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Loxapine Brand Names
ADASUVE | Loxitane | Loxitane C
What is Loxapine
Loxapine is a conventional dibenzoxazepine antipsychotic used in the treatment of psychotic disorders such as schizophrenia.
Loxapine is metabolized to several active metabolites including amoxapine, a commercially available tetracyclic antidepressant.
Loxapine is considered an intermediate potency antipsychotic. Anticholinergic effects and other adverse reactions such as orthostatic hypotension and sedation are less likely to occur with loxapine than low potency antipsychotics such as chlorpromazine.
Additionally, extrapyramidal symptoms are generally less frequent with loxapine than high potency antipsychotics such as haloperidol.
Oral loxapine was initially approved by the FDA in 1975 as an oral formulation for the treatment of schizophrenia.
In December 2012, an oral inhalational formulation (Adasuve) was approved by the FDA for the acute treatment of agitation associated with schizophrenia or bipolar I disorder in adults.
Due to the risk of bronchospasm, which may result in respiratory distress or respiratory arrest, inhalational loxapine is only available through the Adasuve Risk Evaluation and Mitigation Strategy (ADASUVE REMS) program and must be administered by a healthcare professional.
Healthcare facilities where Adasuve is administered must be enrolled in and fulfill the requirements of the REMS program.
Indications
- agitation
- autistic disorder
- behavioral or psychological symptoms of dementia
- schizophrenia
For the treatment of schizophrenia
Side Effects
- agitation
- agranulocytosis
- akathisia
- akinesia
- alopecia
- amenorrhea
- aplastic anemia
- asthenia
- blurred vision
- bronchospasm
- confusion
- constipation
- cough
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dysphagia
- dyspnea
- dystonic reaction
- edema
- elevated hepatic enzymes
- eosinophilia
- fever
- flushing
- galactorrhea
- gynecomastia
- hemolytic anemia
- hepatitis
- hyperprolactinemia
- hypertension
- hyperthermia
- hyponatremia
- hypotension
- hypothermia
- ileus
- insomnia
- jaundice
- leukopenia
- menstrual irregularity
- nasal congestion
- nausea
- neuroleptic malignant syndrome
- neutropenia
- orthostatic hypotension
- pancytopenia
- photosensitivity
- polydipsia
- pruritus
- pseudoparkinsonism
- ptosis
- purpura
- rash
- respiratory arrest
- retinopathy
- seborrhea
- seizures
- SIADH
- sinus tachycardia
- skin hyperpigmentation
- stroke
- syncope
- tardive dyskinesia
- throat irritation
- thrombocytopenia
- tremor
- urinary retention
- visual impairment
- vomiting
- water intoxication
- weight gain
- weight loss
- wheezing
- xerostomia
Monitoring Parameters
- AIMS assessment
- blood pressure
- CBC
- ophthalmologic exam
- thyroid function tests (TFTs)
Contraindications
- acute bronchospasm
- agranulocytosis
- ambient temperature increase
- anticholinergic medications
- asthma
- breast cancer
- breast-feeding
- cardiac disease
- cerebrovascular disease
- children
- chronic obstructive pulmonary disease (COPD)
- closed-angle glaucoma
- CNS depression
- coadministration with other CNS depressants
- coma
- dehydration
- dementia
- driving or operating machinery
- dysphagia
- emphysema
- ethanol ingestion
- ethanol intoxication
- geriatric
- heart failure
- hepatic disease
- hyperprolactinemia
- hyperthermia
- hypotension
- hypothermia
- hypovolemia
- infants
- infertility
- leukopenia
- myocardial infarction
- neonates
- neurological disease
- neutropenia
- orthostatic hypotension
- overdose
- Parkinson’s disease
- pregnancy
- pregnancy testing
- prostatic hypertrophy
- pulmonary disease
- requires a specialized care setting
- seizure disorder
- seizures
- strenuous exercise
- stroke
- syncope
- tardive dyskinesia
- urinary retention
Loxapine is contraindicated in patients with a hypersensitivity to loxapine or other dibenzoxazepines (e.g., amoxapine)
Interactions
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Tramadol
- Acrivastine; Pseudoephedrine
- Aldesleukin, IL-2
- Alprazolam
- Amifampridine
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Anticholinergics
- Aripiprazole
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Brexpiprazole
- Bromocriptine
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Cabergoline
- Cannabidiol
- Capsaicin; Metaxalone
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Cetrorelix
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlorcyclizine
- Chlordiazepoxide; Clidinium
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Clemastine
- Clobazam
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Dantrolene
- Degarelix
- Deutetrabenazine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Promethazine
- Dicyclomine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dopamine
- dopamine agonists
- Doxylamine
- Doxylamine; Pyridoxine
- Ephedrine
- Epinephrine
- Esketamine
- Eszopiclone
- Ethanol
- Ethosuximide
- Fenfluramine
- Flavoxate
- Fluoxetine; Olanzapine
- Fluphenazine
- food
- Gabapentin
- Ganirelix
- General anesthetics
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Goserelin
- Guaifenesin; Phenylephrine
- Haloperidol
- Histrelin
- Homatropine; Hydrocodone
- Hydantoins
- Hydrocodone; Phenylephrine
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Iloperidone
- Indacaterol; Glycopyrrolate
- Isocarboxazid
- Lasmiditan
- Leuprolide
- Leuprolide; Norethindrone
- Levocetirizine
- Levodopa
- Lithium
- Lofexidine
- Lorazepam
- Lumateperone
- Lurasidone
- Maprotiline
- Meclizine
- Mepenzolate
- Meperidine; Promethazine
- Meprobamate
- Mesoridazine
- Metaxalone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methscopolamine
- Methylphenidate
- Metoclopramide
- Molindone
- Monoamine oxidase inhibitors
- Nafarelin
- Non-Ionic Contrast Media
- Norepinephrine
- Olanzapine
- Opiate Agonists
- Orphenadrine
- Oxybutynin
- Paliperidone
- Paroxetine
- Pemoline
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenylephrine
- Phenylephrine; Promethazine
- Pimozide
- Pregabalin
- Prilocaine; Epinephrine
- Prochlorperazine
- Promethazine
- Propantheline
- Quazepam
- Quetiapine
- Rasagiline
- Risperidone
- Rotigotine
- Safinamide
- Scopolamine
- Sedating H1-blockers
- Selegiline
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Tetrabenazine
- Thalidomide
- Thioridazine
- Thiothixene
- Tizanidine
- tobacco
- Tramadol
- Tranylcypromine
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Triprolidine
- Triptorelin
- Valproic Acid, Divalproex Sodium
- Vigabatrin
- Zaleplon
- Ziprasidone
- Zolpidem
- Zonisamide
