Loxapac (loxapine)

Loxapac  (loxapine)
Brand name: Loxapac ®
Active ingredient name: Loxapine
Type of drug: Typical antipsychotic
Form: Oral tablets, oral solution, short acting injection
Brand name available in Canada from: Sandoz Canada Inc.
Generic: Yes: Apo-Loxapine (Apotex Inc.); Dom-Loxapine Tablets (Dominion Pharmacal); Nu-Loxapine (Nu-Pharm Inc.); PHL-Loxapine (Pharmel Inc.); Loxapine (MM Therapeutics Inc.)
Listed on Ontario formulary: Yes


What is Loxapac used for?
Loxapac is used to treat symptoms of schizophrenia and other psychotic illnesses in adults and adolescents 16 years and older. It can also be used to treat other conditions. Discuss with your doctor the reason you are using Loxapac.

How should I take Loxapac?
Loxapac can be taken with or without food. It is often taken twice daily, but can also be taken once daily. Discuss your dosing schedule with your physician.
 
How much Loxapac should I take?
Loxapac is available as 2.5, 5, 10, 25, and 50 mg tablets. The oral solution is available in a 25 mg/mL concentration. The injection is available in a 50 mg/mL concentration.
 
If you are taking an oral form of Loxapac, your initial dose will usually be 10 mg twice daily. Most people need between 60 and 100 mg daily, but your doctor will decide on the ideal dose based on your response, up to a maximum of 250 mg a day. Some individuals may be on higher doses.  Discuss your dose with your prescriber.
 
The injectable form of Loxapac is a short-acting injection most often used in a hospital setting to help calm patients. It is used short-term and not continued into the community.
 
What are the common side effects seen with Loxapac

Side effects of Loxapac may include:

  • Abnormal movements (extrapyramidal symptoms)
  • Changes in monthly menstrual cycle (amenorrhea)
  • Decreased sexual interest and/or function
  • Swelling of breasts and milk production in males and females
  • Blurred vision
  • Dizziness
  • Drowsiness
  • Dryness of mouth
  • Headache
  • Increased sensitivity of skin to sun
  • Nausea or vomiting
  • Weight gain (less compared to atypical antipsychotics)

What are rare but potentially serious adverse effects with Loxapac?

  • Decrease in white blood cell count (agranulocytosis)
  • Neuroleptic Malignant Syndrome (NMS)
  • Sudden cardiac death (heart attack)
  • Torsades de pointes (serious heart arrhythmia)

Warnings/Precautions
Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics.  Most deaths appear to be either cardiovascular or infectious.  Xylac is not approved for the treatment of dementia-related psychosis.  Some individuals with dementia may however be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.

 
What medications interact with Loxapac?
Tell all your doctors, pharmacists, and dentist that you are taking Loxapac. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription and herbal and vitamin products

The following types of medications may interaction with Loxapac:

  • Certain medications for  allergies (e.g., Benadryl [diphenhydramine])
  • Certain medications for sleep (e.g., lorazepam, zopiclone)
  • Certain medications for pain (e.g., fentanyl)
  • Antiparkinson medications

Avoid drinking alcohol or using illegal drugs while taking Loxapac.

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