lurasidone LATUDA

Class: Second Generation Antipsychotic/​Benzoisothiazole
FDA Indications: Bipolar Depression, Schizophrenia
Off-Label Use: Bipolar II Disorder, Depression
Prescribing
Forms: 20, 40, 60, 80, 120mg tablet
Dose Range: 20-160 mg/day
Starting: Initiate at 20 mg qd for bipolar depression, max dose 120 mg qd; for schizophrenia start at 40 mg, max dose 160 mg qd
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis
Monitoring:

NAMI drug fact sheet

Precautions
Serious Side Effects: , , ,
Not Classified: This drug has been reviewed by CredibleMeds but the evidence available at this time did not result in a decision for it to be placed in any of the four QT risk categories. This is not an indication that this drug is free of a risk of QT prolongation or torsades de pointes since it may not have been adequately tested for these risks in patients.
Side Effects: sedation/somnolence, dizziness, nausea, akathisia, agitation, vomiting, EPS, dyspepsia, rhinitis/rhinorrhea
Pharmacodynamics
1° MOA: 5HT2A–D2 antagonist
Target: Antagonism at: Partial agonism at: Postsynaptic 5HT1A
Pharmacokinetics
t½: 18° TMAX: 1.5-3°
Substrate of: 3A4
Inhibits: ∅ ; Induces:
Active Metabolites: ID-14283, ID-14326
DDIs
Misc
  • - take with at least a 350 Kcal meal; food was shown to ↑ bioavailability up to 60%
  • - minimal sedation
  • - one of the few metabolically friendly antipsychotics (neutral for weight gain, lipids, and glucose)
  • - Weight neutral d/t its lack of affinity for H1 and low affinity for 5-HT2C
  • - ∅ QTc ↑—one of the few SGAs without a QTc warning
  • - minimal EPS
Special Populations

Category B—No adequate or well-controlled studies of the drug's use have been conducted during pregnancy. Animal studies have shown no evidence of teratogenicity, but exposure to antipsychotic medications during the third trimester has been associated with extrapyramidal and withdrawal symptoms in neonates

No lactation studies of lurasidone have been performed in humans, and it is not clear whether the drug is excreted in human milk.

All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo.

Moderate and Severe Renal Impairment: Recommended starting dose is 20 mg per day, and the maximum recommended dose is 80 mg per day

Moderate and Severe Hepatic Impairment: Recommended starting dose is 20 mg per day. The maximum recommended dose is 80 mg per day in moderate hepatic impairment and 40 mg per day in severe hepatic impairment

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Last updated January 20 2018 15:32:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.