of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.glycopyrronium tosylate topicalMonitor Closely (1)glycopyrronium tosylate topical, loxapine. 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. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.haloperidolMonitor Closely (2)haloperidol and loxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. haloperidol and loxapine both increase sedation. Use Caution/Monitor.henbaneMonitor Closely (3)henbane decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. henbane decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.homatropineMonitor Closely (3)homatropine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. homatropine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.hydrocodoneSerious - Use Alternative (1)hydrocodone, loxapine. 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 both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and loxapine both increase sedation. Use Caution/Monitor.hyoscyamineMonitor Closely (3)hyoscyamine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. hyoscyamine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.hyoscyamine sprayMonitor Closely (3)loxapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. hyoscyamine spray decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. hyoscyamine spray decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.iloperidoneMonitor Closely (2)iloperidone and loxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. iloperidone and loxapine both increase sedation. Use Caution/Monitor.imipramineMonitor Closely (1)loxapine and imipramine both increase sedation. Use Caution/Monitor.incobotulinumtoxinAMonitor Closely (1)loxapine, 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 (3)ipratropium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. ipratropium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.isoproterenolMonitor Closely (1)loxapine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ketamineMonitor Closely (1)ketamine and loxapine both increase sedation. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)loxapine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lasmiditanMonitor Closely (1)lasmiditan, loxapine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lemborexantMonitor Closely (1)lemborexant, loxapine. 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 increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levodopaSerious - Use Alternative (1)loxapine decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.levomilnacipranMonitor Closely (1)levomilnacipran, loxapine. 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).levorphanolMonitor Closely (1)levorphanol and loxapine both increase sedation. Use Caution/Monitor.linezolidMonitor Closely (1)linezolid, loxapine. 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).lisdexamfetamineMonitor Closely (1)loxapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lisurideSerious - Use Alternative (1)loxapine decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.lithiumMonitor Closely (1)lithium, loxapine. 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).lofepramineMonitor Closely (1)loxapine and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)loxapine and lofexidine both increase sedation. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam and loxapine both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (2)lorazepam, loxapine. Mechanism: unknown. Use Caution/Monitor. Risk of resp. depression, hypotension. lorazepam and loxapine both increase sedation. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin, loxapine. 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).lormetazepamMonitor Closely (1)lormetazepam and loxapine both increase sedation. Use Caution/Monitor.lurasidoneMonitor Closely (1)lurasidone, loxapine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (1)loxapine and maprotiline both increase sedation. Use Caution/Monitor.maravirocMonitor Closely (1)maraviroc, loxapine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.marijuanaMonitor Closely (1)loxapine and marijuana both increase sedation. Use Caution/Monitor.meclizineMonitor Closely (3)meclizine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. meclizine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of loxapine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.melatoninMonitor Closely (1)loxapine and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (2)meperidine, loxapine. 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). meperidine and loxapine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)loxapine and meprobamate both increase sedation. Use Caution/Monitor.metaproterenolMonitor Closely (1)loxapine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxaloneMonitor Closely (1)metaxalone and loxapine both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (2)methadone, loxapine. 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). methadone and loxapine both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (1)loxapine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolMonitor Closely (1)methocarbamol and loxapine both increase sedation. Use Caution/Monitor.methscopolamineMonitor Closely (3)methscopolamine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. methscopolamine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.methyldopaSerious - Use Alternative (1)loxapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.methylenedioxymethamphetamineMonitor Closely (1)loxapine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylergonovineMonitor Closely (1)methylergonovine, loxapine. 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).methylphenidateMonitor Closely (1)loxapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.metoclopramideMonitor Closely (1)loxapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.metoclopramide intranasalSerious - Use Alternative (2)loxapine, 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 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.midazolamMonitor Closely (1)midazolam and loxapine both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, loxapine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)loxapine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.milnacipranMonitor Closely (1)milnacipran, loxapine. 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).mirtazapineMonitor Closely (1)loxapine and mirtazapine both increase sedation. Use Caution/Monitor.modafinilMonitor Closely (1)loxapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (1)morphine and loxapine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)loxapine and motherwort both increase sedation. Use Caution/Monitor.moxonidineMonitor Closely (1)loxapine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)loxapine and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine and loxapine both increase sedation. Use Caution/Monitor.naratriptanMonitor Closely (1)naratriptan, loxapine. 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).norepinephrineMonitor Closely (1)loxapine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (1)loxapine and nortriptyline both increase sedation. Use Caution/Monitor.olanzapineMonitor Closely (2)loxapine and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. loxapine and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (1)oliceridine, loxapine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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.olopatadine intranasalSerious - Use Alternative (1)loxapine 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. onabotulinumtoxinAMonitor Closely (3)onabotulinumtoxinA decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. onabotulinumtoxinA decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.opium tinctureMonitor Closely (1)opium tincture and loxapine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam and loxapine both increase sedation. Use Caution/Monitor.oxybutyninMonitor Closely (3)oxybutynin decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use