredients. People who are allergic to any of the following should not use Secuado.

  • Asenapine
  • Secuado
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Secuado.

Severe Liver Problems. Secuado should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to find out if it is working well enough to use this medicine.

What should I know about Secuado before using it?

Do not use Secuado unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share Secuado with other people, even if they have the same condition as you. It may harm them.

Keep Secuado out of the reach of children.

Because Secuado can make it hard for you to regulate your body temperature, try to avoid becoming too hot or dehydrated. Drink plenty of water, limit your exposure to the heat and sun, do not overexercise, and wear light and breathable clothing.

Secuado is a patch that is applied to the skin. Read and follow the instructions that come with Secuado, and make sure that you or a caregiver understands how to apply it properly. If you have any questions, talk to your health care provider.

 Do not open the pouch until you are ready to use Secuado. Do not cut the patch. 

Each patch should only be worn for 24 hours. You should wear only one patch at a time. The patch should be applied to clean, dry, unbroken skin that is hairless or nearly hairless. It can be applied to the upper arm, upper back, stomach area, or hip. Do not apply Secuado to areas where you have tight clothing, such as the waistband. Apply the patch to a different area each time to help limit skin irritation. Do not apply it to the same area two times in a row.

If you have any burning or irritation after applying Secuado, remove it and apply a new patch to a new area.

Avoid swimming or bathing while wearing Secuado. This may cause the patch to fall off. You may shower while wearing the patch.

Do not apply heat directly to the patch, such as with a hair dryer, heating pad, or electric blanket. Applying heat to the patch could cause too much medicine to be absorbed into your body.

If your patch falls off, do not reapply the patch. Apply a new patch to a different area of skin.

People who are 65 or older can be at greater risk of some side effects from Secuado. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using Secuado?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them find out if Secuado is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Psychosis Related to Dementia. There is a higher risk of death, stroke, or ministroke in older adults who use Secuado or another antipsychotic and have memory loss or psychosis related to dementia. Secuado is not approved to treat dementia-related psychosis.

Pregnancy. Secuado used later in pregnancy may lead to an increased risk of certain problems in your newborn. Tell your health care provider if you are pregnant or plan to become pregnant while using Secuado. Your health care provider will let you know if you should use Secuado while you are pregnant or trying to get pregnant. If you become pregnant while using Secuado, you can register with the National Pregnancy Registry for Atypical Antipsychotics by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry. This registry collects safety information about the use of psychiatric medicines during pregnancy.

Breastfeeding. It is not known if Secuado passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Secuado while breastfeeding.

Other Medicines and Supplements. Secuado may interact with other medicines and supplements. Before using Secuado, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

How can I get more information about Secuado?

For more information about Secuado, you can visit the drugmaker’s website at www.secuado.com or call them at 800-455-8070.

Interactions

Does Secuado interact with foods or drinks?

There are no known interactions between Secuado and foods or drinks.

It is unknown if drinking alcohol will affect Secuado. Drinking alcohol while using Secuado could increase your risk of sleepiness, dizziness, feeling lightheaded, or fainting upon standing.

Does Secuado interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Secuado.

  • Paroxetine, which is a medicine commonly used for anxiety and depression
  • Fluvoxamine (Luvox), which is a medicine commonly used for obsessive-compulsive disorder (OCD)
  • A medicine for high blood pressure
  • Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as amiodarone, chlorpromazine, moxifloxacin, quinidine, sotalol, thioridazine, or ziprasidone
  • Ciprofloxacin, which is an antibiotic used for bacterial infections
  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety

Some other medicines may alter the blood levels of Secuado, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Secuado. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Secuado?

If you or someone else has used too much Secuado, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Secuado?

If the patch falls off, or if you miss a dose, apply a new patch right away to a new area of skin. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not apply double or extra patches.