lumateperone CAPLYTA

Class: Second Generation Antipsychotic
FDA Indications: Schizophrenia
Off-Label Use:
Prescribing
Forms: 10.5, 21, 42mg capsule
Dose Range: 42-42 mg/day
Starting: 42 mg administered orally once daily with food. Dose titration is not required.
Stopping: Recommend taper as rapid d/c can lead to rebound psychosis (though its long t½ allows for faster tapers than others in its class)
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:
Pharmacodynamics
1° MOA: 5HT2A–D2 antagonist and pre-synaptic partial agonist at D2
2° MOA: Dopamine phosphoprotein modulator
Target: Partial agonist at D2 Antagonism at:
Pharmacokinetics
t½: 18° TMAX: 3-4°
Substrate of: 1A2, 3A4
Inhibits: ∅ ; Induces:
Active Metabolites:
DDIs
Misc
  • - Only requires D2 receptor occupancy as low as 40%
  • - Exhibits 60x greater affinity for 5-HT2A than D2
  • - ↓ EPS risk due to lower receptor occupancy for efficacy and its apparent regioselectivity for mesolimbic brain pathways rather than nigrostriatal pathways
Special Populations

Category Not assigned.

Lactation studies have not been conducted to assess the presence of in human milk, the effects on the breastfed infant, or the effects on milk production

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


2019 BEE℞S Recommendation: Avoid, except in schizophrenia or bipolar disorder. Increased risk of CVA and greater rate of cognitive decline and mortality in persons with dementia. Avoid antipsychotics for behavioral problems of dementia or delirium unless nonpharmacological options have failed or are not possible and the older adult is threatening substantial harm to self or others.

For patients with moderate, severe or end-stage renal impairment (CLcr<60 mL/min), the max recommended dosage is 2 mg qd for patients with MDD and 3 mg qd for patients with schizophrenia

For patients with moderate to severe hepatic impairment (Child-Pugh score ≥7), the max recommended dosage is 2 mg qd for patients with MDD and 3 mg qd for patients with schizophrenia

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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.