Adasuve
loxapine
loxapine
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or nurse.
If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
What ADASUVE is and what it is used for
What you need to know before you use ADASUVE
How to use ADASUVE
Possible side effects
How to store ADASUVE
Contents of the pack and other information
ADASUVE contains the active substance loxapine, which belongs to a group of medicines called antipsychotics. ADASUVE works by blocking certain chemicals in the brain (neurotransmitters) such as dopamine and serotonin thus causing calming effects and relieving aggressive behaviour.
ADASUVE is used to treat acute symptoms of mild-to-moderate agitation that may occur in adult patients who have schizophrenia or bipolar disorder. These are diseases characterised by symptoms such as:
(Schizophrenia) Hearing, seeing, or sensing things which are not there, suspiciousness, mistaken beliefs, incoherent speech and behaviour and emotional flatness. People with this condition may also feel depressed, guilty, anxious or tense.
(Bipolar disorder) Feeling “high”, having excessive amounts of energy, needing much less sleep than usual, talking very quickly with racing ideas, and sometimes severe irritability.
if you are allergic to loxapine or amoxapine;
if you have symptoms of wheezing or shortness of breath;
if you have lung problems like asthma or chronic obstructive pulmonary disease (which your doctor may have called “COPD”).
Your doctor or nurse will talk to you before you use ADASUVE and determine whether it is appropriate for you.
ADASUVE may cause narrowing of the airways (bronchospasm) and may cause you to wheeze, cough, feel chest tightness or have shortness of breath. Typically, this will occur within 25 minutes of use.
Neuroleptic Malignant Syndrome (NMS) is a set of symptoms that can occur if you are taking antipsychotic medicines, including ADASUVE. These symptoms can be high fever, rigid muscles,
irregular or fast heart rate or pulse. NMS can cause death. Do not use ADASUVE again if NMS occurs.
Antipsychotic medicines like ADASUVE can cause movements that you may not be able to control including making faces, sticking out your tongue, smacking or puckering your lips, blinking rapidly, or moving your legs, arms or fingers rapidly. Treatment with ADASUVE may have to be stopped if this occurs.
ADASUVE should be used with caution in patients who are intoxicated or delirious.
Before treatment with ADASUVE, tell your doctor or nurse if you:
have or had breathing problems like asthma or other chronic lung diseases such as bronchitis or emphysema
have or had heart problems or stroke
have or had low or high blood pressure
have or had seizures (convulsions)
have or had glaucoma (increased pressure in the eye)
have or had urinary retention (incomplete emptying of the bladder)
already used ADASUVE and you developed symptoms of wheezing or shortness of breath
ever had muscle or eye movements you can’t control, lack of coordination, sustained muscle contraction, or feeling restless or unable to sit still
are an older person with dementia (loss of memory and other mental abilities).
ADASUVE is not for use in children and adolescents under 18 years.
Tell your doctor if you are using or have recently used or might use any other medicines, including:
adrenaline
medicines to treat a breathing problem
medicines that may put you at a risk for seizures (for example, clozapine, tricyclics or SSRIs, tramadol, mefloquine)
medicines to treat Parkinson’s disease
lorazepam or other centrally acting medicines (to treat anxiety, depression, pain, or to help you sleep) or any other medicines that cause sleepiness
recreational (illegal) drugs
medicines like fluvoxamine, propranolol, and enoxacin and other medicines that inhibit a certain liver enzyme called “CYP450 1A2.”
medicines to treat schizophrenia, depression, or pain since you may be more at risk for seizures Using ADASUVE and adrenaline together may cause your blood pressure to drop.
Because ADASUVE affects the nervous system, alcohol should be avoided when using ADASUVE.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine. You should not breast-feed for a period of 48 hours after receiving ADASUVE and should discard the milk produced in the meantime.
The following symptoms may occur in newborn babies of mothers that have repeatedly used antipsychotic medicines in the last three months of their pregnancy: shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.
Do not drive or use any tools or machines after using ADASUVE until you know how ADASUVE affects you since dizziness, sedation, and sleepiness have been reported as a potential side effect of ADASUVE.
Always use this medicine exactly as your doctor or nurse has told you. Check with your doctor or nurse if you are not sure.
The recommended initial dose is 9.1 mg. After 2 hours, your doctor may prescribe a second dose after carefully considering your condition and your dose may be reduced to 4.5 mg if your doctor believes that this is a more appropriate dose to treat your condition.
You will use ADASUVE under the supervision of a doctor or nurse.
ADASUVE is for inhalation use. After the doctor or nurse has prepared ADASUVE for you to use, you will be asked to take the device in your hand, exhale and then put the mouthpiece in your mouth, inhale the medicine through the device and then hold your breath briefly.
If you are concerned that you are given more ADASUVE than you feel necessary, tell your doctor or nurse of your concern. Patients who have been given more ADASUVE than they should may experience any of the following symptoms: extreme tiredness or sleepiness, trouble breathing, low blood pressure, throat irritation or a bad taste in the mouth, muscle or eye movements you can’t control.
If you have any further questions on the use of this medicine, ask your doctor or nurse.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
If you get any of the following side effects, talk to your doctor immediately and stop taking the medicine:
any breathing symptoms such as wheezing, cough, shortness of breath, or chest tightness, as these could mean that the medicine is irritating your airways (uncommon occurrence unless you have asthma or COPD);
light-headedness or fainting, as these could mean that the medicine is lowering your blood pressure (uncommon occurrence);
worsening agitation or confusion, especially combined with fever or muscle stiffness (rare occurrence). These can be associated with a severe condition called neuroleptic malignant syndrome (NMS)
Additional side effects which have been related to long term use of loxapine by mouth and which may be relevant for ADASUVE include faintness upon standing, increased heart rate, increased blood pressure, blurred vision, dry eyes, and decreased urination.
If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this
medicine.
Keep this medicine out of the sight and reach of children.
Do not use ADASUVE after the expiry date which is stated on the product label. The expiry date refers to the last day of that month.
Store in the original pouch until ready for use in order to protect from light and moisture.
Do not use ADASUVE if you notice an open or torn pouch or any signs of physical damage to the medicine.
Do not throw away any medicines via household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
The active substance is loxapine. Each single-dose inhaler contains 5 mg loxapine and delivers 4.5 mg of loxapine.
ADASUVE 4.5 mg inhalation powder, pre-dispensed consists of a single-dose, disposable white plastic inhaler that contains loxapine. Each inhaler is packaged in a sealed foil pouch. ADASUVE 4.5
mg is supplied in a carton of 1 or 5 single dose inhalers.
Ferrer Internacional, S.A. Gran Vía Carlos III, 94
08028- Barcelona España
Ferrer Internacional, S.A.
Joan Buscalla, 1-9, 08173 Sant Cugat del Vallès Barcelona, Spain
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
AOP Orphan Pharmaceuticals AG LT Tel +370 672 12222
AOP Orphan Pharmaceuticals AG BG Teл.: +35 988 6666096
AOP Orphan Pharmaceuticals AG CZ Tel: +420 251 512 947
AOP Orphan Pharmaceuticals AG HU Tel.: +36 1 3192633
Ferrer Internacional, S.A.
Tlf: +34 93 600 37 00
Ferrer Internacional, S.A. Tel.: +34 93 600 37 00
Ferrer Deutschland GmbH Tel: +49 (0) 2407 502311 0
Ferrer Internacional, S.A. Tel.: +34 93 600 37 00
AOP Orphan Pharmaceuticals AG LT Tel: +370 672 12222
Ferrer Internacional, S.A.
Tlf: +34 93 600 37 00
Ferrer Galenica S.A. Τηλ: +30 210 52 81 700
AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244-0
Ferrer Farma, S.A. Tel.: +34 93 600 37 00
AOP Orphan Pharmaceuticals S.A. PL Tel: +48 22 5424068
Ferrer Internacional, S.A. Tél: +34 93 600 37 00
Ferrer Portugal, S.A. Tel: +351 214449600
AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244-0
Galenica S.A.
Tel: +30 210 52 81 700
Ferrer Internacional, S.A.
Tel.: +34 93 600 37 00
AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244-0
Ferrer Internacional, S.A.
Sími: +34 93 600 37 00
AOP Orphan Pharmaceuticals AG SK Tel: +421 31 5502271
Angelini S.p.A. Tel: +39 06 780531
Ferrer Internacional, S.A.
Puh/Tel: +34 93 600 37 00
Τhespis Pharmaceutical Ltd Tηλ:
++357 22 67 77 10
Ferrer Internacional, S.A.
Tel: +34 93 600 37 00
AOP Orphan Pharmaceuticals AG LT
Ferrer Internacional, S.A.
Tel +370 672 12222 Tel.: +34 93 600 37 00
The following information is intended for healthcare professionals only:
Read all instructions before use. See the SmPC for more information.
ADASUVE is provided in a sealed pouch.
When ADASUVE is removed from the pouch, the indicator light is off.
The indicator light turns on (green) when the tab is pulled out. The inhaler is then ready for use.
The indicator light automatically turns off again when the medicine is inhaled. Read the following 5 steps before administering ADASUVE to a patient.
Firmly pull the plastic tab from the rear of the inhaler. The green light turns on indicating that the inhaler is ready for use.
Hold the inhaler away from the mouth and breathe out fully to empty lungs.
Inhale through the mouthpiece with a steady deep breath.
Remove the mouthpiece from the mouth and hold breath briefly.
NOTE: If the green light stays on after the patient inhales, instruct the patient to repeat steps 3-5.