This study will compare the safety and effects over time for giving both ADASUVE and lorazepam (intramuscular) compared to that of each agent given alone.

The objective of this study is to compare the safety and pharmacodynamic profiles of concomitant administration of a single dose of ADASUVE and lorazepam (IM) compared to that of each agent administered alone. Respiratory pharmacodynamics will be monitored through recordings of respirations/minute and pulse oximetry. Other pharmacodynamic safety measures will include effects on blood pressure, heart rate, sedation and psychomotor measures of attention, information processing speed, reaction time, and coordination.

Initially, 4 subjects will receive lorazepam 1 mg IM + ADASUVE 10 mg open label to validate the dose regimen. After the safety data are reviewed and the dose regimen confirmed, 18 non-obese, healthy male or female volunteers between the ages of 18 and 50 will be enrolled in this double-blinded, double-dummy, randomized, 3-period cross-over drug interaction study.

Inclusion Criteria:

• Male and female subjects between the ages of 18 to 50 years, inclusive.
• Body mass index (BMI) ≥18 and ≤32.
• Subjects who are willing and able to comply with the study schedule and requirements, and stay at the CRU for 9 days.
• Subjects who speak, read, and understand English and are willing and able to provide written informed consent on an IRB approved form prior to the initiation of any study procedures.
• Subjects who are in good general health prior to study participation as determined by a detailed medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, urinalysis, and in the opinion of the Principal Investigator.
• Female participants (if of child-bearing potential and sexually active) who agree to use a medically acceptable and effective birth control method throughout the study and for 30 days following the end of the study
• Male participants (if sexually active with a partner of child-bearing potential) who agree to use a medically acceptable and effective birth control method from the first dose and for 90 days following last dose of study drug. Male participants must refrain from donating sperm for the same period.

Exclusion Criteria:

• Subject history, which includes: any cardiovascular disease or disorder; asthma, chronic obstructive lung disease, or any use of an inhaler prescribed for wheezing or bronchospasm must be excluded; sleep apnea; acute narrow-angle glaucoma; any neurological, gastrointestinal, hepatic, renal, hematologic, endocrine and/or metabolic disease or disorder; psychiatric illness or mental disorder except for short term situational anxiety or depression of < 2 years duration; any substance abuse or addiction within the last 2 years; pregnancy within the past 6 months.
• Subjects who have taken prescription or nonprescription medication within 7 days of Visit 2.
• Subjects who have had an acute illness within the last 7 days of Visit 2.
• Subjects who have a history of HIV positivity.
• Subjects who test positive for alcohol or have a positive urine drug screen.
• Subjects who have a history of allergy or intolerance to loxapine or amoxapine.
• Subjects who have a history of allergy or intolerance to lorazepam or any other benzodiazepine.
• Subjects who have a history of allergy or intolerance to polyethylene glycol, propylene glycol, or benzyl alcohol
• Female subjects who have a positive pregnancy test at screening or at admission to Visit 2, or are breastfeeding.
• Subjects who have received an investigational drug within 30 days prior to the Screening Visit.
• Subjects who have any other disease(s), by history, physical examination, or laboratory abnormalities that, in the investigator's opinion, presents undue risk to the subject or may confound the interpretation of study results.
• Subjects who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving lorazepam or ADASUVE.

IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com

Safety Population

From time of first study treatment to 30 days after the last study treatment

Adverse events reported to the investigator by telephone report, by historical report at the follow-up visit, or to study personnel during the follow-up assessment, regardless of treatment group (if known) or suspected causal relationship to study drug, were recorded on the AE CRF. AEs were collected pre-dose, 15, 30, 45, 60, 75, 90 & 105 min; 2, 3, 4, 5, 6, 7, 8, 9 12 and 24 hours.

The 1-mg IM lorazepam dose used in this study was lower than that used in some previous studies assessing the effects of concomitant administration of antipsychotics with up to 2-mg lorazepam for the treatment of agitation.