Home Drug Guide Lumateperone Tosylate

Drug Guide

Generic Name

Lumateperone Tosylate

Brand Names Caplyta

Classification

Therapeutic: Antipsychotic, atypical

Pharmacological: Dopamine-serotonin modulator

FDA Approved Indications

Schizophrenia in adults

Mechanism of Action

Lumateperone modulates dopamine and serotonin receptors, acting as a dopamine D2 and serotonin 5-HT2A receptor antagonist, which helps balance neurotransmission implicated in schizophrenia.

Dosage and Administration

Adult: Starting dose of 42 mg once daily orally with or without food. Adjustments based on response and tolerability.

Pediatric:

Geriatric:

Renal Impairment: No specific adjustment required, but caution advised in severe impairment.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended.

Pharmacokinetics

Absorption: Rapidly absorbed, Tmax approximately 1-2 hours.

Distribution: Widely distributed, highly protein-bound.

Metabolism: Primarily metabolized in the liver via CYP3A4.

Excretion: Excreted mainly in feces and urine.

Half Life: Approximately 21-27 hours.

Contraindications

Known hypersensitivity to lumateperone or its components

Precautions

History of QT prolongation, cardiac arrhythmias, neuroleptic malignant syndrome, or other significant cardiovascular conditions.
Use with caution in elderly patients with dementia-related psychosis due to increased risk of death.

Adverse Reactions - Common

Dizziness (Common)
Somnolence (Common)
Dry mouth (Common)
Nausea (Common)

Adverse Reactions - Serious

QT prolongation (Uncommon)
Neuroleptic malignant syndrome (Rare)
Tardive dyskinesia (Uncommon)
Hyperglycemia or hypoglycemia (Uncommon)

Drug-Drug Interactions

CYP3A4 inhibitors (increase lumateperone levels)
CYP3A4 inducers (decrease levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of neuroleptic side effects, including movement disorders, metabolic changes, and cardiovascular status.

Diagnoses:

Risk for injury related to dizziness or sedation.
Risk for metabolic imbalance.

Implementation: Administer according to prescribed schedule, monitor for adverse effects, and educate patient about symptoms to report.

Evaluation: Assess effectiveness in symptom control and monitor adverse effects.

Patient/Family Teaching

Take medication as prescribed, without abrupt discontinuation.
Report symptoms of movement disorders, QT prolongation (e.g., palpitations, dizziness), or significant side effects.
Avoid alcohol and other CNS depressants.
Be aware of potential for increased blood sugar levels.

Special Considerations

Black Box Warnings:

Increased risk of death in elderly patients with dementia-related psychosis.
Potential for suicidal thoughts and behaviors.

Genetic Factors: Genetic variations in CYP3A4 may affect metabolism.

Lab Test Interference: May slightly alter blood glucose or lipid levels.

Overdose Management

Signs/Symptoms: Dizziness, drowsiness, tachycardia, hypotension, or extrapyramidal symptoms.

Treatment: Supportive care, monitor vital signs, and consider gastric lavage or activated charcoal if ingestion is recent.

Storage and Handling

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

Stability: Stable until the expiration date on the container.