Drug interactions
Asenapine + Zotepine
Severity: Moderate
Asenapine and Zotepine: 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
Both antipsychotics block alpha-1 adrenergic receptors, so together they can cause orthostatic hypotension, dizziness and syncope. Combining antipsychotics also adds to sedation, QT prolongation and seizure risk, since zotepine lowers the seizure threshold.
What this interaction means in plain words
Asenapine and Zotepine 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
Additive alpha-1 adrenergic blockade, with additive D2, H1 and QT-related effects.
What to do
Avoid antipsychotic combination where possible and monitor standing blood pressure, especially during dose changes. Use the lowest effective doses and check ECG in patients with cardiac risk factors.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Asenapine and Zotepine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Zotepine?
MediHelp rates the interaction as moderate. Asenapine and Zotepine 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. Both antipsychotics block alpha-1 adrenergic receptors, so together they can cause orthostatic hypotension, dizziness and syncope. Combining antipsychotics also adds to sedation, QT prolongation and seizure risk, since zotepine lowers the seizure threshold.
How serious is the interaction between Asenapine and Zotepine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid antipsychotic combination where possible and monitor standing blood pressure, especially during dose changes. Use the lowest effective doses and check ECG in patients with cardiac risk factors.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
