Can you take Asenapine with Pentamidine?

Asenapine has a major potential interaction with Abnormal Electrocardiogram.

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; congenital long QT syndrome; recent acute myocardial infarction; and/or uncompensated heart failure.

Pentamidine has a major potential interaction with Abnormal Glucose Tolerance.

Pentamidine may have direct toxic effects on beta cells of the pancreas. Hypoglycemia, which may be severe and/or prolonged, as well as hyperglycemia and insulin-dependent diabetes mellitus, the latter of which may be irreversible, have been reported. The onset of pentamidine-induced hypoglycemia generally varied from 5 to 7 days after start of therapy to several days after therapy stops. In some cases, hyperglycemia and progression to diabetes followed, although these effects have occurred independently also. Pancreatic toxicity has been reported with both parenteral use and, less frequently, oral inhalation of pentamidine. The risk appears to be related to total cumulative dosage and prior therapy with the drug, particularly within the last 3 months. Therapy with pentamidine, regardless of route of administration, should be administered cautiously in patients with or predisposed to diabetes or spontaneous hypoglycemia. Blood glucose should be monitored more closely during and for some time after pentamidine therapy.

Pentamidine has a major potential interaction with Alcoholism.

Acute and potentially fatal pancreatitis has been reported with parenteral use and, rarely, oral inhalation of pentamidine. Patients with a history of or known risk factors for pancreatitis, such as alcohol abuse or hypertriglyceridemia, should be monitored closely during therapy with pentamidine. Therapy should be discontinued at the first signs or symptoms suggestive of pancreatitis (e.g., nausea, vomiting, abdominal pain, hyperamylasemia with dysglycemia, rising triglycerides, decreasing serum calcium), and preferably permanently discontinued if clinical pancreatitis develops.

Asenapine has a moderate potential interaction with Alcoholism.

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

Asenapine has a major potential interaction with Arrhythmia.

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; congenital long QT syndrome; recent acute myocardial infarction; and/or uncompensated heart failure.

Asenapine has a moderate potential interaction with Arrhythmia.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Pentamidine has a moderate potential interaction with Asthma.

Orally inhaled pentamidine may induce bronchospasm and cough. Therapy with aerosolized pentamidine should be administered cautiously in patients with severe bronchospastic disease or a history of extensive smoking. Pretreatment with a beta-2 adrenergic bronchodilator prior to each dose of aerosolized pentamidine may be helpful in patients who experience respiratory symptoms from the medication.

Asenapine has a moderate potential interaction with Bipolar Disorder.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset.

Pentamidine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Hematologic toxicities have been associated occasionally with the parenteral use of pentamidine. Leukopenia and, less frequently, thrombocytopenia have been reported and may be severe (e.g., leukocyte count < 1000/mm3, platelet count < 20,000/mm3). Anemia, neutropenia, pancytopenia, and prolonged clotting time have occurred rarely. Therapy with pentamidine should be administered cautiously in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts, including platelets, should be performed prior to and periodically during and after therapy. Marked depression of blood counts may be indication for withdrawal of pentamidine therapy.

Pentamidine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Asenapine has a moderate potential interaction with Breast Cancer.

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

Pentamidine has a major potential interaction with Cardiovascular Conditions and Disorders.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with Cardiovascular Conditions and Disorders.

Parenteral use of pentamidine may be associated with serious and potentially fatal cardiovascular effects. Sudden and severe hypotension, cardiorespiratory arrest, ventricular tachycardia, torsade de pointes, ECG abnormalities, and facial flushing have been reported. Therapy with pentamidine should be administered cautiously in all patients but in particular, those with preexisting hypotension, severe cardiovascular disease, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be in a supine position and blood pressure monitored closely during and after administration of the drug until blood pressure is stable. Equipment for emergency resuscitation should be readily available if the parenteral route is used. ECGs should also be performed before, during, and after parenteral therapy.

Pentamidine has a major potential interaction with Cerebrovascular Insufficiency.

Parenteral use of pentamidine may be associated with serious and potentially fatal cardiovascular effects. Sudden and severe hypotension, cardiorespiratory arrest, ventricular tachycardia, torsade de pointes, ECG abnormalities, and facial flushing have been reported. Therapy with pentamidine should be administered cautiously in all patients but in particular, those with preexisting hypotension, severe cardiovascular disease, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be in a supine position and blood pressure monitored closely during and after administration of the drug until blood pressure is stable. Equipment for emergency resuscitation should be readily available if the parenteral route is used. ECGs should also be performed before, during, and after parenteral therapy.

Pentamidine has a major potential interaction with Cerebrovascular Insufficiency.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Asenapine has a moderate potential interaction with Cerebrovascular Insufficiency.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Pentamidine has a moderate potential interaction with COPD.

Orally inhaled pentamidine may induce bronchospasm and cough. Therapy with aerosolized pentamidine should be administered cautiously in patients with severe bronchospastic disease or a history of extensive smoking. Pretreatment with a beta-2 adrenergic bronchodilator prior to each dose of aerosolized pentamidine may be helpful in patients who experience respiratory symptoms from the medication.

Pentamidine has a major potential interaction with Dehydration.

Patients who are dehydrated may be particularly susceptible to the nephrotoxic and hypotensive effects associated with the parenteral use of pentamidine. Dehydration should preferably be corrected prior to initiation of therapy. In patients who may be at risk for dehydration, such as those with severe and/or prolonged diarrhea or vomiting, fluid status and blood pressure should be monitored closely. If signs of renal irritation develop during therapy, hydration should be increased as indicated, accompanied by a reduction in dosage if necessary. Therapy should be withdrawn if urinary output decreases progressively or azotemia increases.

Pentamidine has a major potential interaction with Dehydration.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Asenapine has a moderate potential interaction with Dehydration.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a major potential interaction with Dementia.

Antipsychotic drugs are not approved for the treatment of patients with dementia-related psychosis. Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo.

Asenapine has a moderate potential interaction with Depression.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset.

Pentamidine has a major potential interaction with Diabetes Mellitus.

Pentamidine may have direct toxic effects on beta cells of the pancreas. Hypoglycemia, which may be severe and/or prolonged, as well as hyperglycemia and insulin-dependent diabetes mellitus, the latter of which may be irreversible, have been reported. The onset of pentamidine-induced hypoglycemia generally varied from 5 to 7 days after start of therapy to several days after therapy stops. In some cases, hyperglycemia and progression to diabetes followed, although these effects have occurred independently also. Pancreatic toxicity has been reported with both parenteral use and, less frequently, oral inhalation of pentamidine. The risk appears to be related to total cumulative dosage and prior therapy with the drug, particularly within the last 3 months. Therapy with pentamidine, regardless of route of administration, should be administered cautiously in patients with or predisposed to diabetes or spontaneous hypoglycemia. Blood glucose should be monitored more closely during and for some time after pentamidine therapy.

Asenapine has a moderate potential interaction with Diabetes Mellitus.

Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported with the use of atypical antipsychotic agents. Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. It is recommended that patients with risk factors for diabetes mellitus starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment, and periodically thereafter. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when treatment with these agents was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the atypical antipsychotic drug.

Asenapine has a major potential interaction with Diarrhea.

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; congenital long QT syndrome; recent acute myocardial infarction; and/or uncompensated heart failure.

Pentamidine has a major potential interaction with Diarrhea.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with Diarrhea.

Patients who are dehydrated may be particularly susceptible to the nephrotoxic and hypotensive effects associated with the parenteral use of pentamidine. Dehydration should preferably be corrected prior to initiation of therapy. In patients who may be at risk for dehydration, such as those with severe and/or prolonged diarrhea or vomiting, fluid status and blood pressure should be monitored closely. If signs of renal irritation develop during therapy, hydration should be increased as indicated, accompanied by a reduction in dosage if necessary. Therapy should be withdrawn if urinary output decreases progressively or azotemia increases.

Asenapine has a moderate potential interaction with Diarrhea.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a moderate potential interaction with Dysphagia.

Esophageal dysmotility and aspiration have been associated with the use of antipsychotic drugs. These drugs should be administered cautiously in patients at risk for aspiration pneumonia.

Asenapine has a moderate potential interaction with Head Injury.

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

Asenapine has a moderate potential interaction with Heart Failure.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Pentamidine has a major potential interaction with High Cholesterol.

Acute and potentially fatal pancreatitis has been reported with parenteral use and, rarely, oral inhalation of pentamidine. Patients with a history of or known risk factors for pancreatitis, such as alcohol abuse or hypertriglyceridemia, should be monitored closely during therapy with pentamidine. Therapy should be discontinued at the first signs or symptoms suggestive of pancreatitis (e.g., nausea, vomiting, abdominal pain, hyperamylasemia with dysglycemia, rising triglycerides, decreasing serum calcium), and preferably permanently discontinued if clinical pancreatitis develops.

Asenapine has a moderate potential interaction with High Cholesterol.

Atypical antipsychotic drugs have been associated with undesirable alterations in lipid levels. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. Before or soon after initiation of antipsychotic medications, a fasting lipid profile should be obtained at baseline and monitored periodically during treatment.

Pentamidine has a major potential interaction with History - Cerebrovascular Disease.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with History - Cerebrovascular Disease.

Parenteral use of pentamidine may be associated with serious and potentially fatal cardiovascular effects. Sudden and severe hypotension, cardiorespiratory arrest, ventricular tachycardia, torsade de pointes, ECG abnormalities, and facial flushing have been reported. Therapy with pentamidine should be administered cautiously in all patients but in particular, those with preexisting hypotension, severe cardiovascular disease, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be in a supine position and blood pressure monitored closely during and after administration of the drug until blood pressure is stable. Equipment for emergency resuscitation should be readily available if the parenteral route is used. ECGs should also be performed before, during, and after parenteral therapy.

Pentamidine has a major potential interaction with History - Myocardial Infarction.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with History - Myocardial Infarction.

Parenteral use of pentamidine may be associated with serious and potentially fatal cardiovascular effects. Sudden and severe hypotension, cardiorespiratory arrest, ventricular tachycardia, torsade de pointes, ECG abnormalities, and facial flushing have been reported. Therapy with pentamidine should be administered cautiously in all patients but in particular, those with preexisting hypotension, severe cardiovascular disease, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be in a supine position and blood pressure monitored closely during and after administration of the drug until blood pressure is stable. Equipment for emergency resuscitation should be readily available if the parenteral route is used. ECGs should also be performed before, during, and after parenteral therapy.

Asenapine has a moderate potential interaction with History - Myocardial Infarction.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a moderate potential interaction with Hyperprolactinemia.

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

Asenapine has a major potential interaction with Hypokalemia.

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; congenital long QT syndrome; recent acute myocardial infarction; and/or uncompensated heart failure.

Pentamidine has a major potential interaction with Hypotension.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with Hypotension.

Parenteral use of pentamidine may be associated with serious and potentially fatal cardiovascular effects. Sudden and severe hypotension, cardiorespiratory arrest, ventricular tachycardia, torsade de pointes, ECG abnormalities, and facial flushing have been reported. Therapy with pentamidine should be administered cautiously in all patients but in particular, those with preexisting hypotension, severe cardiovascular disease, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be in a supine position and blood pressure monitored closely during and after administration of the drug until blood pressure is stable. Equipment for emergency resuscitation should be readily available if the parenteral route is used. ECGs should also be performed before, during, and after parenteral therapy.

Asenapine has a moderate potential interaction with Hypotension.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a moderate potential interaction with Ischemic Heart Disease.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a major potential interaction with Liver Disease.

Asenapine is contraindicated in patients with severe hepatic impairment (Child-Pugh C). Asenapine is a high clearance drug and its exposure has shown to be 7-fold higher in subjects with severe hepatic impairment than the exposure observed in subjects with normal hepatic function. No dosage adjustment for asenapine is required in patients with mild to moderate hepatic impairment (Child-Pugh A and B) because the drug exposure is similar to that in subjects with normal hepatic function.

Pentamidine has a moderate potential interaction with Liver Disease.

Parenteral use of pentamidine may cause elevated liver function tests. Therapy with pentamidine should be administered cautiously in patients with hepatic impairment. Serum transaminase, alkaline phosphatase, and bilirubin levels should be measured periodically, and the dosing frequency reduced or therapy withdrawn if significant elevations develop.

Pentamidine has a moderate potential interaction with Liver Disease.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Asenapine has a major potential interaction with Magnesium Imbalance.

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; congenital long QT syndrome; recent acute myocardial infarction; and/or uncompensated heart failure.

Asenapine has a major potential interaction with Neuroleptic Malignant Syndrome.

The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

Asenapine has a moderate potential interaction with Neutropenia.

Cases of leukopenia, neutropenia, and agranulocytosis have been reported with the use of atypical antipsychotic agents. Patients with preexisting low white blood cell count may be at increased risk. Therapy with these agents should be administered cautiously in patients with a history of, or predisposition to, decreased white blood cell or neutrophil counts. Clinical monitoring of hematopoietic function is recommended. At the first sign of a clinically significant decline in white blood cells, discontinuation of atypical antipsychotic therapy should be considered in the absence of other causative factors, and the patient closely monitored for fever or other signs and symptoms of infection.

Pentamidine has a major potential interaction with Pancreatitis.

Acute and potentially fatal pancreatitis has been reported with parenteral use and, rarely, oral inhalation of pentamidine. Patients with a history of or known risk factors for pancreatitis, such as alcohol abuse or hypertriglyceridemia, should be monitored closely during therapy with pentamidine. Therapy should be discontinued at the first signs or symptoms suggestive of pancreatitis (e.g., nausea, vomiting, abdominal pain, hyperamylasemia with dysglycemia, rising triglycerides, decreasing serum calcium), and preferably permanently discontinued if clinical pancreatitis develops.

Pentamidine has a major potential interaction with Renal Dysfunction.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with Renal Dysfunction.

Parenteral use of pentamidine may be associated with nephrotoxicity, usually evidenced by elevations in BUN or serum creatinine concentrations. Azotemia has also been reported. Although pentamidine-induced nephrotoxicity is generally mild to moderate in severity and reversible following discontinuation of the drug, acute renal failure has occurred occasionally. Limited evidence suggests that nephrotoxicity may occur more frequently in patients with AIDS and may be accompanied by severe, sometimes life-threatening hyperkalemia. Therapy with pentamidine should be administered cautiously in patients with renal impairment. The need for dosage adjustments is uncertain. To minimize the risk of toxicity, patients should be adequately hydrated and use with other nephrotoxic agents should be avoided. Renal function and serum potassium levels should be closely monitored, and the dosing frequency reduced or therapy withdrawn if toxicity develops.

Asenapine has a moderate potential interaction with Seizures.

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

Asenapine has a moderate potential interaction with Syncope.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a moderate potential interaction with Tardive Dyskinesia.

Tardive dyskinesia (TD) has occurred in patients treated with antipsychotic drugs; the syndrome consists of potentially irreversible, involuntary, dyskinetic movements. The risk appears highest in older patients (particularly older women) but it is not possible to predict which patients are likely to develop TD; whether antipsychotic drugs differ in their potential to cause TD is unknown. The risk of TD and the likelihood that it will become irreversible increase with the duration of therapy and the total cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low dosages; it may also occur after discontinuation of therapy. TD may remit (partially or completely) upon discontinuation of antipsychotic therapy, although antipsychotic therapy itself may suppress (or partially suppress) signs/symptoms of TD, possibly masking the underlying process; the effect of symptomatic suppression on the long-term course of TD is unknown. In patients with preexisting drug-induced TD, initiating or increasing the dosage of antipsychotic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. In patients requiring chronic therapy, the lowest dose and shortest duration of therapy producing a satisfactory clinical response are recommended; the need for continued therapy should be reassessed periodically. If signs/symptoms of TD occur during antipsychotic therapy, discontinuation of the offending agent should be considered; however, some patients may require treatment despite the presence of TD.

Pentamidine has a major potential interaction with Vomiting.

Orally inhaled pentamidine is generally not associated with significant systemic toxicity due to limited absorption from the respiratory tract. However, detectable serum concentrations have been reported in some patients receiving chronic oral inhalation therapy, and systemic adverse effects have occasionally occurred. Therefore, when pentamidine is administered by oral inhalation, clinicians may want to heed the usual warnings and precautions associated with parenteral use of the drug.

Pentamidine has a major potential interaction with Vomiting.

Patients who are dehydrated may be particularly susceptible to the nephrotoxic and hypotensive effects associated with the parenteral use of pentamidine. Dehydration should preferably be corrected prior to initiation of therapy. In patients who may be at risk for dehydration, such as those with severe and/or prolonged diarrhea or vomiting, fluid status and blood pressure should be monitored closely. If signs of renal irritation develop during therapy, hydration should be increased as indicated, accompanied by a reduction in dosage if necessary. Therapy should be withdrawn if urinary output decreases progressively or azotemia increases.

Asenapine has a moderate potential interaction with Vomiting.

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Asenapine has a moderate potential interaction with Weight Loss.

Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported with the use of atypical antipsychotic agents. Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. It is recommended that patients with risk factors for diabetes mellitus starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment, and periodically thereafter. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when treatment with these agents was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the atypical antipsychotic drug.

Asenapine has a moderate potential interaction with Weight Loss.

Weight gain has been observed with atypical antipsychotic use. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. When treating pediatric patients with atypical antipsychotic agents, weight gain should be monitored and assessed against that expected for normal growth. Monitor weight at baseline and frequently thereafter.