Drug Action
Loxapine is a dopamine D2 and serotonin 5- HT2A receptor antagonist. It also binds to noradrenergic, histaminergic, and cholinergic receptors.
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Drug reference
Loxapine is a dopamine D2 and serotonin 5- HT2A receptor antagonist. It also binds to noradrenergic, histaminergic, and cholinergic receptors.
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Rapid control of mild-to-moderate agitation in patients with schizophrenia or bipolar disorder (specialist supervision in hospital) ▶BY INHALATION ▶Adult: 9.1 mg as a single dose, followed by 9.1 mg after 2 hours if required, alternatively 4.5 mg as a single dose, followed by 4.5 mg after 2 hours if required, lower dose may be given if more appropriate or if the higher dose not previously tolerated
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Acute respiratory symptoms. asthma. cardiovascular disease. cerebrovascular disease. chronic obstructive pulmonary disease. dehydration—risk of hypotension. elderly patients (especially those with dementia-related psychosis). hypovolaemia—risk of hypotension
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Bronchodilator treatment should be available Nervous system for treatment of possible severe respiratory side-effects (bronchospasm). history of extrapyramidal symptoms. risk factors for hypoventilation
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Educational risk minimisation materials are available for health care professionals. Adasuve ® 4.5 mg inhalation powder may be difficult to obtain.
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→Appendix 1: loxapine
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▶Common or very common Fatigue. taste altered. throat irritation ▶Uncommon Bronchospasm. oculogyration. restlessness ▶Frequency not known Dry eye. hypertension. syncope. vision blurred
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Manufacturer advises use only if potential benefit outweighs risk.
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Manufacturer advises to avoid for 48 hours after dose (express and discard milk produced during this time)—present in milk in animal studies.
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Manufacturer advises to observe patient during the first hour after each dose for signs and symptoms of bronchospasm.
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Manufacturer advises remove pull-tab and wait for green light to turn on (product must be used within 15 minutes of pulling tab); instruct patient to inhale through mouthpiece and then hold breath briefly. When green light turns off, this indicates the dose has been delivered.
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There can be variation in the licensing of different medicines containing the same drug. Inhalation powder ▶Adasuve (Galen Ltd) Loxapine 9.1 mg Adasuve 9.1mg/dose inhalation powder | 1 dose P £58.30 (Hospital only) eiiii F 401
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9.1 mg as a single dose, followed by 9.1 mg after
First-line fragment. Read the complete Indications and Dose section above.
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