form of both agents. Use Caution/Monitor.solifenacin decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.stiripentolstiripentol, loxapine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilsufentanil and loxapine both increase sedation. Use Caution/Monitor.sumatriptansumatriptan, 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).sumatriptan intranasalsumatriptan intranasal, 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).tapentadoltapentadol and loxapine both increase sedation. Use Caution/Monitor.teduglutideteduglutide increases levels of loxapine by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.temazepamtemazepam and loxapine both increase sedation. Use Caution/Monitor.terbutalineloxapine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tetrabenazineloxapine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.thioridazineloxapine and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneloxapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and thiothixene both increase sedation. Use Caution/Monitor.tiotropiumtiotropium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.tiotropium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tolterodinetolterodine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.tolterodine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.topiramateloxapine and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadoltramadol and loxapine both increase sedation. Use Caution/Monitor.tranylcyprominetranylcypromine, 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).trazodoneloxapine and trazodone both increase sedation. Use Caution/Monitor.triazolamtriazolam and loxapine both increase sedation. Use Caution/Monitor.triclofostriclofos and loxapine both increase sedation. Use Caution/Monitor.trifluoperazineloxapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and trifluoperazine both increase sedation. Use Caution/Monitor.trihexyphenidyltrihexyphenidyl decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.trihexyphenidyl decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipramineloxapine and trimipramine both increase sedation. Use Caution/Monitor.triprolidinetriprolidine and loxapine both increase sedation. Use Caution/Monitor.trospium chloridetrospium chloride decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.trospium chloride decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.vecuroniumvecuronium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.vecuronium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.loxapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.venlafaxinevenlafaxine, 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).vilazodonevilazodone, 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).xylometazolineloxapine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineloxapine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideloxapine and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneloxapine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and ziprasidone both increase sedation. Use Caution/Monitor.zolmitriptanzolmitriptan, 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).zotepineloxapine and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and zotepine both increase sedation. Use Caution/Monitor.Minor (6)brimonidinebrimonidine increases effects of loxapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.chasteberrychasteberry decreases effects of loxapine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).ethanolethanol, loxapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.eucalyptusloxapine and eucalyptus both increase sedation. Minor/Significance Unknown.sageloxapine and sage both increase sedation. Minor/Significance Unknown.smokingsmoking decreases levels of loxapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.abobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA increases effects of loxapine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.aclidiniumMonitor Closely (3)aclidinium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. aclidinium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.acrivastineMonitor Closely (1)acrivastine and loxapine both increase sedation. Use Caution/Monitor.albuterolMonitor Closely (1)loxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilMonitor Closely (1)alfentanil and loxapine both increase sedation. Use Caution/Monitor.almotriptanMonitor Closely (1)almotriptan, 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).alprazolamMonitor Closely (1)alprazolam and loxapine both increase sedation. Use Caution/Monitor.amifampridineMonitor Closely (1)loxapine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amisulprideContraindicated (1)amisulpride, loxapine. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.amitriptylineMonitor Closely (1)loxapine and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalMonitor Closely (1)amobarbital and loxapine both increase sedation. Use Caution/Monitor.amoxapineMonitor Closely (2)loxapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. loxapine and amoxapine both increase sedation. Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (3)anticholinergic/sedative combos decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. anticholinergic/sedative combos decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.apomorphineMonitor Closely (1)loxapine and apomorphine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)loxapine decreases effects of apomorphine by pharmacodynamic antagonism. Contraindicated.arformoterolMonitor Closely (1)loxapine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazoleMonitor Closely (2)aripiprazole and loxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and loxapine both increase sedation. Use Caution/Monitor.armodafinilMonitor Closely (1)loxapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineMonitor Closely (1)asenapine and loxapine both increase sedation. Use Caution/Monitor.asenapine transdermalMonitor Closely (1)asenapine transdermal and loxapine both increase sedation. Use Caution/Monitor.atracuriumMonitor Closely (3)atracurium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atracurium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineMonitor Closely (3)atropine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMMonitor Closely (3)loxapine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. atropine IV/IM decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine IV/IM decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibMonitor Closely (1)avapritinib and loxapine both increase sedation. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and loxapine both increase sedation. Use Caution/Monitor.baclofenMonitor Closely (1)baclofen and loxapine both increase sedation. Use Caution/Monitor.belladonna alkaloidsMonitor Closely (3)belladonna alkaloids decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna alkaloids decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumMonitor Closely (4)belladonna and opium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna and opium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. belladonna and opium and loxapine both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (2)benperidol and loxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. benperidol and loxapine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen and loxapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/acetaminophen, 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.benzphetamineMonitor Closely (1)loxapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineMonitor Closely (1)loxapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.brexanoloneMonitor Closely (1)brexanolone, loxapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and loxapine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and loxapine both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of loxapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and loxapine both increase sedation. Use Caution/Monitor.bromocriptineSerious - Use Alternative (1)loxapine decreases effects of bromocriptine by pharmacodynamic antagonism. Contraindicated.brompheniramineMonitor Closely (1)brompheniramine and loxapine both increase sedation. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and loxapine both increase sedation. Use Caution/Monitor.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and loxapine both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantMonitor Closely (1)buprenorphine subdermal implant and loxapine both increase sedation. Use Caution/Monitor.buprenorphine transdermalMonitor Closely (1)buprenorphine transdermal and loxapine both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionMonitor Closely (2)buprenorphine, long-acting injection and loxapine both increase sedation. Use Caution/Monitor. loxapine 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.butabarbitalMonitor Closely (1)butabarbital and loxapine both increase sedation. Use Caution/Monitor.butalbitalMonitor Closely (1)butalbital and loxapine both increase sedation. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol