Multiple dose pharmacokinetics of inhaled loxapine in subjects on chronic, stable antipsychotic regimens

J Clin Pharmacol. 2015 Sep;55(9):985-94. doi: 10.1002/jcph.502. Epub 2015 May 6.

Abstract

This randomized, double-blind, placebo-controlled, parallel-group study was to determine the pharmacokinetic characteristics, safety, and tolerability of multiple doses of inhaled loxapine aerosol in subjects on a stable, oral, chronic antipsychotic regimen. Loxapine was delivered by means of a unique thermally generated aerosol comprising drug particles of a size designed for deep lung delivery and absorption. Thirty-two subjects were randomized 1:1:1:1 to receive inhaled loxapine (total doses of 15, 20, or 30 mg) or inhaled placebo administered in 3 divided doses, given 4 hours apart. Following inhalation, the median Tmax was 2 minutes, and concentrations declined to about half Cmax approximately 5 minutes later across the 3 dose levels. The dose proportionality across data from this study combined with data from the single-dose study showed a slope (90%CI) of log AUCinf versus log dose of 0.818 (0.762-0.875) across the 8 doses (n = 60 subjects) studied, indicating reasonable dose proportionality. The most common adverse events were cough (3 of 32, 9%), sedation (3 of 32, 9%), and dysgeusia (2 of 32, 6%). The inhalation of multiple doses of inhaled loxapine were well tolerated in study subjects and provided a safe, well-tolerated means for rapidly and reliably achieving therapeutic plasma concentrations of loxapine. ClinicalTrials.gov identifier: NCT00555412.

Keywords: ADASUVE; Staccato; agitation; inhaled loxapine; multiple dose; pharmacodynamics; pharmacokinetics.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Adult
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / blood
  • Antipsychotic Agents / metabolism
  • Antipsychotic Agents / pharmacokinetics*
  • Area Under Curve
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Half-Life
  • Humans
  • Loxapine / administration & dosage*
  • Loxapine / blood
  • Loxapine / metabolism
  • Loxapine / pharmacokinetics*
  • Male
  • Middle Aged

Substances

  • Antipsychotic Agents
  • Loxapine

Associated data

  • ClinicalTrials.gov/NCT00555412