Drug interactions
Asenapine + Perhexiline
Severity: Moderate
Asenapine and Perhexiline: moderate 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
Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index. Asenapine is a weak CYP2D6 inhibitor and could modestly raise perhexiline levels, which matters because accumulation can cause hepatotoxicity and neuropathy.
What this interaction means in plain words
Asenapine and Perhexiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Asenapine weakly inhibits CYP2D6, the main metabolic pathway of perhexiline.
What to do
Monitor perhexiline plasma concentrations and liver function after asenapine is started or stopped. Adjust the perhexiline dose according to levels.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Asenapine with Perhexiline?
MediHelp rates the interaction as moderate. Asenapine and Perhexiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index. Asenapine is a weak CYP2D6 inhibitor and could modestly raise perhexiline levels, which matters because accumulation can cause hepatotoxicity and neuropathy.
How serious is the interaction between Asenapine and Perhexiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor perhexiline plasma concentrations and liver function after asenapine is started or stopped. Adjust the perhexiline dose according to levels.
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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