loxapine
Loxapine is a typical antipsychotic used to treat schizophrenia. Loxapine is taken by mouth, typically once or twice daily. It can cause more movement-related side effects compared with atypical antipsychotics, such as aripiprazole (Abilify). It used to be sold under the brand name Loxitane, which is no longer available. Oral loxapine is now only available as generic capsules.
What is Loxapine?
What is Loxapine used for?
- Schizophrenia
How Loxapine works
Loxapine is an antipsychotic medication. It's not exactly clear how loxapine works, but it's thought to regulate dopamine and serotonin levels in your brain. Dopamine and serotonin are natural chemicals that affect your thoughts and mood. Imbalances in these chemical levels might cause symptoms of schizophrenia, such as seeing things that aren't there (hallucinations) and believing things that aren't real (delusions).
Drug facts
Side effects of Loxapine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Drowsiness
- Extrapyramidal symptoms (movement problems, such as shakiness, stiffness, excess saliva, and loss of facial expression)
- Restless muscles (akathisia)
Less Common Side Effects
- Dizziness
- Feeling faint
- Sleepiness or trouble sleeping
- Confusion
- Trouble swallowing or breathing
- Agitation (distress)
- Slurred speech
- Hair loss
- Dry mouth
- Nausea
Loxapine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Neuroleptic malignant syndrome (NMS): high fever, muscle stiffness, confusion, sweating, changes in pulse, heart rate, and blood pressure
- Uncontrollable muscle movements of the face, tongue, or other body parts: sticking out your tongue, puffing out your cheeks, puckering your mouth, lip smacking, chewing, shaking in your arms and legs
- Serious infection (from low blood cell count): fever, weakness, fatigue, sore throat, cough, body aches, chills
- Seizures
The following Loxapine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Difficulty with speaking or swallowing
lip smacking or puckering
loss of balance control
mask-like face
puffing of the cheeks
rapid or fine, worm-like movements of the tongue
restlessness or desire to keep moving
shuffling walk
slowed movements
stiffness of the arms and legs
trembling and shaking of the fingers and hands
uncontrolled chewing movements
uncontrolled movements of the arms or legs
Less common
Constipation (severe)
difficult urination
inability to move the eyes
muscle spasms, especially of the neck and back
skin rash
twisting movements of the body
Rare
Difficult or fast breathing
fast heartbeat or irregular pulse
fever (high)
high or low blood pressure
increased blinking or spasms of the eyelid
increased sweating
loss of bladder control
muscle stiffness (severe)
seizures
sore throat and fever
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual bleeding or bruising
unusual facial expressions or body positions
unusual tiredness or weakness
unusually pale skin
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Dizziness, faintness, or lightheadedness when suddenly getting up from a lying or sitting position
drowsiness (severe)
irregular, fast or slow, or shallow breathing
loss of consciousness
muscle trembling, jerking, stiffness, or uncontrolled movements (severe)
pale or blue lips, fingernails, or skin
troubled breathing (severe)
unusual tiredness or weakness (severe)
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Blurred vision
confusion
dizziness, lightheadedness, or fainting
drowsiness
dryness of the mouth
Less common
Constipation (mild)
decreased sexual ability
enlargement of the breasts (males and females)
headache
increased sensitivity of the skin to sunlight
missing menstrual periods
nausea or vomiting
trouble with sleeping
unusual secretion of milk
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Loxapine
Pros
- A good option if other schizophrenia medications haven't worked or have caused bothersome side effects
- Dose can be adjusted by your provider based on your response
- Available as a lower-cost generic medication
Cons
- More likely to cause trouble controlling movements compared to other treatment options
- Can raise your heart rate and lower your blood pressure
- Risk of developing abnormal muscle movements that might not go away after you stop taking loxapine
Pharmacist tips for Loxapine
- Loxapine can cause drowsiness, sleepiness, and dizziness. Don't drive or do anything that requires concentration until you know how loxapine affects you.
- Loxapine can cause your blood pressure to drop when you change positions. This can cause falls and fainting. Be very careful when you stand after sitting or lying down.
- Talk to your provider if you have a history of heart conditions. Loxapine can raise your pulse. It can also lower your blood pressure.
- Loxapine is an anticholinergic medication. This class of medications can cause constipation, dry mouth, and blurred vision. It can also worsen conditions, such as glaucoma and difficulty urinating. Taking loxapine with other medications, such as benztropine (Cogentin), trihexyphenidyl (Artane), and diphenhydramine (Benadryl), can worsen these side effects. Let your provider know if any of these symptoms become bothersome.
- Antipsychotic medications can cause abnormal muscle movements called tardive dyskinesia. Usually, this problem goes away when you stop the medication, but there's a chance it might not. Let your healthcare provider know if you start having muscle twitches, smacking your lips, sticking your tongue out, or having trouble controlling your face or mouth.
Common questions about Loxapine
You might start to feel the calming effects of Loxapine within 20 to 30 minutes, but it can take longer to feel the full effects. Keep in mind that when you're starting Loxapine for the first time, it might take some time before you and your provider find the right dose of the medication that works best for you. Talk with your provider if you're not sure whether this medication is working for you.
Weight gain and weight loss have both been reported by people who've taken Loxapine, but it's unclear if the medication has a definitive effect on weight. If weight gain is a concern, talk to your provider before starting Loxapine.
Loxapine can cause drowsiness, but it's usually mild and typically only occur when you first start the medication or when your provider raises your dose. Sleepiness generally starts within 20 to 30 minutes after taking the medication, is strongest within around 1.5 to 3 hours, and can last up to 12 hours. Let your provider know if you feel very drowsy and they can check to see if they need to adjust your dose of Loxapine.
Some people did report feeling more agitated while taking Loxapine, but it's not a common side effect. In general, this medication is sedating, which means it helps calm you down or make you more sleepy. In fact, people do report feeling drowsy when they first starting Loxapine for the first time or whenever their provider raises their dose. If you feel more anxious after starting Loxapine, contact your healthcare provider.
Drinking alcohol isn't recommended while you're taking Loxapine. Combining Loxapine with alcohol might not only worsen your health condition, but might also worsen side effects like drowsiness, problems with coordination, and trouble thinking clearly.
If you're pregnant or thinking of becoming pregnant, tell your provider before starting Loxapine. This medication hasn't been well-studied in human pregnancy. But taking antipsychotics, including Loxapine, during the third trimester of pregnancy can be harmful to your baby. Your baby might be born with movement disorders or withdrawal symptoms, such as agitation, stiff or limp muscles, shakiness, sleepiness, high-pitched crying, and poor feeding.
Yes, loxapine is available as an inhaler called Adasuve. Adasuve is only used to treat agitation related to schizophrenia and bipolar I disorder and it has to be given by a healthcare provider.
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Risks and warnings for Loxapine
Loxapine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk of death in older adults
- Risk factors: Older adults with dementia-related psychosis
People over the age of 65 who also have dementia sometimes have some schizophrenia-like symptoms, such as hallucinations. Older people with dementia-related psychosis have a higher risk of death if they take medications like loxapine. Because of this risk, loxapine shouldn't be used in people 65 years and older with dementia-related psychosis. Let your provider know if you or your loved one has dementia before starting loxapine.
Uncontrollable body movements (tardive dyskinesia)
- Risk factors: Long-term use | Taking high doses of loxapine or other antipsychotics | Older age | Female and 65 years or older
Loxapine, like all antipsychotics, can cause uncontrollable movements (tardive dyskinesia) involving your face, tongue, and other body parts. Symptoms include shaking, muscle stiffness, or feeling like you can't sit still. This condition might go away once you stop the medication, but there's a chance it can become permanent. The risk is greatest if you've been taking loxapine for a long time or have been taking high doses, but it can also occur at any point during treatment or at any dose. Tell your provider right away if you notice any unusual movements.
Neuroleptic malignant syndrome
Loxapine can cause a rare but life-threatening condition called neuroleptic malignant syndrome (NMS). Symptoms of NMS include high fever, muscle stiffness, confusion, sweating, and changes in heart rate and blood pressure. If you notice any of these symptoms, get medical help right away.
Falls
- Risk factors: Conditions or taking medications that make you dizzy or less alert
Loxapine can cause a sudden drop in blood pressure, sleepiness, and problems with balance. Dizziness, falls, and fainting can happen due to a sudden drop in blood pressure when you change positions, such as going from sitting to standing. To avoid falling, change positions slowly until your body is used to the medication.
Low white blood cell count
- Risk factors: History of low white blood cell count
Loxapine can lower the amount of white blood cells (WBCs) in your body. WBCs help your body fight off infections and diseases. Having fewer WBCs means you're more likely to get sick. If you notice a fever or that you're getting sick more easily, let your provider know right away. Blood tests might be done before you start loxapine and during the first few months of taking this medication to make sure that you have a healthy amount of white blood cells. If the amount of white blood cells in your body is too low, you'll need to stop the medication.
Seizures
- Risk factors: History of seizures | Conditions that make it easier to have seizures
Loxapine can make you more likely to have seizures, especially if you have a history of seizures or have conditions that make it easier to have a seizure. Let your provider know if you've had seizures in the past before starting the medication, so your provider can monitor you more closely.
Vision changes
- Risk factors: Long-term use
Loxapine can cause vision changes, especially if it's taken for a long time. Let your provider know right away if you notice any changes in your vision.
High prolactin levels
Loxapine can cause the prolactin levels in your blood to go up. Prolactin is a hormone in your body that affects lactation and the reproductive system. High prolactin levels can lead to milky nipple discharge, enlarged male breasts, sexual dysfunction, absent or irregular menstrual periods, and weak bones. Let your provider know if you experience these symptoms.
Loxapine dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 capsules | $19.65 | $0.66 |
| 10mg | 60 capsules | $25.46 | $0.42 |
| 5mg | 90 capsules | $35.83 | $0.40 |
| 50mg | 30 capsules | $28.26 | $0.94 |
Typical dosage for Loxapine
The dose depends on how severe your symptoms are and how you've responded to other medications for schizophrenia in the past.
In general, the typical starting dose is 10 mg by mouth twice a day. Your healthcare provider will raise your dose rather quickly over the first 7 to 10 days until your symptoms of schizophrenia are controlled. The typical maintenance dose ranges from 20 mg to 100 mg daily. The maximum daily dose is 250 mg.
Interactions between Loxapine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bromopride
- Metoclopramide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acepromazine
- Alfentanil
- Alprazolam
- Amifampridine
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amobarbital
- Amoxapine
- Anileridine
- Aripiprazole
- Asenapine
- Baclofen
- Belladonna
- Belladonna Alkaloids
- Benperidol
- Benzhydrocodone
- Bromazepam
- Buprenorphine
- Bupropion
- Buspirone
- Butabarbital
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbamazepine
- Carbinoxamine
- Carisoprodol
- Carphenazine
- Cetirizine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpromazine
- Chlorzoxazone
- Clobazam
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Codeine
- Cyclobenzaprine
- Desipramine
- Dexmedetomidine
- Diacetylmorphine
- Diazepam
- Dibenzepin
- Dichloralphenazone
- Difenoxin
- Dihydrocodeine
- Diphenhydramine
- Diphenoxylate
- Donepezil
- Doxepin
- Doxylamine
- Droperidol
- Enflurane
- Epinephrine
- Esketamine
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethopropazine
- Ethylmorphine
- Fentanyl
- Flibanserin
- Fluphenazine
- Flurazepam
- Fluspirilene
- Fospropofol
- Gabapentin
- Gabapentin Enacarbil
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Halazepam
- Haloperidol
- Halothane
- Hexobarbital
- Hydrocodone
- Hydromorphone
- Hydroxyzine
- Imipramine
- Isoflurane
- Ketamine
- Ketazolam
- Ketobemidone
- Lemborexant
- Levocetirizine
- Levorphanol
- Lithium
- Lofepramine
- Lofexidine
- Lorazepam
- Magnesium Oxybate
- Meclizine
- Melitracen
- Melperone
- Meperidine
- Mephobarbital
- Meprobamate
- Meptazinol
- Mesoridazine
- Metaxalone
- Methacholine
- Methadone
- Methdilazine
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Methylene Blue
- Midazolam
- Milnacipran
- Molindone
- Moricizine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nicomorphine
- Nitrazepam
- Nitrous Oxide
- Nortriptyline
- Olanzapine
- Opipramol
- Opium
- Opium Alkaloids
- Orphenadrine
- Oxazepam
- Oxycodone
- Oxymorphone
- Papaveretum
- Paregoric
- Pentazocine
- Pentobarbital
- Perampanel
- Perazine
- Periciazine
- Perphenazine
- Phenobarbital
- Pimozide
- Piperacetazine
- Pipotiazine
- Piritramide
- Potassium Oxybate
- Prazepam
- Pregabalin
- Primidone
- Prochlorperazine
- Promazine
- Promethazine
- Propofol
- Protriptyline
- Quazepam
- Quetiapine
- Ramelteon
- Remifentanil
- Remimazolam
- Remoxipride
- Revefenacin
- Scopolamine
- Secobarbital
- Secretin Human
- Sertindole
- Sodium Oxybate
- Sufentanil
- Sulpiride
- Suvorexant
- Tapentadol
- Temazepam
- Thiethylperazine
- Thiopental
- Thiopropazate
- Thioridazine
- Tianeptine
- Tilidine
- Tiotropium
- Tizanidine
- Tolonium Chloride
- Topiramate
- Tramadol
- Trazodone
- Triazolam
- Trifluoperazine
- Trifluperidol
- Triflupromazine
- Trimeprazine
- Trimipramine
- Zaleplon
- Zolpidem
- Zopiclone
- Zotepine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Betel Nut
How much does Loxapine cost?
$19.65
Loxapine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Loxapine will not be safe for you to take.
- In a coma or sedated state caused by alcohol or medications
- Allergy to loxapine or amoxapine
What are alternatives to Loxapine?
Loxapine images
