Indications for SECUADO:
Apply to clean, dry, hairless intact skin of the upper arm, upper back, abdomen, or hip. Rotate application site. Initially apply one 3.8mg/24hrs patch once daily; may increase to 5.7mg/24hrs or 7.6mg/24hrs, as needed, after 1 week.
Severe hepatic impairment.
Increased mortality in elderly patients with dementia-related psychosis.
Elderly (not for dementia-related psychosis; may increase risk of death). Avoid in congenital long QT syndrome, cardiac arrhythmias. Discontinue if neuroleptic malignant syndrome occurs; consider discontinuing if tardive dyskinesia occurs. Cardio- or cerebrovascular disease. Volume depletion. Pre-existing low WBC/ANC or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; consider discontinuing if significant WBC declines. Monitor for hyperglycemia/diabetes, dyslipidemia, and weight gain prior to or soon after initiation. Perform fall risk assessments when initiating and recurrently on long-term therapy. History of seizures. Strenuous exercise. Exposure to extreme heat. Dehydration. Aspiration risk. Avoid exposing transdermal system to external heat sources. Write ℞ for smallest practical amount. Neonates: may cause extrapyramidal and/or withdrawal symptoms (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers.
Avoid drugs that can prolong QT interval (eg, Class 1A or Class III antiarrhythmics, ziprasidone, chlorpromazine, thioridazine, gatifloxacin, moxifloxacin, alcohol). Potentiates antihypertensives, paroxetine; adjust dose of these drugs. Potentiated by strong CYP1A2 inhibitors (eg, fluvoxamine, ciprofloxacin, enoxacin); reduce dose of Secuado. Caution with other CNS drugs, drugs that are CYP2D6 substrates /inhibitors, drugs that cause orthostatic hypotension, and drugs with anticholinergic activity.
Application site reactions, extrapyramidal disorder, weight gain, headache, somnolence; orthostatic hypotension, syncope, QT prolongation, leukopenia, dysphagia, hypersensitivity reactions, hyperprolactinemia.