Drug interactions
Asenapine + Donepezil
Severity: Major
Asenapine and Donepezil: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Donepezil can prolong the QT interval and cause bradycardia, and asenapine also prolongs QTc. The combination raises the risk of torsades de pointes, notably in older patients.
What this interaction means in plain words
Asenapine and Donepezil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Asenapine belongs to Central Nervous System; Donepezil belongs to Central Nervous System.
Why it happens
Additive QTc prolongation, with donepezil-related bradycardia increasing arrhythmia susceptibility.
What to do
Obtain ECG at baseline and after changes, and correct electrolytes. Consider an antipsychotic with less QT effect if QTc rises or the patient has syncope.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Asenapine with Donepezil?
MediHelp rates the interaction as major. Asenapine and Donepezil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Donepezil can prolong the QT interval and cause bradycardia, and asenapine also prolongs QTc. The combination raises the risk of torsades de pointes, notably in older patients.
How serious is the interaction between Asenapine and Donepezil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain ECG at baseline and after changes, and correct electrolytes. Consider an antipsychotic with less QT effect if QTc rises or the patient has syncope.
What other medicines interact with Asenapine?
MediHelp also lists interactions of Asenapine with, for example, Pimozide, Thioridazine, Vandetanib. The full list is on the Asenapine page.
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