AdultPediatricDosage Forms & Strengths powder for oral inhalation 10mg/single-use inhaler Schizophrenia & Bipolar I Agitation Indicated for acute treatment of agitation associated with schizophrenia or bipolar I disorder in adults 10 mg inhaled PO once within a 24-hr period Must be administered only by a healthcare professional Dosing Considerations Because of the risk of bronchospasm, is only available through a restricted program under a risk evaluation and mitigation strategy (REMS) and must be administered only in an enrolled healthcare facility Prior to administering, screen all patients for a history of asthma, COPD, or other pulmonary disease, and examine patients (including chest auscultation) for respiratory signs (eg, wheezing) Administration Step 1. Open pouch and remove inhaler from package (indicator light on inhaler is off) Step 2. Firmly pull the plastic tab from the rear of the inhaler; check that the green light turns on to indicate that the inhaler is ready for use Use the inhaler within 15 minutes after removing the tab to prevent automatic deactivation of the inhaler; the green light will turn off, indicating that the inhaler is not usable Discard the inhaler after one use Step 3. Explain procedure to patient; inform the patient that the inhaler may produce a flash of light and a clicking sound, and it may become warm during use Step 4. Instruct the patient to hold the inhalator away from the mouth and breathe out fully to empty the lungs Step 5. Instruct the patient to put the mouthpiece of the inhaler between the lips, close the lips, and inhale through the mouthpiece with a steady deep breath; check that the green light turns off indicating that the dose has been delivered Step 6. Instruct the patient to remove the mouthpiece from the mouth and hold the breath for as long as possible, up to 10 seconds NOTE: If the green light remains on after the patient inhales, the dose has NOT been delivered; instruct the patient to repeat Steps 4-6 up to 2 additional times; if the green light still does not turn off, discard the inhaler and use a new oneSafety and efficacy not establishedInteraction CheckerEnter a drug name and loxapine inhaledNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)amisulprideamisulpride, loxapine inhaled. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.Serious - Use Alternative (24)apomorphineloxapine inhaled decreases effects of apomorphine by pharmacodynamic antagonism. Contraindicated.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, 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.bromocriptineloxapine inhaled decreases effects of bromocriptine by pharmacodynamic antagonism. Contraindicated.cabergolineloxapine inhaled decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.calcium/magnesium/potassium/sodium oxybatesloxapine inhaled, calcium/magnesium/potassium/sodium oxybates. Either increases effects 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.dopamineloxapine inhaled decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.fentanylfentanyl, 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 intranasalfentanyl 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 transdermalfentanyl 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 transmucosalfentanyl 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.hydrocodonehydrocodone, 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.levodopaloxapine inhaled decreases effects of levodopa by pharmacodynamic antagonism. Contraindicated.lisurideloxapine inhaled decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.methyldopaloxapine inhaled decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.metoclopramide intranasalloxapine inhaled, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.loxapine inhaled increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.mometasone inhaledmometasone inhaled increases toxicity of loxapine inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Agents used to treat airway disease may enhance the toxic effect of inhaled loxapine.olopatadine intranasalloxapine inhaled and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. pramipexoleloxapine inhaled decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.ropiniroleloxapine inhaled decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.rotigotineloxapine inhaled decreases effects of rotigotine by pharmacodynamic antagonism. Contraindicated.safinamideloxapine inhaled decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.selinexorselinexor, loxapine inhaled. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sodium oxybateloxapine inhaled, sodium oxybate. Either increases effects 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.sufentanil SLsufentanil SL, loxapine inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. 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.Monitor Closely (254)abobotulinumtoxinAabobotulinumtoxinA increases effects of loxapine inhaled by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.aclidiniumloxapine inhaled increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.aclidinium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.albuterolloxapine inhaled increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilalfentanil and loxapine inhaled both increase sedation. Use Caution/Monitor.almotriptanalmotriptan, 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).alprazolamalprazolam and loxapine inhaled both increase sedation. Use Caution/Monitor.amitriptylineloxapine inhaled and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital and loxapine inhaled both increase sedation. Use Caution/Monitor.amoxapineloxapine inhaled and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.loxapine inhaled and amoxapine both increase sedation. Use Caution/Monitor.anticholinergic/sedative combosloxapine inhaled increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.anticholinergic/sedative combos decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.apomorphineloxapine inhaled and apomorphine both increase sedation. Use Caution/Monitor.arformoterolloxapine inhaled increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazolearipiprazole and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.aripiprazole and loxapine inhaled both increase sedation. Use Caution/Monitor.armodafinilloxapine inhaled increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.atracuriumloxapine inhaled increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atracurium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.atropineloxapine inhaled increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.atropine IV/IMloxapine inhaled increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IM decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.azelastineazelastine and loxapine inhaled both increase sedation. Use Caution/Monitor.baclofenbaclofen and loxapine inhaled both increase sedation. Use Caution/Monitor.belladonna alkaloidsloxapine inhaled increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna alkaloids decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.belladonna and opiumloxapine inhaled increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opium and loxapine inhaled both increase sedation. Use Caution/Monitor.belladonna and opium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.benperidolbenperidol and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.benperidol and loxapine inhaled both increase sedation. Use Caution/Monitor.benzphetamineloxapine inhaled increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineloxapine inhaled increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benztropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.brexanolonebrexanolone, loxapine inhaled. Either increases toxicity of the other by sedation. Use Caution/Monitor.brompheniraminebrompheniramine and loxapine inhaled both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and loxapine inhaled both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and loxapine inhaled both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionloxapine inhaled increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.butabarbitalbutabarbital and loxapine inhaled both increase sedation. Use Caution/Monitor.butalbitalbutalbital and loxapine inhaled both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and loxapine inhaled both increase sedation. Use Caution/Monitor.caffeineloxapine inhaled increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbinoxaminecarbinoxamine and loxapine inhaled both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and loxapine inhaled both increase sedation. Use Caution/Monitor.chloral hydratechloral hydrate and loxapine inhaled both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and loxapine inhaled both increase sedation. Use Caution/Monitor.chlorpheniraminechlorpheniramine and loxapine inhaled both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.chlorpromazine and loxapine inhaled both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and loxapine inhaled both increase sedation. Use Caution/Monitor.cinnarizinecinnarizine and loxapine inhaled both increase sedation. Use Caution/Monitor.cisatracuriumloxapine inhaled increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cisatracurium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.clemastineclemastine and loxapine inhaled both increase sedation. Use Caution/Monitor.clomipramineloxapine inhaled and clomipramine both increase sedation. Use Caution/Monitor.clonazepamclonazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.clonidineclonidine, loxapine inhaled. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateclorazepate and loxapine inhaled both increase sedation. Use Caution/Monitor.clozapineclozapine and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal