Lurasidone (Oral)

Lurasidone is a medication given to people with psychotic mental disorders, such as schizophrenia, and low mood associated with depression and bipolar disorder.

Overview

Lurasidone is thought to work by affecting the levels of two chemicals in the brain, called serotonin and dopamine.

This medication is not approved for use in people with dementia-related psychosis, and children with depression. People with suicidal thoughts or a history of suicidal thoughts are only prescribed this medication when the benefits outweigh the risks.

Lurasidone is known to produce certain side effects in some individuals. The most common side effects include drowsiness, uncontrolled movements or shaking, weight gain, high blood sugar, changes to mental state and nausea.

A number of medications interact with lurasidone in ways that produce harmful side effects. Make sure your doctor is aware of all other medications and supplements that you are taking. Ketoconazole and rifampin are particularly dangerous when taken with lurasidone.

Avoid grapefruit and grapefruit juice while you are taking lurasidone.

Lurasidone is commonly sold under the brand name Latuda.

Conditions Treated

  • Bipolar disorder

Type Of Medicine

  • Antipsychotic

Side Effects

As well as its desired effects, this medication can also cause negative side effects in some individuals.

In some people, lurasidone can trigger a serious condition called neuroleptic malignant syndrome. You should stop taking the medication and contact your doctor immediately if you notice any of the symptoms listed below:

  • Changes to your heartbeat, including a rapid or irregular heartbeat
  • High blood pressure
  • High fever
  • Increased sweating
  • Losing control of your bladder
  • Low blood pressure
  • Muscle spasms, seizures, or convulsions
  • Muscle stiffness
  • Pale skin
  • Problems with your breathing
  • Tiredness, weakness, or fatigue

Lurasidone can cause a movement disorder called dyskinesia in some people. Consult your doctor immediately if you notice any uncontrolled movements in your body while you are taking the medication. For example:

  • Chewing movements
  • Movements in the arms or legs
  • Moving, puckering or smacking of the lips
  • Puffing out your cheeks
  • Unusual movements of the tongue

This medicine can increase your blood sugar levels. This is of particular concern in people with diabetes, as their diabetes medication may need to be adjusted in order to compensate for this side-effect. Contact your doctor immediately if you experience an increased thirst or an increased frequency of urination.

Lurasidone can cause weight gain in some people. Your doctor might ask you to come in to check that you are not gaining weight and to advise you on ways to prevent weight gain during your treatment.

In some people, lurasidone can lower the white blood count. White blood cells are part of your immune system, and when their levels are low, you are more likely to get an infection. Do your best to avoid people who have infections, and check with your doctor if you think you have got an infection of any kind. For example, you may experience:

  • Chills or a fever
  • Hoarseness or a cough
  • Muscle pain, especially in the back or side
  • Painful urination or difficulty urinating

You may experience drowsiness, dizziness, or difficulty concentrating while you are taking the medication. You may also be more prone to experience lightheadedness when you stand up after being in a sitting or lying position. When you stand up, do so slowly, and stand still for a few moments before walking. This should help reduce the lightheadedness. If it does not, or if the symptoms get work, check with your doctor. You should also not operate heavy machinery, or drive until you have seen how your body reacts to the medication, and you are sure that you can do so safely.

This medication can affect your body's ability to regulate heat, and so you may have difficulty adapting to higher temperatures when you are taking this medication. Try to avoid activities and locations with high temperatures or humidity.

You may experience changes in your mental state when you are taking this medication. You may become agitated and irritable, or you may experience thoughts and behaviors that are out of the ordinary for you. Some people can experience suicidal thoughts when taking this drug. If you experience any of these symptoms, consult your doctor immediately.

Some people experience nausea while taking this drug. Talk to your doctor if you experience this side-effect, particularly if it is extreme, or if it does not go away.

This is not a complete list of side-effects, and you may experience other effects that are not listed here. Pay attention to your body when you are taking this drug, and if you notice any side-effects that are unusual, concerning, or bothersome, consult your doctor for advice. Sometimes side-effects go away after a few weeks of taking a new medication, as your body adapts to the drug. However, in other cases, you may be prescribed another drug to help manage them.

Overdose

If you believe you or your child has taken an overdose of lurasidone, seek emergency medical assistance immediately.

Allergic reaction

It is rare for patients to have a serious allergic reaction to lurasidone, but they can occur. Some people are also allergic to the non-active ingredients in some medications, such as the filler ingredients in tablets. Tell your doctor about anything that you are allergic to before you start taking lurasidone. If you experience the symptoms of an allergic reaction while you are taking this medication, seek emergency medical assistance immediately. Such symptoms include:

  • Dizziness, fatigue, or drowsiness
  • Itching on the skin
  • Problems with your breathing, such as shortness of breath
  • Rashes, hives, or redness on the skin
  • Swollen tongue, throat, neck, face or hands

Dosage

Every patient will receive a dose of lurasidone based on the type of symptoms they are experiencing, their age, and any other medical conditions they have. Always take this medication exactly as prescribed by your doctor. Do not take larger doses that you have been advised to take, and do not take it for longer than you have been prescribed.

Below are the average doses given for various conditions:

  • Schizophrenia: A starting dose of 40 mg orally once a day. Depending on your response to the drug, your doctor may increase the dosage up to a maximum of 160 mg per day.
  • Bipolar disorder: A starting dose of 20 mg orally, once per day. Your doctor may increase this up to a maximum of 120 mg per day.

You should take this medication with a meal of at least 350 kcals. If you do not take the medication with food, it may not be as effective.

It may take a number of weeks before your symptoms improve. Keep taking the medication as directed, and do not increase the dose if you do not initially see an improvement.

If you forget to take one of your scheduled doses of amitriptyline, take it as soon as you can. The exception is when you are approaching the time of your next scheduled dose. In this case, skip the dose you missed and carry on as normal from the next dose. Do not double your dose after you have missed one -- you will not receive any extra benefit, and it might be harmful to do so.

Do not stop taking the medication abruptly. Your body will adapt to the presence of the medication, and if you suddenly stop taking it, this can trigger harmful side effects. At the end of your treatment, your doctor may want to lower your dose gradually to prevent this from happening.

Interactions

Lurasidone can interact with certain medications in ways that can produce negative side effects. Before you take this medication, you should discuss with your doctor any medications, vitamin products, or herbal supplements that you are currently taking. This will help your doctor determine whether lurasidone is safe for you to take.

In particular, central nervous system depressants can be harmful when taken alongside lurasidone, because lurasidone itself can have a depressant effect on the nervous system, and taking more than one such drug can be harmful or even fatal in extreme cases. Central nervous system depressant medications include:

  • Anesthetics, including some dental anesthetics, so if you are due to have any dental work performed, tell your dentist that you are taking this medication
  • Certain antihistamines and allergy medications
  • Some medications given for colds including some over-the-counter remedies
  • Muscle relaxants
  • Narcotics
  • Prescription painkillers
  • Sedatives
  • Seizure medication such as barbiturates
  • Tranquilizers

Alcohol is also a central nervous system depressant and so should be avoided while you are taking lurasidone.

Other medications that can interact in harmful ways with lurasidone include antibiotics, antivirals, antifungals, St. John's wort, and seizure medications. This includes, but is not limited to, the following medications:

  • Alfentanil
  • Amprenavir
  • Aprepitant
  • Atazanavir
  • Boceprevir
  • Buprenorphine
  • Bupropion
  • Butorphanol
  • Carbamazepine
  • Clarithromycin
  • Clozapine
  • Cobicistat
  • Codeine
  • Conivaptan
  • Crizotinib
  • Darunavir
  • Delavirdine
  • Deutetrabenazine
  • Dezocine
  • Diltiazem
  • Dronedarone
  • Enzalutamide
  • Erythromycin
  • Fentanyl
  • Fluconazole
  • Fosamprenavir
  • Fosaprepitant
  • Fosphenytoin
  • Hydrocodone
  • Hydromorphone
  • Idelalisib
  • Imatinib
  • Indinavir
  • Iohexol
  • Iopamidol
  • Isavuconazonium
  • Itraconazole
  • Ketoconazole
  • Letermovir
  • Levorphanol
  • Meperidine
  • Methadone
  • Metoclopramide
  • Metrizamide
  • Mibefradil
  • Mitotane
  • Morphine
  • Nalbuphine
  • Nefazodone
  • Nelfinavir
  • Oxycodone
  • Oxymorphone
  • Pentazocine
  • Phenobarbital
  • Phenytoin
  • Posaconazole
  • Primidone
  • Propoxyphene
  • Remifentanil
  • Ribociclib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Saquinavir
  • Sufentanil
  • Tapentadol
  • Telaprevir
  • Telithromycin
  • Tetrabenazine
  • Tipranavir
  • Topiramate
  • Tramadol
  • Troleandomycin
  • Verapamil
  • Voriconazole
  • Zonisamide

This is not an exhaustive list of medications and other drugs may interact with lurasidone. Talk to your doctor about all medication and products that you are taking before you start taking lurasidone.

Avoid grapefruit and grapefruit juice during your course of treatment with lurasidone. This can increase the levels of the drug in your bloodstream, and lead to potentially harmful side-effects including muscle spasms and tremors, changes to your temperature, high blood sugar, weight gain, and seizures.

Avoid alcohol during your course of treatment with lurasidone. Both alcohol and lurasidone can have a calming effect on the central nervous system, and the combined effect of both drugs can be dangerous. You may experience dizziness, drowsiness, feeling faint, and a lack of concentration.

Warnings

Your doctor will want to monitor your response to this medication. You may be asked to come in for regular examinations, and you may be asked to undergo tests such as blood tests. This is to ensure that the medication is working properly, and that there are no untoward side-effects taking place.

If you undergo any other medical tests while you are taking lurasidone, including blood tests, tell the doctor in charge of the test that you are taking lurasidone. This is because this medication can interfere with the results of some tests.

There are some people for whom lurasidone may not be an appropriate choice of medication, such as people with certain medical conditions. You should discuss any other medical conditions you currently have, and your medical history, with your doctor before you begin to take lurasidone. The conditions listed below are of particular concern.

Studies have not tested the efficacy of lurasidone beyond 6 weeks of treatment. Your doctor may want to see you more frequently after 6 weeks to make sure the medication is still working properly.

Serious potential health consequences

There can be very serious consequences if this medication is taken by people with some medical conditions when they are at a particular age. These include:

  • Dementia-related psychosis in older individuals: this medication is not approved for use by elderly patients with dementia. There is an increased risk of fatality, often caused by heart problems, or by infection.
  • People who have suicidal thoughts: people who have suicidal thoughts, especially young adults, are usually not given this medication unless the benefits outweigh the risks.
  • Children with depression: Lurasidone is not approved for use in pediatric patients who suffer from depression

Increased risk of side-effects

Certain conditions may increase the changes that you will experience unpleasant or harmful side-effects when you are taking lurasidone. If you have any of the conditions below, your doctor will probably want to monitor you more closely, and may want you to undergo frequent tests to make sure the medication is not causing any harm to you. These conditions include:

  • Dementia or Alzheimer's disease
  • Dehydration
  • Difficulty swallowing
  • Heart problems, including heart disease, irregular heartbeat, damage to the blood vessels in the heart, or a history of heart attacks
  • History of strokes
  • Low blood pressure (hypotension)
  • Low blood volume (hypovolemia)

Conditions that lurasidone can make worse

The symptoms of some medication conditions may become more intense when you take lurasidone. Your doctor may want to monitor you more closely if you have any of the conditions below:

  • Diabetes, or pre-diabetes
  • High blood sugar (hyperglycemia)
  • High cholesterol, or high level of fat in the blood (dyslipidemia)
  • High prolactin levels (hyperprolactinemia)
  • History of seizures
  • Problems with the blood or bone marrow, such as leukopenia, neutropenia or agranulocytosis

Conditions that can affect how lurasidone works

Certain conditions can affect how quickly lurasidone is removed from the body. This may mean that your doctor may want to give you a different dose of lurasidone than they normally would. These conditions include:

  • Moderate to severe kidney disease
  • Moderate to severe liver disease

Pregnancy

This medication may cause harm to the fetus if it is taken by pregnant women, particularly in the third trimester. It should only be taken if the potential benefits outweigh the risk to the unborn baby. If you become pregnant during your course of treatment with lurasidone, inform your doctor immediately.

Breastfeeding

It is not known whether lurasidone enters the breastmilk. For this reason, you will usually be advised not to breastfeed while you are taking lurasidone, or if possible, you may be prescribed an alternative drug instead.

Children and young adults

This medication may increase the risk of suicidal thoughts or behavior when taken by children and young adults. If this medication is prescribed to your child, your doctor will probably want to see them regularly for checkups. Ensure that you keep all of these appointments.

Storage

In order to maintain the safety and potency of your medication, you should observe the following guidelines when storing it:

Avoid heat: Excess heat can damage the medication. You should store this medication at room temperature, well away from any source of heat such as radiators and cooking devices. Do not store the medication in the glove compartment of your vehicle.

Avoid cold: Do not refrigerate or freeze the medication and this can damage it.

Avoid moisture: Store the medication in a dry location. Excess moisture can damage the tablets, and for this reason you should not store the medication in the bathroom.

Avoid light: Store the medication in a dark location, and do not keep the tablets near sources of direct sunlight, such as near a window or on the dashboard of your car.

Keep away from children: Lurasidone can be very harmful if taken by children, so you should always ensure that the medication is in a place that children cannot see or reach. Store the medication in a child-resistant container to prevent children from gaining access to it.

Check for damage: If the tablets are soft, crumbly or if you notice a change in their color, they may be damaged. Do not take damaged medication, as it may be harmful to do so.

Expiry date: Check the expiration date on the medication before you take it. Do not take any medication that has passed its expiry date, as it may be dangerous or less potent.

Dispose safely: After you have finished taking the medication, take any remaining tablets to your pharmacist, or to a medication take-back scheme. Do not throw them away in the trash.

Summary

Lurasidone is an antipsychotic medication used to treat conditions such as schizophrenia. It is also used to treat depression in people with bipolar disorder. Lurasidone is thought to work by affecting the levels of serotonin and dopamine in the brain.

People who have dementia-related psychosis, and children who have depression, are not recommended to take this medication. Some people may experience suicidal thoughts while taking lurasidone, so people with a history of such thoughts are generally not advised to take this medication unless the benefits outweigh the potential risks.

Some people experience side-effects when they are taking lurasidone. The most common side effects include nausea, drowsiness, uncontrolled movements, high blood sugar, and emotional changes.

Some medications can cause harmful side-effects when taken at the same time as lurasidone. Tell your doctor about all other medications and supplements that you are taking.

Avoid grapefruit, grapefruit juice, and alcohol while you are taking lurasidone.