Drug interactions
Asenapine + Tolcapone
Severity: Moderate
Asenapine and Tolcapone: 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
Tolcapone raises dopaminergic activity in Parkinson disease while asenapine blocks dopamine receptors, so the two have opposing effects and may reduce each other's benefit. Additive sedation or dizziness is possible but is a secondary concern.
What this interaction means in plain words
Asenapine and Tolcapone 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.
Asenapine belongs to Central Nervous System; Tolcapone belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between COMT inhibition (enhanced levodopa dopaminergic effect) and D2 receptor blockade by asenapine, with possible additive sedation.
What to do
Monitor parkinsonian motor symptoms and psychiatric status, and choose a low-D2-affinity antipsychotic if one is required in Parkinson disease. Watch for sedation and orthostatic symptoms.
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
Other interactions of Tolcapone
- Isocarboxazid + Tolcapone Contraindicated
- Phenelzine + Tolcapone Contraindicated
- Tolcapone + Tranylcypromine Contraindicated
- Metoclopramide + Tolcapone Major
- Apomorphine + Tolcapone Moderate
- Brexpiprazole + Tolcapone Moderate
Frequently asked questions
Can I take Asenapine with Tolcapone?
MediHelp rates the interaction as moderate. Asenapine and Tolcapone 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. Tolcapone raises dopaminergic activity in Parkinson disease while asenapine blocks dopamine receptors, so the two have opposing effects and may reduce each other's benefit. Additive sedation or dizziness is possible but is a secondary concern.
How serious is the interaction between Asenapine and Tolcapone?
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 parkinsonian motor symptoms and psychiatric status, and choose a low-D2-affinity antipsychotic if one is required in Parkinson disease. Watch for sedation and orthostatic symptoms.
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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