*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Loxapine is a medication used to treat schizophrenia. It’s a first-generation antipsychotic that works in the brain to rebalance dopamine, improving thinking, mood, and behavior. Schizophrenia symptoms it addresses include hallucinations, which are non-existing voices or images that seem real. This drug’s effectiveness has been established in clinical studies involving acutely ill schizophrenic patients.
If you’re considering Loxapine, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Loxapine or another medication may help your symptoms.
Boxed Warning: Loxapine – Risk of Death in Elderly Patients with Dementia-Related Psychosis
Loxapine has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Loxapine can cause an increased risk of death in elderly patients with dementia-related psychosis. Regardless of your age, you should talk with your doctor about serious risks with loxapine and any other medications before starting treatment.
What Is Loxapine?
Loxapine is a medication used to help people with schizophrenia. It’s in a group of medicines known as first-generation antipsychotics. Loxapine works by changing how certain chemicals in the brain interact, which can improve schizophrenia symptoms for some people.1
The U.S. Food and Drug Administration (FDA) has checked and approved loxapine to make sure it’s safe and works for treating schizophrenia. This approval means that doctors can use it as a trusted treatment for this specific condition. However, like any medication, it can have some side effects, which include trouble speaking or involuntary movements.1
Schizophrenia Treatment, Covered by Insurance
Grow Therapy enables you to find a psychiatrist or psychiatric nurse practitioner who can diagnose your condition, prescribe appropriate medications, and monitor your reaction to medication. Find A Provider
Are Clozapine & Loxapine the Same Thing?
No, clozapine and Loxapine are not the same. They are both used to help with mental health issues, but they work differently.
One big difference is that you need regular blood tests when using clozapine to watch for changes in white blood cell count. With Loxapine, you don’t need those tests because it’s less likely to cause that issue. So, they have some similarities but also important differences.2
How Does Loxapine Work?
Loxapine works by helping to balance certain chemicals in the brain. When these chemicals are out of balance, it can lead to problems like confusion, mood swings, and impulsive thoughts.1
Loxapine affects the way these chemicals bind in the brain, which can make people feel more like themselves and improve issues like hearing voices or seeing things that aren’t real, which often happen in conditions like schizophrenia.
How Sedating Is Loxapine?
Loxapine can have sedative effects, which means it can make you feel drowsy or sleepy. This sedation can vary from person to person. Some individuals may experience significant drowsiness when taking loxapine, while others may not feel as affected. It’s important to discuss these potential sedative effects with your healthcare provider, as they can help you determine the best time to take the medication and whether it’s suitable for your specific needs.
What Is Loxapine Used to Treat?
Loxapine is an FDA-approved medication primarily used to treat schizophrenia. FDA approval signifies that the drug has undergone thorough testing and is proven to be safe and effective for specific conditions. In some cases, healthcare providers may also use loxapine “off-label,” which means for conditions other than its FDA-approved use.
Some off-label uses of loxapine, as with other antipsychotic medications, may include treating conditions like anxiety, personality disorders, or post-traumatic stress disorder (PTSD).3 Prescribers might choose off-label use based on their clinical judgment when they believe it could benefit a patient, even though it hasn’t received formal FDA approval for those conditions.
Common Side Effects of Loxapine
Common side effects of loxapine may include difficulties with speaking or swallowing, unusual facial movements like lip smacking or puffing of the cheeks, loss of balance control, and restlessness. While these effects can be concerning, not everyone experiences them, and they may not always require medical attention.
Common side effects of loxapine include:1
- Difficulty with speaking or swallowing
- Lip smacking or puckering
- Dizziness
- Loss of balance control
- Mask-like face
- Puffing of the cheeks
- Tongue protrusion
- Restlessness or desire to keep moving
*All medications, including loxapine, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Loxapine
Serious side effects of loxapine can affect different parts of your body and need quick medical attention. They include issues of dizziness and confusion. You might also experience muscle problems that make you move strangely or have trouble breathing. Some of these problems can become long-lasting.
Serious side effects of loxapine include:1
- Seizures
- Muscle issues and difficulty breathing
- Persistent tardive dyskinesia with involuntary facial movements
- Rapid or low blood pressure
- Rare hematologic problems
- Skin reactions
- Anticholinergic effects, causing dry mouth and constipation
- Gastrointestinal issues, including nausea and vomiting
- Liver damage, which can cause elevated liver enzymes
- Other reactions like weight changes and paresthesia (tingling sensations).
*All medications, including loxapine, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Resources For Schizophrenia
Treatment for Schizophrenia, Covered by Insurance – Grow Therapy enables you to find a psychiatrist or psychiatric nurse practitioner who can diagnose your condition, prescribe appropriate medications, and monitor your reaction to medication. Find A Provider
Schizophrenia Newsletter – Free newsletter from Choosing Therapy for those impacted by Schizophrenia. Get encouragement, tips, and latest info sent twice per week. Sign Up
Loxapine Warnings & Precautions
Taking loxapine comes with important warnings and precautions. Elderly patients with dementia-related issues should avoid it due to the increased risk of harm. Always discuss these concerns with your healthcare provider.
Avoid taking loxapine if you:1
- You are diagnosed with dementia-related psychosis: Loxapine is not approved for this condition and can pose risks, especially to elderly patients.
- You have a history of tardive dyskinesia: Tardive dyskinesia is a condition characterized by potentially irreversible, involuntary, and abnormal movements, often involving the face and mouth. Loxapine use may worsen these symptoms. While the risk is highest among the elderly, especially elderly women, it’s challenging to predict which patients may develop this condition when starting antipsychotic treatment.
- You have a history of neuroleptic malignant syndrome (NMS): Neuroleptic malignant syndrome (NMS) is a severe and potentially fatal reaction that can occur in association with antipsychotic drugs like loxapine. NMS is characterized by a combination of symptoms, including extremely high body temperature, muscle rigidity, confusion, and autonomic instability (such as irregular pulse or blood pressure).
- You are allergic to loxapine or any of its components: Allergic reactions can be harmful, so it’s essential to avoid the medication if you have known allergies.
- You have a history of seizures or convulsive disorders: Loxapine may lower the threshold for seizures, potentially leading to more frequent or severe episodes. It’s especially important for individuals with a history of seizures to be cautious when using loxapine.
- You have a history of cardiovascular disease: Loxapine can affect heart function, causing changes in pulse rates and blood pressure. Individuals with pre-existing heart conditions should be closely monitored while using this medication.
- You are at risk for falls: Loxapine may cause drowsiness and postural hypotension, increasing the risk of falls and potential injuries. This risk should be assessed, especially for individuals who are more vulnerable to falls.
- You have a history of blood disorders: Rarely, loxapine has been associated with blood-related issues like leukopenia, neutropenia, and agranulocytosis. Patients with a history of these conditions should have their blood counts monitored frequently during treatment.
- You are pregnant or breastfeeding: Loxapine’s safety during pregnancy and lactation is not well-established, and potential risks to both the mother and child should be carefully weighed. Pregnant or nursing individuals should discuss the benefits and risks with their healthcare provider before using loxapine.
Loxapine Dosages for FDA-Approved Treatment
Loxapine doses vary based on individual factors such as age and the condition being treated. Typically, treatment begins with an initial dose of 10 mg twice daily, which may be increased to a total of 50 mg daily for severely disturbed patients. The therapeutic and maintenance range usually falls between 60 mg and 100 mg daily, with some individuals requiring higher or lower doses.1
However, daily doses exceeding 250 mg are not recommended. Loxapine is approved for adults and not indicated for children. For off-label uses, dosages are determined by healthcare providers based on individual needs.
Loxapine Forms & Strengths
Loxapine is available in various strengths to cater to individual needs. It comes in oral capsules, with strengths ranging from 5 mg to 100 mg. The choice of strength depends on the patient’s condition and individual response. Prescribers consider factors like the patient’s age, medical history, and the need for rapid symptom control.1
While standard capsules typically act relatively quickly, there are no extended-release or sustained-release formulations for loxapine, so dosages and forms are adjusted based on the patient’s specific requirements for managing symptoms.
Loxapine is available in the following forms and strengths:1
- 5 mg oral capsule
- 10 mg oral capsule
- 25 mg oral capsule
- 50 mg oral capsule
- 100 mg oral capsule
How Should I Take Loxapine?
To take loxapine effectively, follow your prescriber’s instructions closely. It comes in capsule form for oral ingestion and is usually taken two to four times a day. Aim to take your doses at consistent times daily. While it can be taken with or without food, it’s a good idea to establish a routine that works best for you and minimizes the chances of missing a dose.
It’s vital to adhere to your healthcare provider’s recommendations to ensure the medication’s effectiveness and manage your condition properly. If you have any questions or concerns about your dosage or the timing of your doses, don’t hesitate to consult your doctor or pharmacist for guidance.
What Happens If I Miss a Dose of Loxapine?
If you miss a dose of loxapine, take it as soon as you remember. However, if it’s close to the time for your next scheduled dose, skip the missed one and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one. It’s important to maintain a consistent dosing routine, but if you have questions or concerns about missed doses, consult your healthcare provider for guidance on how to proceed.
Schizophrenia Treatment, Covered by Insurance
Grow Therapy enables you to find a psychiatrist or psychiatric nurse practitioner who can diagnose your condition, prescribe appropriate medications, and monitor your reaction to medication. Find A Provider
Can You Overdose on Loxapine?
An overdose of loxapine is possible and may lead to various symptoms, depending on the amount consumed and individual tolerance. These symptoms can range from mild central nervous and cardiovascular system depression to severe outcomes like low blood pressure, breathing difficulties, and loss of consciousness.1
If an overdose is suspected, immediate medical attention is crucial. Treatment is primarily supportive and may include gastric lavage, dialysis, and specific symptom management, such as anticholinergic agents for extrapyramidal symptoms. Seek prompt medical care if an overdose is suspected.
What Should You Do If You Take Too Much Loxapine?
If you take too much loxapine, it’s essential to seek immediate medical attention. Contact your healthcare provider, go to the nearest emergency room, or call a poison control center if available. Do not delay in getting professional medical assistance, as prompt intervention is crucial in cases of potential overdose.
What to Avoid When Taking Loxapine
When taking loxapine, it’s important to avoid certain situations. Don’t use loxapine if you’re heavily sedated due to alcohol, barbiturates, or narcotics. Also, if you know you’re allergic to dibenzoxazepines, a group of compounds including loxapine, you should not take it. These precautions help prevent adverse reactions and ensure safe use of the medication. Always tell your healthcare provider about any medications, substances, or allergies you have to get the right guidance on using loxapine.
8 substances you should avoid while taking loxapine include:1
- Alcohol: Combining alcohol with loxapine can increase drowsiness and may be unsafe.
- Barbiturates: Using barbiturates along with loxapine can lead to excessive sedation and should be avoided.
- Narcotics: Narcotic medications can intensify the sedative effects of loxapine, so do not combine them.
- CNS depressants: Other central nervous system depressants, like sedatives or tranquilizers, may interact with loxapine and lead to increased sedation.
- Grapefruit: Grapefruit and grapefruit juice can interact with loxapine and may affect its metabolism, so it’s advised to avoid them.
- Herbal supplements: Some herbal supplements can have sedative effects that may interact with loxapine, so consult your healthcare provider before using them.
- Over-the-counter medications: Non-prescription drugs like antihistamines or sleep aids may increase drowsiness when combined with loxapine.
- Other antipsychotic medications: Using multiple antipsychotic medications simultaneously can lead to excessive sedation and is generally discouraged.
How to Get a Prescription for Loxapine
To obtain a prescription for loxapine, you’ll need to consult with a qualified healthcare provider, typically a psychiatrist, a psychiatric nurse practitioner, or a general practitioner. They will assess your condition, medical history, and symptoms to determine if loxapine is a suitable and helpful treatment for your specific needs.
This evaluation may include discussing your mental health history, conducting a physical examination, and possibly ordering additional tests to ensure an accurate diagnosis. If your healthcare provider deems loxapine appropriate for your condition, they will provide you with a prescription, along with guidance on how to take the medication safely and effectively.
Questions to Ask Your Healthcare Provider About Loxapine
If you are considering or currently taking loxapine, it’s important to have an open dialogue with your healthcare provider, psychiatrist, and therapist. You may want to discuss questions about its effectiveness, potential side effects, the right dosage, and how it fits into your overall treatment plan.
If you’re considering a change in medication or prescriber, online psychiatry services can be a convenient option, allowing you to connect with qualified professionals from the comfort of your own home.
Questions to ask your care team about loxapine include:
- How safe is loxapine, and what are the potential side effects I should watch for?
- What is the expected timeframe for me to adjust to taking loxapine, and when can I expect to see improvements in my symptoms?
- Are there any interactions or risks associated with taking loxapine alongside other medications I’m currently using?
- What is the recommended dosage of loxapine to minimize side effects while effectively managing my condition?
- Can you explain the signs of potential allergic reactions or serious side effects I should be aware of?
- Are there lifestyle changes, dietary restrictions, or activities I should avoid while taking loxapine?
- What is the plan for regular monitoring and follow-up to assess my progress and address any concerns?
- How do I handle a missed dose, and what should I do if I accidentally take more than the prescribed amount?
- Can you provide guidance on the best practices for taking loxapine, such as with or without food?
- Are there any potential long-term effects or risks I should be aware of with loxapine treatment?
- What alternatives or additional therapies should I consider alongside loxapine to support my overall mental health?
- Can you explain the process for adjusting the dosage if needed, and what factors may necessitate such changes?
- How can I best communicate any changes or concerns related to my mental health while taking loxapine?
- Are there specific lifestyle modifications or coping strategies that can enhance the effectiveness of loxapine in managing my condition?
In My Experience
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
Treatment for Schizophrenia, Covered by Insurance – Grow Therapy enables you to find a psychiatrist or psychiatric nurse practitioner who can diagnose your condition, prescribe appropriate medications, and monitor your reaction to medication. Find A Provider
Talk Therapy – BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free assessment
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