Home Drug Guide Lurasidone Hydrochloride

Drug Guide

Generic Name

Lurasidone Hydrochloride

Brand Names Latuda

Classification

Therapeutic: Antipsychotic, atypical

Pharmacological: Dopamine D2 and serotonin 5-HT2A receptor antagonist

FDA Approved Indications

  • Schizophrenia in adults and adolescents (13 years and older)
  • Depressive episodes associated with bipolar disorder (bipolar depression) in adults

Mechanism of Action

Lurasidone primarily exerts its effects through antagonism of dopamine D2 and serotonin 5-HT2A receptors, which helps balance neurotransmitters implicated in mood and thought disorders.

Dosage and Administration

Adult: Start with 40 mg once daily, with or without food. Adjust based on response and tolerability, typically up to 160 mg per day.

Pediatric: Not FDA approved for children under 13. For adolescents 13 and older, dosing similar to adult, starting at 40 mg once daily.

Geriatric: Use caution; start at lower end of dosing range and monitor closely.

Renal Impairment: No specific dose adjustment recommended for mild to moderate impairment; use caution in severe impairment.

Hepatic Impairment: Start at lower doses; monitor for adverse effects; specific dosing guidance not established.

Pharmacokinetics

Absorption: Well absorbed with food; absorption significantly increases when taken with meals (≥350 kcal).

Distribution: High protein binding (~99%).

Metabolism: Primarily via CYP3A4 enzyme; minimal CYP2D6 metabolism.

Excretion: Excreted mainly in feces; minor renal excretion.

Half Life: Approximately 18-26 hours, supporting once-daily dosing.

Contraindications

  • Hypersensitivity to lurasidone or any component of the formulation.

Precautions

  • Use with caution in patients with a history of seizures, cardiovascular disease, or QT prolongation. May increase risk of EPS and metabolic changes. Watch for neuroleptic malignant syndrome. Avoid use in combination with other drugs that prolong QT interval.

Adverse Reactions - Common

  • Akathisia (Common)
  • Drowsiness (Common)
  • Nausea (Common)
  • Extrapyramidal symptoms (Less common)
  • Weight gain (Less common)

Adverse Reactions - Serious

  • QT prolongation, Torsades de Pointes (Rare)
  • Neuroleptic malignant syndrome (Rare)
  • Severe hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) - increase lurasidone levels
  • CYP3A4 inducers (e.g., rifampin, carbamazepine) - decrease effectiveness

Drug-Food Interactions

  • High-fat or high-calorie meals significantly increase absorption.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for therapeutic response, side effects including EPS, metabolic parameters, and QT interval.

Diagnoses:

  • Risk for falls due to dizziness or sedation
  • Risk for metabolic syndrome

Implementation: Administer with or without food; advise patient to take consistently. Monitor for signs of tardive dyskinesia and metabolic changes.

Evaluation: Assess symptom control, monitor side effects, and laboratory parameters.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of movement disorders, agitation, or changes in mood.
  • Avoid alcohol and CNS depressants.
  • Be cautious about activities requiring alertness until effects are known.

Special Considerations

Black Box Warnings:

  • Increased mortality in elderly patients with dementia-related psychosis.

Genetic Factors: Consider CYP3A4 genotype testing if adverse effects or unusual responses occur.

Lab Test Interference: May cause slight increases in prolactin levels; monitor as clinically indicated.

Overdose Management

Signs/Symptoms: Somnolence, sedation, agitation, extrapyramidal symptoms, orthostatic hypotension, QT prolongation.

Treatment: Supportive care, monitored cardiac rhythm, activated charcoal if ingestion recent, no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.