Patient leaflet - Adasuve
1. What ADASUVE is and what it is used for
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.
2. What you need to know before you use ADASUVE 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”).
Warnings and precautions
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).
Children and adolescents
ADASUVE is not for use in children and adolescents under 18 years.
Other medicines and ADASUVE
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.
ADASUVE with alcohol
Because ADASUVE affects the nervous system, alcohol should be avoided when using ADASUVE.
Pregnancy and breast-feeding
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.
Driving and using machines
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.
3. How to use 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 use more ADASUVE than you should
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.
4. Possible side effects
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)
Also talk to your doctor if you have any of the following side effects that could also happen with other forms of this medicine:
Very common (may affect more than 1 in 10 people): bad taste in the mouth or sleepiness.
Common (may affect up to 1 in 10 people): dizziness, throat irritation, dry mouth or tiredness.
Uncommon (may affect up to 1 in 100 people): muscle or eye movements you can’t control, lack of coordination, sustained muscle contraction, or feeling restless or unable to sit still.
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.
Reporting of side effects
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.
5. How to store ADASUVE
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.
6. Contents of the pack and other informationThe active substance is loxapine. Each single-dose inhaler contains 5 mg loxapine and delivers 4.5 mg of loxapine.
What ADASUVE looks like and contents of the pack
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.
Marketing Authorisation Holder
Ferrer Internacional, S.A.
Gran Vía Carlos III, 94
08028– Barcelona
España
Manufacturer
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:
België/Belgique/Belgien
Ferrer Internacional, S.A.
Tél/Tel: +34 93 600 37 00
Lietuva
AOP Orphan Pharmaceuticals AG LT
Tel +370 672 12222
| Etnrapua AOP Orphan Pharmaceuticals AG BG Ten.: +35 988 6666096 | Luxembourg/Luxemburg Ferrer Internacional, S.A. Tél/Tel: +34 93 600 37 00 |
| Česká republika AOP Orphan Pharmaceuticals AG CZ Tel: +420 251 512 947 | Magyarország AOP Orphan Pharmaceuticals AG HU Tel.: +36 1 3192633 |
| Danmark Ferrer Internacional, S.A. Tlf: +34 93 600 37 00 | Malta Ferrer Internacional, S.A. Tel.: +34 93 600 37 00 |
| Deutschland Ferrer Deutschland GmbH Tel: +49 (0) 2407 502311 0 | Nederland Ferrer Internacional, S.A. Tel.: +34 93 600 37 00 |
| Eesti AOP Orphan Pharmaceuticals AG LT Tel: +370 672 12222 | Norge Ferrer Internacional, S.A. Tlf: +34 93 600 37 00 |
| EZZáha Ferrer Galenica S.A. TqX: +30 210 52 81 700 | Österreich AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244–0 |
| España Ferrer Farma, S.A. Tel.: +34 93 600 37 00 | Polska AOP Orphan Pharmaceuticals S.A. PL Tel: +48 22 5424068 |
| France Ferrer Internacional, S.A. Tél: +34 93 600 37 00 | Portugal Ferrer Portugal, S.A. Tel: +351 214449600 |
| Hrvatska AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244–0 | Romania Galenica S.A. Tel: +30 210 52 81 700 |
| Ireland Ferrer Internacional, S.A. Tel.: +34 93 600 37 00 | Slovenija AOP Orphan Pharmaceuticals AG Tel: +43 1 5037244–0 |
| Ísland Ferrer Internacional, S.A. Sími: +34 93 600 37 00 | Slovenská republika AOP Orphan Pharmaceuticals AG SK Tel: +421 31 5502271 |
| Italia Angelini S.p.A. Tel: +39 06 780531 | Suomi/Finland Ferrer Internacional, S.A. Puh/Tel: +34 93 600 37 00 |
| Kúnpog Thespis Pharmaceutical Ltd Trp.: | Sverige Ferrer Internacional, S.A. |
| ++357 22 67 77 10 | Tel: +34 93 600 37 00 |
| Latvija AOP Orphan Pharmaceuticals AG LT | United Kingdom Ferrer Internacional, S.A. |
Tel +370 672 12222
Tel.: +34 93 600 37 00
This leaflet was last revised in
Other sources of information
Detailed information on this medicine is available on the European Medicines Agency web site:.
The following information is intended for healthcare professionals only:
Read all instructions before use. See the SmPC for more information.
Becoming familiar with ADASUVE: The pictures below show the important features of ADASUVE.
- 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.
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1. Open pouch
Do not open the pouch until ready to use. Tear open the foil pouch and remove the inhaler from the package.
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2. Pull tab
Firmly pull the plastic tab from the rear of the inhaler. The green light turns on indicating that the inhaler is ready for use.
Use within 15 minutes after removing the tab (or until the green light turns off) to prevent automatic deactivation of the inhaler.
Instruct the patient to:
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3. Exhale
Hold the inhaler away from the mouth and breathe out fully to empty lungs.
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4. Inhale
Inhale through the mouthpiece with a steady deep breath.
IMPORTANT: Check that the green light turns off after the patient inhales.
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5. Hold breath