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loxapine

N05AH01

Forms & Strengths

Capsule: 5 mg, 10 mg, 25 mg, 50 mg
Inhalation powder: 10 mg (Adasuve)
Concentrate: 25 mg/mL (historical/discontinued in some regions)

Adult Dosing

Oral (Schizophrenia): Initial 10 mg twice daily, titrate up to 20-50 mg twice daily; maintenance range 20-250 mg/day in divided doses
Inhalation (Agitation associated with schizophrenia or bipolar disorder): 10 mg single dose via dedicated inhaler; max 1 dose per 24 hours

Pediatric Dosing

Safety and efficacy not established in pediatric patients under 18 years of age

Indications

Management of manifestations of schizophrenia
Rapid treatment of acute agitation associated with schizophrenia or bipolar I disorder (inhalation form)

Mechanism of Action

Dibenzo-oxazepine dibenzodiazepine derivative classified as a typical (first-generation) antipsychotic
Exerts antipsychotic activity primarily through strong antagonism at central dopamine D2 and serotonin 5-HT2 receptors

Contraindications

Hypersensitivity to loxapine or amoxapine
Comatose or severely depressed states from any cause
History of bronchospasm, asthma, or active airway disease (for inhalation formulation due to risk of severe bronchospasm)

Adverse Reactions

Extrapyramidal symptoms including akathisia, dystonia, and parkinsonism
Sedation, somnolence, and dizziness
Anticholinergic effects such as dry mouth, constipation, and blurred vision
Tardive dyskinesia with long-term use
Neuroleptic Malignant Syndrome (rare)
Bronchospasm, wheezing, and dyspnea (specifically with inhalation route)

Drug Interactions

Central nervous system (CNS) depressants and alcohol: additive sedation and respiratory depression
Anticholinergic agents: increased risk of severe anticholinergic adverse effects
Dopamine agonists (e.g., levodopa): mutual antagonism of therapeutic effects
Drugs lowering the seizure threshold: increased risk of seizures

Curated Content: Needs Vetting Before Put to Clinical Use