Lurasidone (Oral Route): Uses, Dosage, Precautions and Side Effects

Lurasidone (Oral Route): Description and Overview

Lurasidone is an atypical antipsychotic medication used to treat certain mental and mood disorders. Available as oral tablets, it is primarily prescribed for schizophrenia and depressive episodes associated with bipolar disorder. Lurasidone works by modifying the effects of natural substances in the brain, chiefly the neurotransmitters dopamine and serotonin, to improve mood, thinking, and behavior.

Therapeutic Uses

Lurasidone is approved by the U.S. Food and Drug Administration for:

• Schizophrenia in adults and adolescents (13 years and older)
• Bipolar depression (depressive episodes in Bipolar I disorder) in adults and pediatric patients aged 10-17
• Adjunctive treatment with lithium or valproate for depression in bipolar disorder

In some cases, lurasidone may be prescribed “off-label” for other mental health conditions, such as major depressive disorder or certain symptoms in autism spectrum disorder.

Pharmacological Profile and Mechanism of Action

Lurasidone belongs to the benzisothiazole class of atypical antipsychotics. Its therapeutic effects are believed to result from antagonism of dopamine D2 and serotonin 5-HT2A and 5-HT7 receptors, as well as partial agonism at 5-HT1A receptors.

• Reduces psychotic symptoms through D2 blockade.
• Improves mood and depressive symptoms via serotonergic receptor targeting.
• Has minimal activity at muscarinic, histamine, and adrenergic receptors, reducing risks of sedation, orthostatic hypotension, and weight gain typically seen with other antipsychotics.

Dosage Forms and Administration

Lurasidone is supplied as immediate-release tablets, available in multiple strengths:

• 20 mg
• 40 mg
• 60 mg
• 80 mg
• 120 mg

Key administration instructions:

• Take once daily, preferably at the same time each day.
• Must be taken with food (at least 350 calories) to enhance absorption and effectiveness.
• Do not break, crush, or chew the tablets — swallow whole with water.

Recommended Dosages

Dosage adjustments are recommended for individuals with moderate renal or hepatic impairment. Maximum daily doses may be lower for those with severe hepatic dysfunction.

Special Precautions

• Inform your healthcare provider about any allergies, medications (including supplements), and past medical history, especially related to liver or kidney problems, diabetes, seizures, heart conditions, or low white blood cell counts.
• Lurasidone is not intended for use in treating behavioral problems in older adults with dementia-related psychosis due to increased risk of death.
• Monitor for the emergence of suicidal thoughts, especially in children, adolescents, and young adults.
• Caution is advised for pregnant or breastfeeding women. Discuss risks and benefits with your provider.

Warnings and Contraindications

• Boxed warning: Increased mortality in elderly patients with dementia-related psychosis.
• Risk of suicidal ideation in pediatric and adolescent populations.
• Risk of neuroleptic malignant syndrome (NMS), a rare but potentially fatal condition.
• May cause metabolic changes (e.g., hyperglycemia, dyslipidemia, weight gain).
• May increase the risk of falling, especially in elderly patients.
• Use caution in patients with a history of seizures or those at increased risk of QT prolongation.

Drug Interactions

• Avoid strong CYP3A4 inhibitors (such as ketoconazole, clarithromycin) and inducers (such as rifampin, carbamazepine)—these can significantly affect lurasidone blood levels.
• Inform your provider if you are taking medications that prolong the QT interval.
• Alcohol and sedatives may increase drowsiness and impair judgment.

Possible Side Effects

Lurasidone may cause side effects. Some are more common, while others are less frequent but serious.

Common Side Effects

• Drowsiness or sleepiness
• Restlessness (akathisia)
• Nausea and vomiting
• Insomnia
• Anxiety or agitation
• Dizziness
• Fatigue

Less Common but Serious Side Effects

• Neuroleptic malignant syndrome (stiff muscles, high fever, confusion, irregular heartbeat)
• Tardive dyskinesia (unusual, involuntary movements)
• Seizures
• Severe allergic reactions (rash, itching, swelling, difficulty breathing)
• Sudden cardiac events (rare)

Contact a healthcare professional if you experience new or worsening symptoms, including suicidal thoughts or behaviors.

Storage and Handling

• Store lurasidone tablets at room temperature, away from excess heat, moisture, and direct light.
• Keep out of reach of children and pets.
• Do not store in the bathroom or in areas with high humidity.
• Dispose of unused tablets properly, following your pharmacist’s guidance or local disposal regulations.

Missed Dose and Overdose

• If you miss a dose, take it as soon as you remember.
• If it is almost time for your next dose, skip the missed one—do not double up to catch up.
• In case of overdose, seek emergency medical assistance or contact a poison control center immediately. Overdose symptoms may include severe drowsiness, difficulty breathing, or loss of consciousness.

Guidelines for Use and Patient Advice

• Take the medication daily, with food, at the same time for consistent benefit.
• Do not abruptly stop taking lurasidone without consulting your healthcare provider, even if you feel well—sudden discontinuation may cause withdrawal symptoms or worsening condition.
• Attend all scheduled medical appointments for monitoring blood counts, metabolic markers, and periodic mental status evaluations.
• Inform your provider immediately if you become pregnant or plan to breastfeed.

Frequently Asked Questions (FAQs)

Q: What should I do if I forget to take a dose?

A: Take it as soon as you remember, unless it is close to your next dose. Do not double the dose to make up for the missed one.

Q: Can lurasidone be used for conditions other than schizophrenia or bipolar depression?

A: Lurasidone may sometimes be prescribed “off-label” for other mental health conditions at your provider’s discretion. Always follow your provider’s instructions and ask about any concerns.

Q: How long will it take for lurasidone to work?

A: It may take several weeks to feel the full benefits. Continue the medication as directed, and discuss any concerns about effectiveness with your healthcare provider.

Q: What should I avoid while taking lurasidone?

A: Avoid alcohol and limit use of other sedating drugs. Do not drive or operate machinery until you know how lurasidone affects you. Grapefruit or grapefruit juice should be avoided, as it may increase lurasidone levels and risk of side effects.

Q: Who should not take lurasidone?

A: Those with a known allergy to lurasidone or ingredients in the formulation, and elderly patients with dementia-related psychosis, due to safety risks. Discuss all health conditions with your provider before starting lurasidone.

Patient Support and Additional Information

• For urgent concerns or suspected overdose, call 911 or the Poison Help Line.
• Mental health crisis helplines and support groups, such as the National Alliance on Mental Illness (NAMI), are available for patients and their families.
• Consult your pharmacist or healthcare provider for further information about drug interactions, management of side effects, and general medication guidance.

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medha deb

 

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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