Drug & supplement interaction

Arsenic + Asenapine

Asenapine brand names: Saphris, Secuado.

Major Interaction
The bottom line Major

Arsenic has a major interaction with Asenapine. Arsenic trioxide can prolong the QT interval.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Arsenic and Asenapine

Here is the interaction we found between these two, with the evidence behind it.

Major

QT INTERVAL-PROLONGING DRUGS

Why this applies to Asenapine

Asenapine falls under QT INTERVAL-PROLONGING DRUGS — the group Arsenic interacts with.

Arsenic trioxide can prolong the QT interval.
Up to 40% of patients treated with prescription arsenic trioxide have a prolonged QT interval on their electrocardiogram (ECG). Theoretically, non-prescription arsenic could have an additive effect when combined with drugs that prolong the QT interval.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with this pair: asenapine (Saphris, Secuado) can already stretch out the heart's electrical recovery time, something doctors call the QT interval. Arsenic does the same thing. In fact, up to 40% of people given prescription arsenic trioxide show a longer QT on their ECG. Stack the two together and the effect can add up, which in rare cases can trigger a dangerous heart rhythm.

This isn't about asenapine being switched on or off by arsenic. It's simply two QT-stretching effects piling on top of each other. The good news is there's no real reason to take arsenic as a supplement, so the easiest move is to avoid arsenic-containing products entirely. If you're worried about any exposure or product you're using, please check in with your pharmacist or doctor first.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Arsenic Also Interacts With Other Medications

Arsenic has 160 major, known drug interactions in our database — the Asenapine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Arsenic

Covers the 2,830 medications we’ve checked against Arsenic. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Asenapine

This page covers Arsenic only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Asenapine page lists 122 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 9 major · 78 moderate · 35 minor.

From our pharmacist’s overview on the Asenapine page

“The heart rhythm risk is the one to understand first. Asenapine (Saphris, Secuado), an antipsychotic for schizophrenia and bipolar disorder, can affect the QT interval, the electrical reset between heartbeats, and 13 ingredients on this list can prolong it too, including everyday grapefruit.”

Reviewed by 2 · Jul 18, 2026

Open the Asenapine interaction page

One more smart check

Taking Arsenic as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4 real supplement products containing Arsenic, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Arsenic. Your product may carry other ingredients that interact with Asenapine too, on top of Arsenic — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Arsenic and Asenapine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Arsenic
Steady interest

#954 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Asenapine
Steady interest

#2,125 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Arsenic

What is Arsenic?

Arsenic
  • Homeopathic digestive complaints
  • Traditional remedy for inflammatory conditions
  • Prescription use in certain leukemias (medical, not supplement)
  • Anxiety and restlessness (homeopathic tradition)

Arsenic is a naturally occurring element that is toxic in its inorganic form, and it is not a supplement you should take to improve your health. While arsenic trioxide is a real, doctor-prescribed cancer medicine, and tiny homeopathic doses exist, there is no good reason to take arsenic on your own. Avoid arsenic-containing products and talk to a pharmacist or doctor about any concerns.

Read the full Arsenic monograph & all interactions
Medication

About Asenapine

What Is Asenapine Used For?

Brand names: Saphris, Secuado

Asenapine treats schizophrenia in adults and bipolar I disorder (manic or mixed episodes) in adults and in children ages 10 to 17. It can be used alone or alongside lithium or valproate in adults with bipolar I disorder.

The sublingual tablet forms (Saphris and the generic asenapine sublingual tablet) are approved for both schizophrenia and bipolar I disorder. Secuado, the skin patch, is approved only for schizophrenia in adults.

See full Asenapine drug information
Keep checking

Other Drugs & Arsenic

Browse every other medication we’ve checked against Arsenic — both the ones with a known interaction and the ones without. Select any drug for the full detail.

160Major
0Moderate
0Minor
2,669No known interaction
Major

160 interactions

Showing 60 of 160 major interactions — see all 160 on the Arsenic page.

No interaction 2,669 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Arsenic and Asenapine Together: Common Questions

Can you take Arsenic with Asenapine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Arsenic and Asenapine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Asenapine and Arsenic?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.