Comparative Pharmacology
Head-to-head clinical analysis: RISPERIDONE versus SECUADO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RISPERIDONE versus SECUADO.
RISPERIDONE vs SECUADO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Risperidone is an atypical antipsychotic that antagonizes dopamine D2 receptors and serotonin 5-HT2A receptors. It also has moderate affinity for alpha1-adrenergic and H1-histaminergic receptors, and low affinity for muscarinic receptors.
SECUADO (asenapine) is an atypical antipsychotic with high affinity for serotonin 5-HT2A, 5-HT2C, 5-HT6, and 5-HT7 receptors, as well as dopamine D2, D3, and D4 receptors. It also exhibits moderate affinity for histamine H1 and alpha2-adrenergic receptors, and low affinity for alpha1 and muscarinic receptors. The therapeutic effect in schizophrenia and bipolar disorder is primarily mediated through antagonism at D2 and 5-HT2A receptors.
Initial 2 mg orally once daily, titrated to target dose of 4-6 mg orally once daily (or divided twice daily); maximum 16 mg/day. Alternatively, long-acting IM injection: 25 mg IM every 2 weeks.
Adults: 3.8 mg/24 hours applied transdermally once daily; initially 3.8 mg/24 hours, may titrate to 5.7 mg/24 hours, 7.6 mg/24 hours, or 11.4 mg/24 hours based on tolerability and efficacy. Maximum dose: 11.4 mg/24 hours.
None Documented
None Documented
Clinical Note
moderateRisperidone + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Risperidone is combined with Fluticasone propionate."
Clinical Note
moderateRisperidone + Methylphenidate
"The risk or severity of adverse effects can be increased when Risperidone is combined with Methylphenidate."
Clinical Note
moderateRisperidone + Quinagolide
"The therapeutic efficacy of Quinagolide can be decreased when used in combination with Risperidone."
Clinical Note
moderateRisperidone: 3 hours (CYP2D6 extensive metabolizers), 20 hours (poor metabolizers); active metabolite 9-hydroxyrisperidone: 21-30 hours; steady-state reached in 5-6 days
Terminal elimination half-life: 20-24 hours; steady-state achieved within 5 days.
Renal (70% as metabolites, 14% as parent drug) and fecal (14%)
Primarily renal: 50-80% as unchanged drug; biliary/fecal: <15%.
Category A/B
Category C
Atypical Antipsychotic
Atypical Antipsychotic
Risperidone + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Risperidone."