Loxapine

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Generic Name: Loxapine Brand Name(s): Generics only. No brands available.

Uses

What is Loxapine used for?

Loxapine is used to treat certain mental/mood disorders (such as schizophrenia). This medicine helps you to think more clearly, feel less nervous, and take part in everyday life. It can reduce aggression and the desire to hurt yourself/others. It may also help to decrease hallucinations (such as hearing/seeing things that are not there). Loxapine is a psychiatric medication (antipsychotic type) that works by helping to restore the balance of certain natural substances (such as dopamine) in the brain.

How should I take Loxapine?

Take this medication by mouth, usually 2 to 4 times daily with or without food or exactly as directed by your doctor.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/dropper and mix it in liquid or soft food (such as applesauce, pudding) just before taking. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment. To reduce your risk of side effects such as drowsiness and shaking (tremor), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s directions carefully.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Although you may notice some improvement in your symptoms soon after starting this medication, it may take several weeks to months before you get the full benefit of this drug.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as uncontrolled movements. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Loxapine?

Loxapine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Loxapine in the bathroom or the freezer. There may be different brands of Loxapine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Loxapine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Loxapine?

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (such as low red/white/platelet blood cell counts), a certain eye condition (glaucoma), heart problems (such as fast/irregular heartbeat, low blood pressure), liver disease, a brain disorder/tumor/injury, drug/alcohol/substance abuse, breast cancer, Parkinson’s disease, seizures, a certain severe reaction to other antipsychotic-type medications (neuroleptic malignant syndrome-NMS), difficulty urinating (such as due to prostate problems).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Before having surgery or imaging procedures (such as certain X-rays, CT scans) requiring the use of contrast dye (such as metrizamide), tell your doctor or dentist that you are using this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, lightheadedness, extrapyramidal symptoms (EPS), and tardive dyskinesia (TD). Drowsiness, dizziness, and lightheadedness can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.

Since untreated mental/mood problems (such as schizophrenia) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

It is not known whether this drug passes into breast milk. Discuss the risk and benefits with your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Loxapine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Loxapine. Loxapine is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Loxapine?

Drowsiness, dizziness, lightheadedness, constipation, dry mouth, weight gain, or blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.

This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to lessen these side effects. Therefore, tell your doctor right away if you notice any of the following side effects: stiff muscles, severe muscle spasms/cramping (such as twisting neck, arching back, eyes rolling up), restlessness/constant need to move, shaking (tremor), slow/shuffling walk, drooling/trouble swallowing, mask-like expression of the face.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, fainting, depression/suicidal thoughts, difficulty urinating, signs of infection (such as fever, persistent sore throat), seizures, severe stomach/abdominal pain.

This medication may cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any involuntary/repetitive muscle movements such as lip smacking/puckering, tongue thrusting, chewing, or finger/toe movements.

In rare cases, loxapine may increase your level of a certain chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.

This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Loxapine?

Some products that may interact with this drug include: metoclopramide, certain drugs used for Parkinson’s disease (such as bromocriptine, levodopa, pergolide).

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana, drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Loxapine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Loxapine?

Loxapine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Loxapine?

Loxapine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Loxapine.

What is the dose of Loxapine for an adult?

Usual Adult Dose for Schizophrenia

Initial Dose: 10 mg orally twice a day

-Initial doses of up to 50 mg a day may be needed in severely disturbed patients

Titrate rapidly over the first 7 to 10 days until symptoms are effectively controlled

Maintenance Dose: 60 mg to 100 mg daily in divided doses, 2 to 4 times a day

Maximum dose: 250 mg/day

Comments:

-Daily dosage should be adjusted to the individual patient’s needs based on severity of symptoms and previous antipsychotic drug response.

-Usual therapeutic and maintenance range is 60 to 100 mg daily; however, some patients may respond to lower, and others higher, doses.

-For maintenance therapy, 20 to 60 mg has been satisfactory for a majority of patients.

Use: For the treatment of schizophrenia

Usual Adult Dose for Agitated State

10 mg by oral inhalation once within a 24-hour period

Comments:

-To mitigate the risk of bronchospasm, all patients must undergo screening and examination prior to administration.

-This drug must be administered by a healthcare professional only in an enrolled healthcare facility.

Use: For the acute treatment of agitation associated with schizophrenia or bipolar I disorder

Renal Dose Adjustments

Inhalation: No dosage adjustment necessary

Oral: Data not available

Liver Dose Adjustments

Inhalation: No dosage adjustment necessary

Oral: Data not available

Other Comments

Administration advice:

-Take capsules with or without food

Inhaler:

-Do not administer more than 1 dose within a 24-hour period

-For preparation of inhaler, see below

-Explain to patient that it is normal for the inhaler to produce a flash of light, a clicking sound, and become warm during use.

-To administer dose, patient should breathe out fully to empty the lungs; place mouthpiece between lips, close lips, and inhale with a steady deep breath through the mouthpiece; remove mouthpiece and hold breath as long as possible up to 10 seconds.

-Check that the green light turns off as this will indicate that a dose has been delivered; if the green light remains on, the dose has not been delivered; may repeat administration up to 2 additional times; if still, the green light does not turn off, discard the inhaler and start over with a new one.

Storage requirements:

-Keep inhaler in pouch until ready to use

-The inhaler contains a lithium battery; dispose of in accordance with all federal, state, and local laws.

Preparation techniques:

-Tear open pouch to remove the inhaler; the indicator light should be off.

-Firmly pull the plastic tab from the rear of the inhaler; the green light should turn on indicating the inhaler is ready for use; the inhaler will automatically deactivate if not used within 15 minutes (the green light will turn off and the inhaler is not useable).

-Discard inhaler after 1 use.

General:

-Psychomotor agitation is defined in DSM-IV as “excessive motor activity associated with a feeling of inner tension”.

-Patients exposed chronically to antipsychotics should understand the risk of tardive dyskinesia

-During chronic therapy, patients should be periodically reassessed to determine continued need for treatment.

Monitoring:

-Chronic use: Patients with preexisting low WBC and/or a prior history of drug-induced leukopenia or neutropenia should monitor CBC frequently during the first few months.

-For patients using inhaler, monitor for signs and symptoms of bronchospasm at least every 15 minutes and for at least 1 hour after use; monitoring should include chest auscultation.

Patient advice:

-This drug may impair judgment, thinking, or motor skills; have patient avoid driving or operating machinery until adverse effects are determined.

-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.

-Patients should be aware of signs and symptoms of neuroleptic malignant syndrome and be instructed to contact health care provider right away if symptoms are present.

-Patients should be advised to report signs/symptoms of bronchospasm (e.g., wheezing, shortness of breath, chest tightness, cough).

What is the dose of Loxapine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Loxapine available?

Loxapine is available in the following dosage forms and strengths:

  • Oral capsule,
  • Oral concentrate,
  • Intramuscular solution,
  • Inhalation powder.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Loxapine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 23, 2018 | Last Modified: March 23, 2018

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