Loxapine (Inhalation Route) Proper Use

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Adasuve

Descriptions

Inhaled loxapine is used to treat acute agitation in adult patients with schizophrenia or bipolar I disorder (type of depression). It works in the brain to increase levels of dopamine and serotonin, which are chemicals that help regulate agitation, schizophrenia, and depression. Loxapine is an antipsychotic medicine.

This medicine is available only under a special restricted distribution program called the Adasuve® REMS program.

This product is available in the following dosage forms:

Powder

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of inhaled loxapine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies have not been performed on the relationship of age to the effects of inhaled loxapine in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of inhaled loxapine in the elderly. However, this medicine should not be used for behavioral problems in older adults with dementia.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bromopride
Metoclopramide
Potassium Citrate

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acepromazine
Alfentanil
Alprazolam
Amantadine
Amifampridine
Amineptine
Amitriptyline
Amitriptylinoxide
Amobarbital
Amoxapine
Anileridine
Aripiprazole
Asenapine
Baclofen
Belladonna
Belladonna Alkaloids
Benperidol
Benzhydrocodone
Bromazepam
Buprenorphine
Bupropion
Buspirone
Butabarbital
Butorphanol
Calcium Oxybate
Cannabidiol
Cannabis
Carbamazepine
Carbinoxamine
Carisoprodol
Carphenazine
Cetirizine
Chloral Hydrate
Chlordiazepoxide
Chlorpromazine
Chlorzoxazone
Clobazam
Clomipramine
Clonazepam
Clorazepate
Clozapine
Codeine
Cyclobenzaprine
Daridorexant
Desipramine
Dexmedetomidine
Diacetylmorphine
Diazepam
Dibenzepin
Dichloralphenazone
Difenoxin
Dihydrocodeine
Diphenhydramine
Diphenoxylate
Donepezil
Doxepin
Doxylamine
Droperidol
Enflurane
Epinephrine
Esketamine
Estazolam
Eszopiclone
Ethchlorvynol
Ethopropazine
Ethylmorphine
Fentanyl
Flibanserin
Fluphenazine
Flurazepam
Fluspirilene
Fospropofol
Gabapentin
Gabapentin Enacarbil
Glucagon
Glycopyrrolate
Glycopyrronium Tosylate
Halazepam
Haloperidol
Halothane
Hexobarbital
Hydrocodone
Hydromorphone
Hydroxyzine
Imipramine
Isoflurane
Ketamine
Ketazolam
Ketobemidone
Lacosamide
Lemborexant
LetibotulinumtoxinA-wlbg
Levocetirizine
Levorphanol
Lithium
Lofepramine
Lofexidine
Lorazepam
Magnesium Oxybate
Meclizine
Melitracen
Melperone
Meperidine
Mephobarbital
Meprobamate
Meptazinol
Mesoridazine
Metaxalone
Methacholine
Methadone
Methdilazine
Methocarbamol
Methohexital
Methotrimeprazine
Methylene Blue
Midazolam
Molindone
Moricizine
Morphine
Morphine Sulfate Liposome
Nalbuphine
Nicomorphine
Nitrazepam
Nitrous Oxide
Nortriptyline
Olanzapine
Oliceridine
Opipramol
Opium
Opium Alkaloids
Orphenadrine
Oxazepam
Oxycodone
Oxymorphone
Papaveretum
Paregoric
Pentazocine
Pentobarbital
Perampanel
Perazine
Periciazine
Perphenazine
Phenobarbital
Pimozide
Piperacetazine
Pipotiazine
Piritramide
Potassium Oxybate
Prazepam
Pregabalin
Primidone
Prochlorperazine
Promazine
Promethazine
Propofol
Protriptyline
Quazepam
Quetiapine
Ramelteon
Remifentanil
Remimazolam
Remoxipride
Revefenacin
Ropeginterferon Alfa-2b-njft
Scopolamine
Secobarbital
Secretin Human
Sertindole
Sodium Oxybate
Sufentanil
Sulpiride
Suvorexant
Tapentadol
Temazepam
Thiethylperazine
Thiopental
Thiopropazate
Thioridazine
Tianeptine
Tilidine
Tiotropium
Tizanidine
Tolonium Chloride
Topiramate
Tramadol
Trazodone
Triazolam
Trifluoperazine
Trifluperidol
Triflupromazine
Trimeprazine
Trimipramine
Zaleplon
Zolpidem
Zopiclone
Zotepine
Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Betel Nut

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Proper Use

A doctor or other trained health professional will give you this medicine in a hospital. This medicine is breathed in (inhaled) through the mouth and into the lungs.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Your doctor will check you for breathing problems before and after receiving this medicine.

Precautions

It is very important that your doctor check your progress after you receive the medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

Tell your doctor if you are pregnant or planning to become pregnant. This medicine may cause unwanted effects (eg, withdrawal syndrome) to newborn babies if used during the later part of pregnancy.

This medicine may cause bronchospasm (narrowing of the airways) and may lead to breathing problems. Tell your doctor right away if you have a chest tightness, cough, or trouble breathing.

Check with your doctor right away if you are having seizures, difficulty with breathing, a fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

This medicine may cause blurred vision, dizziness, drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision, which may lead to falls, fractures or other injuries. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

This medicine may add to the effects of alcohol and other CNS depressants (medicine that makes you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above after you receive this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

Blurred vision
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
seizures
sweating
unusual tiredness or weakness

Rare

Inability to sit still
need to keep moving
restlessness

Incidence not known

Chest tightness
cough
decrease in the frequency of urination
decrease in urine volume
decreased vision
difficulty in passing urine (dribbling)
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
eye pain
fast, pounding, or irregular heartbeat or pulse
headache
high fever
inability to move the eyes
increased blinking or spasms of the eyelid
increased sweating
loss of balance control
loss of bladder control
mask-like face
nausea or vomiting
nervousness
noisy breathing
painful urination
pounding in the ears
severe muscle stiffness
shuffling walk
slowed movements
slurred speech
sticking out of tongue
tearing of eyes
tic-like (jerky) movements of the head, face, mouth, and neck
tiredness
trembling and shaking of the fingers and hands
trouble breathing, speaking, or swallowing
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual facial expressions
unusually pale skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Change in taste
drowsiness
loss of taste
sleepiness or unusual drowsiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/loxapine-inhalation-route/proper-use/drg-20060722

Loxapine (Inhalation Route)