Asenapine and Olanzapine interaction

Asenapine and Olanzapine: the Asenapine prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Asenapine (SAPHRIS) label · effective 2025-01-31

Major

Cerebrovascular Adverse Events, Including Stroke, In Elderly Patients with Dementia-Related Psychosis In placebo-controlled trials in elderly subjects with dementia, patients randomized to risperidone, aripiprazole, and olanzapine had a higher incidence of stroke and transient ischemic attack, including fatal stroke.

Warnings and precautionsnames OlanzapineView label on DailyMed
Moderate

Orthostatic Hypotension, Syncope, and Other Hemodynamic Effects Atypical antipsychotics cause orthostatic hypotension and syncope.

Warnings and precautionsby drug classView label on DailyMed
Moderate

As with other antipsychotic drugs, SAPHRIS should be used with caution in patients with a history of seizures or with conditions that potentially lower the seizure threshold.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use SAPHRIS with caution in patient who may experience these conditions.

Warnings and precautionsby drug classView label on DailyMed
Moderate

SAPHRIS and other antipsychotic drugs should be used cautiously in patients at risk for aspiration.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.