Loxapine belongs to the class of medications called antipsychotics. It is used to treat the symptoms of schizophrenia. This medication is believed to work by changing the way that certain nerve signals work in the brain.

Your doctor may choose to use a medication for conditions other than the ones listed in these drug information articles. If you're unsure why you are taking this medication, contact your doctor.

The usual recommended starting dose of loxapine is 10 mg twice daily. Your doctor will increase the dose over time until the best results occur with the least amount of side effects. The first doses of the medication may be given by an injection into the muscle. Once the best dose has been reached, the medication is usually taken in tablet or liquid form by mouth. This medication may be taken with food or with a full 250 mL (eight ounce) glass of milk or water to prevent stomach irritation.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is very important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not double doses.

Apo^®-Loxapine is available as 5 mg, 10 mg, 25 mg, and 50 mg tablets.

5 mg: Each round, yellow, film-coated tablet, engraved "APO" on one side and scored and engraved "LOX" over "5" on the other, contains loxapine succinate equivalent to loxapine 5 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, D&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

10 mg: Each round, green, film-coated tablet, engraved "APO" on one side and scored and engraved "LOX" over "10" on the other, contains loxapine succinate equivalent to loxapine 10 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, D&C Yellow No. 10 Auminum Lake, FD&C Blue No. 1 Aluminum Lake, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

25 mg: Each round, pink, film-coated tablet, engraved "APO" on one side and scored and engraved "LOX" over "25" on the other, contains loxapine succinate equivalent to loxapine 25 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, D&C Red No. 30 Aluminum Lake, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

50 mg: Each round, white, film-coated tablet, engraved "APO"on one side, scored and engraved "LOX" over "50" on the other, contains loxapine succinate equivalent to loxapine 50 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

Loxapine should not be taken by anyone who:

• has an allergy to loxapine or to any of the ingredients of the medication
• is in a coma
• is in a severe drug-induced depressed state from drugs such as alcohol, barbiturates, or narcotics
• is experiencing circulatory collapse

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common:

• blurred vision
• confusion
• dizziness, lightheadedness, or fainting
• drowsiness
• dryness of mouth

  Less common:

• constipation (mild)
• decreased sexual ability
• enlargement of breasts (males and females)
• headache
• increased sensitivity of skin to sun
• missed menstrual periods
• nausea or vomiting
• trouble sleeping
• unusual secretion of milk
• weight gain

Check with your doctor as soon as possible if any of the following side effects occur:

More common:

• difficulty speaking or swallowing
• loss of balance control
• "mask"-like face
• restlessness or desire to keep moving
• shuffling walk
• slowed movements
• stiffness of arms and legs
• trembling and shaking of fingers and hands

  Less common:

• constipation (severe)
• difficult urination
• inability to move eyes
• muscle spasms, especially of the neck and back
• skin rash
• twisting movements of the body

  Rare:

• sore throat and fever
• increased blinking or spasms of eyelid
• uncontrolled twisting movements of neck, trunk, arms, or legs
• unusual bleeding or bruising
• unusual facial expressions or body positions
• yellow eyes or skin

Check with your doctor immediately if any of the following side effects occur:

More common:

• lip smacking or puckering
• puffing of cheeks
• rapid or fine, worm-like movements of tongue
• uncontrolled chewing movements
• uncontrolled movements of arms or legs

Stop taking loxapine and get emergency help immediately if any of the following side effects occur:

Rare:

• convulsions (seizures)
• difficult or fast breathing
• fast heartbeat or irregular pulse
• fever (high)
• high or low blood pressure
• increased sweating
• loss of bladder control
• muscle stiffness (severe)
• unusually pale skin
• unusual tiredness or weakness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Tardive dyskinesia: A syndrome consisting of potentially irreversible, involuntary movements called tardive dyskinesia may develop for people treated with this medication. Although the risk of tardive dyskinesia appears to be highest among seniors, especially senior women, it is impossible to predict, at the beginning of treatment, which people are likely to develop the syndrome. Tell your doctor if you start to experience signs of this syndrome.

Occupational hazards: Loxapine may impair mental or physical abilities, especially during the first few days of treatment. Avoid activities requiring alertness (e.g., operating vehicles or machinery) until you know how this medication affects you. Alcohol and other sedating drugs can make you even less alert when used at the same time as this medication.

Medical conditions: This medication is not recommended for use by people suffering from blood disorders or severe liver disease.

Loxapine should be used with extreme caution by people with a history of seizure disorders, since it increases the risk of seizures. Loxapine should be used with caution by people with heart disease, glaucoma, or a tendency for urinary retention.

Pregnancy and breast-feeding: Safe use of loxapine during pregnancy or nursing has not been established. If you are or may be pregnant, or if you are breast-feeding, talk to your doctor about the risks and benefits of using this medication.

Children: The safety and efficacy of this medication have not been established for use by children and adolescents. Therefore, its use is not recommended for those below the age of 16 years.

The following may affect how loxapine works or increase the risk of side effects:

• alcohol
• antipsychotic medications
• benzodiazepines
• methyldopa
• metoclopramide
• pemoline
• pimozide
• promethazine
• tricyclic antidepressants

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.