which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (2)loxapine inhaled increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. darifenacin decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.desfluraneMonitor Closely (1)desflurane and loxapine inhaled both increase sedation. Use Caution/Monitor.desipramineMonitor Closely (1)loxapine inhaled and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazineMonitor Closely (2)loxapine inhaled and deutetrabenazine both increase sedation. Use Caution/Monitor. loxapine inhaled and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and loxapine inhaled both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)loxapine inhaled increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine and loxapine inhaled both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)loxapine inhaled increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)loxapine inhaled increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromethorphanMonitor Closely (1)dextromethorphan, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dextromoramideMonitor Closely (1)dextromoramide and loxapine inhaled both increase sedation. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine and loxapine inhaled both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (1)diazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.dicyclomineMonitor Closely (2)loxapine inhaled increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. dicyclomine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.diethylpropionMonitor Closely (1)loxapine inhaled increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and loxapine inhaled both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl and loxapine inhaled both increase sedation. Use Caution/Monitor.dihydroergotamineMonitor Closely (1)dihydroergotamine, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dimenhydrinateMonitor Closely (1)dimenhydrinate and loxapine inhaled both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (3)loxapine inhaled increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. diphenhydramine and loxapine inhaled both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl and loxapine inhaled both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone and loxapine inhaled both increase sedation. Use Caution/Monitor.dobutamineMonitor Closely (1)loxapine inhaled increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.donepezil transdermalMonitor Closely (1)donepezil transdermal, loxapine inhaled. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.dopamineMonitor Closely (1)loxapine inhaled increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)loxapine inhaled decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.dopexamineMonitor Closely (1)loxapine inhaled increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinMonitor Closely (1)loxapine inhaled and dosulepin both increase sedation. Use Caution/Monitor.doxepinMonitor Closely (1)loxapine inhaled and doxepin both increase sedation. Use Caution/Monitor.doxylamineMonitor Closely (1)doxylamine and loxapine inhaled both increase sedation. Use Caution/Monitor.droperidolMonitor Closely (2)droperidol and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. droperidol and loxapine inhaled both increase sedation. Use Caution/Monitor.eletriptanMonitor Closely (1)eletriptan, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ephedrineMonitor Closely (1)loxapine inhaled increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (1)loxapine inhaled increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)loxapine inhaled increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ergoloid mesylatesMonitor Closely (1)ergoloid mesylates, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ergotamineMonitor Closely (1)ergotamine, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).estazolamMonitor Closely (1)estazolam and loxapine inhaled both increase sedation. Use Caution/Monitor.ethanolMonitor Closely (1)loxapine inhaled and ethanol both increase sedation. Use Caution/Monitor.Minor (1)ethanol, loxapine inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.etomidateMonitor Closely (1)etomidate and loxapine inhaled both increase sedation. Use Caution/Monitor.eucalyptusMinor (1)loxapine inhaled and eucalyptus both increase sedation. Minor/Significance Unknown.fenfluramineMonitor Closely (1)loxapine inhaled increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fentanylMonitor Closely (1)fentanyl, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).Serious - Use Alternative (1)fentanyl, loxapine inhaled. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl intranasalSerious - Use Alternative (1)fentanyl intranasal, loxapine inhaled. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transdermalSerious - Use Alternative (1)fentanyl transdermal, loxapine inhaled. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transmucosalSerious - Use Alternative (1)fentanyl transmucosal, loxapine inhaled. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fesoterodineMonitor Closely (2)loxapine inhaled increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. fesoterodine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.flavoxateMonitor Closely (2)loxapine inhaled increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. flavoxate decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.flibanserinMonitor Closely (1)flibanserin, loxapine inhaled. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).fluphenazineMonitor Closely (2)fluphenazine and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. fluphenazine and loxapine inhaled both increase sedation. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.formoterolMonitor Closely (1)loxapine inhaled increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.frovatriptanMonitor Closely (1)frovatriptan, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ganaxoloneMonitor Closely (1)loxapine inhaled and ganaxolone both increase sedation. Use Caution/Monitor.glycopyrrolateMonitor Closely (2)glycopyrrolate decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. loxapine inhaled increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.glycopyrrolate inhaledMonitor Closely (3)glycopyrrolate inhaled decreases levels of loxapine inhaled by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. glycopyrrolate inhaled decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. loxapine inhaled increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.glycopyrronium tosylate topicalMonitor Closely (1)glycopyrronium tosylate topical, loxapine inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.guanfacineMonitor Closely (1)guanfacine, loxapine inhaled. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.haloperidolMonitor Closely (2)haloperidol and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. haloperidol and loxapine inhaled both increase sedation. Use Caution/Monitor.henbaneMonitor Closely (2)loxapine inhaled increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. henbane decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.homatropineMonitor Closely (2)loxapine inhaled increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. homatropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.hydrocodoneSerious - Use Alternative (1)hydrocodone, loxapine inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.hydromorphoneMonitor Closely (1)hydromorphone and loxapine inhaled both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and loxapine inhaled both increase sedation. Use Caution/Monitor.hyoscyamineMonitor Closely (2)loxapine inhaled increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. hyoscyamine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.hyoscyamine sprayMonitor Closely (2)loxapine inhaled increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. hyoscyamine spray decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.iloperidoneMonitor Closely (2)iloperidone and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. iloperidone and loxapine inhaled both increase sedation. Use Caution/Monitor.imipramineMonitor Closely (1)loxapine inhaled and imipramine both increase sedation. Use Caution/Monitor.incobotulinumtoxinAMonitor Closely (1)loxapine inhaled, incobotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.ipratropiumMonitor Closely (2)loxapine inhaled increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. ipratropium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.isoproterenolMonitor Closely (1)loxapine inhaled increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ketamineMonitor Closely (1)ketamine and loxapine inhaled both increase sedation. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)loxapine inhaled and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lemborexantMonitor Closely (1)lemborexant, loxapine inhaled. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.levalbuterolMonitor Closely (1)loxapine inhaled increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levodopaSerious - Use Alternative (1)loxapine inhaled decreases effects of levodopa by pharmacodynamic antagonism.