Lurasidone (Latuda): Uses, Dosing, Side Effects, Interactions & Safety
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At‑a‑Glance: Key Facts
What it treats: Schizophrenia (adults & adolescents 13–17) and bipolar I depression (adults; children 10–17 as monotherapy; adults as adjunct with lithium/valproate).
How to take: With food—at least 350 calories—once daily; food more than doubles absorption. Do not split/chew/crush tablets.
Common effects: Somnolence, akathisia, extrapyramidal symptoms, nausea; pediatric bipolar patients may see weight increase and insomnia.
Serious warnings: Boxed warning (mortality in dementia‑related psychosis; suicidality in pediatric/young adults), NMS, tardive dyskinesia, metabolic changes, hyperprolactinemia.
Interactions to avoid: Strong CYP3A4 inhibitors/inducers, and grapefruit; dose reductions with moderate CYP3A4 inhibitors.
PK basics: Peak 1–3 h; half‑life ≈18 h; steady state ≈7 days.
Metabolic profile: Lower relative risk of clinically significant weight gain vs several SGAs in real‑world and pooled data.
Table of Contents
What Is Lurasidone?
Lurasidone is a second‑generation antipsychotic approved for schizophrenia in adults and adolescents (13–17), and for depressive episodes associated with bipolar I disorder—as monotherapy in adults and pediatric patients (10–17), and as adjunctive therapy with lithium or valproate in adults.
Unlike many drug monographs that present outdated or region‑specific indications, the 2025 US label above reflects the most current scope of use. Consumer‑facing summaries (MedlinePlus, Mayo Clinic) align with these indications and emphasize taking lurasidone with food.
How Lurasidone Works
Lurasidone antagonizes dopamine D₂ and serotonin 5‑HT2A/5‑HT7 receptors and partially agonizes 5‑HT1A, a receptor profile thought to contribute to antipsychotic and antidepressant effects. Its low affinity for muscarinic and histamine H₁ receptors helps reduce anticholinergic effects and sedation relative to some peers.
Pharmacokinetically, lurasidone reaches peak levels in 1–3 hours, achieves steady state in ~7 days, and has a mean elimination half‑life ~18 hours.
Who Should—and Shouldn’t—Use It
Indicated for:
Schizophrenia (adults; adolescents 13–17).
Bipolar I depression (adults; children 10–17 as monotherapy; adults adjunct with lithium/valproate).
Not approved for:
Dementia‑related psychosis (boxed mortality warning).
Bipolar mania (efficacy not established).
Use with caution / monitor for:
Suicidal thoughts/behaviors in pediatric/young adult patients (boxed warning applies to antidepressant‑treated populations).
Metabolic changes (hyperglycemia/diabetes, dyslipidemia, weight gain).
Extrapyramidal symptoms, tardive dyskinesia, NMS, orthostatic hypotension, hyperprolactinemia, leukopenia/neutropenia.
Dosing & How to Take Lurasidone
Always take lurasidone with food—≥350 calories—once daily at the same time each day. Food roughly doubles exposure (AUC) and triples Cmax; taking it fasted can underdose you.
Schizophrenia
Adults: Start 40 mg once daily; typical range 40–160 mg/day (max 160 mg/day). No initial titration required.
Adolescents (13–17): Start 40 mg once daily; range 40–80 mg/day (max 80 mg/day).
Bipolar I Depression
Adults (monotherapy or adjunct to lithium/valproate): Start 20 mg once daily; range 20–120 mg/day (max 120 mg/day). In monotherapy trials, higher doses (80–120 mg) did not add benefit on average vs 20–60 mg.
Pediatric (10–17, monotherapy): Start 20 mg once daily; range 20–80 mg/day (max 80 mg/day).
Special Populations
Moderate/Severe Renal impairment: Start 20 mg/day; max 80 mg/day.
Moderate Hepatic impairment: Start 20 mg/day; max 80 mg/day.
Severe Hepatic impairment: Start 20 mg/day; max 40 mg/day.
Administration rules that matter
Swallow tablets whole; do not split, crush, or chew. The (earlier) patient guide and current manufacturer guidance advise against splitting; choose the strength that fits the dose.
Missed dose: Take when remembered unless near the next dose; don’t double up (Mayo echoes general advice).
Side Effects
Common (often dose‑related)
Somnolence, akathisia, extrapyramidal symptoms, nausea (adults).
Nausea, weight increase, insomnia (pediatric bipolar).
Serious (seek urgent care)
Neuroleptic Malignant Syndrome (NMS) (fever, rigidity, confusion, autonomic instability).
Tardive Dyskinesia (involuntary movements).
Hyperglycemia/diabetes, DKA risk.
Leukopenia, neutropenia, agranulocytosis.
Orthostatic hypotension & syncope.
Note on QTc: Thorough‑QT data showed no QTc >500 ms and modest mean changes without exposure‑response; nonetheless, monitor at high doses or in cardiac risk.
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Weight & Metabolic Considerations
Compared with some atypical antipsychotics (e.g., olanzapine, quetiapine, risperidone), lurasidone shows a lower risk of clinically significant weight gain and has a relatively favorable metabolic profile in real‑world cohorts and pooled analyses. That said, weight gain can occur, especially in some pediatric patients—so baseline and periodic weight, lipids, and glucose monitoring is prudent.
Drug & Food Interactions
Avoid altogether (contraindicated)
Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole).
Strong CYP3A4 inducers (e.g., rifampin, carbamazepine, St. John’s wort).
Use with dose adjustment/monitoring
Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil, erythromycin, fluconazole): halve the lurasidone dose.
Moderate CYP3A4 inducers (e.g., modafinil/armodafinil): may require increased dose (monitor).
Food & substances
Food: Take with ≥350 calories for proper absorption.
Grapefruit/juice: Avoid—inhibits CYP3A4 and can dangerously raise levels.
Alcohol: Can add to sedation/impairment—avoid or minimize and ask your clinician.
Special Populations
Pregnancy: Third‑trimester exposure may cause neonatal EPS/withdrawal signs; human data are limited. Monitor newborns if exposed late in pregnancy.
Lactation: Unknown in human milk; present in rat milk. Weigh benefits of breastfeeding against maternal need and potential infant risk.
Pediatrics: Schizophrenia (13–17) and bipolar depression (10–17, monotherapy) are labeled uses with defined dose ranges.
Older adults: Not approved for dementia‑related psychosis (increased mortality).
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Lurasidone FAQs: Dosing, Side Effects, Interactions
What is lurasidone used for?
Schizophrenia (adults, 13–17) and depressive episodes in bipolar I disorder (adults; 10–17 as monotherapy; adults adjunct with lithium/valproate).
Do I have to take lurasidone with food?
Yes. Take each dose with ≥350 calories; food roughly doubles exposure and triples peak levels.
How long does lurasidone take to work?
Some people notice improvements within 1–2 weeks; full effect may take longer.
Does lurasidone cause weight gain?
It can, but risk is relatively lower than several SGAs; monitoring weight and metabolic labs is recommended.
Can I drink alcohol while taking lurasidone?
Best to avoid or minimize; alcohol can add to sedation and impair judgment/coordination.
Can I split, crush, or chew Latuda tablets?
No—swallow whole. Use the exact strength prescribed.
Can I eat grapefruit?
Avoid grapefruit/juice—it inhibits CYP3A4 and can raise lurasidone levels.
What’s lurasidone’s half‑life?
About 18 hours; steady state in ~7 days.
Can I take lurasidone with lithium or valproate?
Yes—adjunctive therapy for adult bipolar depression is on‑label.
Does lurasidone affect the heart rhythm (QT)?
Dedicated studies showed no QTc >500 ms and small mean changes; still use caution in high‑risk settings.
Cost & Access (generic availability)
Generic lurasidone is available and commonly discounted; GoodRx shows current coupon prices and confirms widespread availability.
You Can Recover — Let’s Begin
At Nova Recovery Center, we understand that misuse or dependence on prescription medications like Lurasidone (Latuda) can be overwhelming and isolating. Our team provides a safe, structured environment that offers medical detox, inpatient treatment, and outpatient treatment, ensuring comprehensive care that addresses both the physical and psychological aspects of Lurasidone abuse.
Through individualized treatment plans, evidence-based therapies, and holistic approaches, we help clients uncover the root causes of addiction while building the skills needed for long-term recovery. With a full continuum of care—including detox referrals, residential treatment, intensive outpatient programs, and sober living support—Nova Recovery Center guides individuals step by step toward stability, healing, and a healthier future free from prescription drug misuse.
Get help today. Reach out now to start your path to healing.