Secuado (Asenapine Patch): How This Once-Daily Transdermal Antipsychotic Works and When Telehealth Helps

Last updated: August 26, 2026

Secuado is a once-daily asenapine transdermal patch (extended-release film) used to treat schizophrenia in adults. It delivers the same active medicine as sublingual Saphris, but you wear one patch for 24 hours instead of dissolving a tablet under the tongue twice a day. This guide covers labeled strengths, how to apply it, boxed warnings, how it differs from oral asenapine, and when online psychiatry may support evaluation and follow-up.

See if online depression or mood care may be a fit →

Browse Klarity condition pages →

What is Secuado?

According to the DailyMed SECUADO (asenapine) transdermal system label, Secuado is an atypical antipsychotic in an extended-release transdermal film. MedlinePlus (last revised November 15, 2025) states that asenapine transdermal patches treat schizophrenia and work by changing the activity of certain natural substances in the brain.

Drugs.com FDA approval history records first U.S. approval on October 11, 2019, supplied by Noven Pharmaceuticals. Noven later described a March 2020 U.S. launch and called it the first FDA-approved patch for schizophrenia in adults. Sublingual asenapine remains a separate product (brand Saphris).

Klarity Health connects patients with 2,000+ licensed providers. A visit can review symptoms, current medicines, and whether a patch versus a tablet makes sense for your situation. Coverage, if any, varies by plan. Verify benefits before you book.

How the patch works

Asenapine is a second-generation antipsychotic. Clinicians discuss D2 and 5-HT2A receptor effects that can reduce hallucinations, delusions, and disorganized thinking. The patch releases asenapine through the skin over 24 hours, which avoids twice-daily sublingual technique and the 10-minute no-food-or-drink window that oral Saphris requires.

MedlinePlus notes that transdermal asenapine may help control symptoms but does not cure schizophrenia. Keep using the patch even when you feel well unless your prescriber changes the plan. Do not stop suddenly without guidance.

For background on the sublingual tablet, see our Saphris (asenapine) guide.

FDA-labeled use

DailyMed and the approval history agree: Secuado is indicated for the treatment of adults with schizophrenia. The patch is not the same labeled set as sublingual Saphris, which also includes bipolar I mania programs. Do not assume the patch is interchangeable with the tablet for every diagnosis.

Off-label uses belong in a documented clinical relationship, not in a blog post.

Typical dosing (label ranges)

Always follow the prescription on your patch carton. DailyMed highlights:

• Starting dose: 3.8 mg/24 hours
• After one week, if appropriate: increase to 5.7 mg/24 hours or 7.6 mg/24 hours
• Wear time: apply one patch to one site every 24 hours

MedlinePlus says your doctor will probably start you on a low dose and increase it no more often than once a week. Remove the old patch before you apply a new one.

How to apply Secuado

From MedlinePlus and DailyMed patient directions:

• Apply to clean, dry, intact skin on the upper back, upper arm, abdomen (stomach), or hip
• Choose an area that tight clothing will not rub and that is relatively free of hair
• Do not apply to cuts, irritated or red skin, rash, burns, or other skin problems
• Rotate to a different site each day to limit irritation
• If the skin burns or is irritated after application, remove the patch and apply a new one to a different area

Do not cut the patch unless your clinician and the carton instructions explicitly allow it. Keep used patches away from children and pets.

Boxed warning and other safety points

DailyMed boxed warning: elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. SECUADO is not approved for the treatment of patients with dementia-related psychosis.

MedlinePlus repeats that older adults with dementia may also have a greater chance of stroke or ministroke during antipsychotic treatment, and that the patches are not FDA-approved for behavioral problems in older adults with dementia.

Drugs.com notes that common side effects in the development program included extrapyramidal disorder, application site reaction, and weight gain. The safety profile was described as consistent with sublingual asenapine, plus local skin reactions from the patch itself.

Tell your clinician about heart rhythm history, low white blood cell counts, seizures, diabetes or high lipids, movement disorders, liver problems, and all other medicines. Asenapine can interact with other CNS depressants and with drugs that affect similar metabolic pathways. Your prescriber matches the plan to your labs and history.

If you or someone you know is in crisis, call or text 988 (U.S. Suicide & Crisis Lifeline) or go to the nearest emergency department.

Secuado vs Saphris

A clinician decides whether a patch, a tablet, or a different antipsychotic is the better fit. Telehealth can review that choice. It does not replace in-person care when exams, injections, labs, or emergency treatment are needed.

When telehealth helps

Online visits may be enough for history-taking, medication review, side-effect check-ins, and refill coordination when you are stable. You still need a licensed prescriber in your state, and some plans require prior authorization for brand patches.

Insurance may cover psychiatry visits or the medicine itself. Coverage typically varies by plan, formulary tier, and prior authorization rules. Klarity does not guarantee that any plan will pay. Check your benefits before you book.

See if online depression or mood care may be a fit →

Frequently asked questions

Is Secuado a controlled substance?

Asenapine is an atypical antipsychotic, not a stimulant. Follow storage and disposal rules on the carton, and never share patches.

Can I shower with the patch on?

Follow the patient instructions in your box. DailyMed and MedlinePlus emphasize keeping the patch on intact skin for 24 hours and replacing it on schedule. Ask your pharmacist if water exposure is a concern for your specific lot.

Does insurance cover the Secuado patch?

It depends on the plan. Many commercial and Medicare formularies treat brand transdermal antipsychotics as specialty or prior-auth products. Verify your benefits. A Klarity visit can document medical need; it cannot promise coverage.

Disclaimer

This article is educational and is not medical advice, a diagnosis, or a promise of insurance coverage. Antipsychotic selection is individualized. Confirm facts on the current FDA/DailyMed label and with your licensed clinician. Coverage varies by plan. Verify benefits before booking.

Browse Klarity condition pages →