Latuda

Latuda belongs to the class of medications known as antipsychotics. It operates by altering how certain brain chemicals function. This drug is prescribed to manage schizophrenia in adults and adolescents aged 13 and above. Additionally, Latuda helps alleviate depressive episodes linked to bipolar disorder, also termed bipolar depression, in adults and children who are at least 10 years old.

Before taking this medicine

Avoid Latuda if you’re hypersensitive to lurasidone.

Numerous drugs can interact with lurasidone, potentially leading to hazardous outcomes. Some shouldn’t be paired with it. Your treatment plan might shift if you’re also taking:

• antifungal treatments like ketoconazole or voriconazole;
• antibiotics such as clarithromycin or rifampin;
• antivirals like ritonavir;
• St. John’s wort; or
• antiepileptic drugs such as carbamazepine and phenytoin are commonly prescribed to control seizures.

Latuda isn’t cleared for psychotic states arising from dementia. Lurasidone may raise the risk of death in older adults with dementia-linked conditions.

Inform your doctor about any prior:

• heart issues or strokes;
• high or low blood pressure;
• raised cholesterol or triglycerides (blood lipids);
• diabetes or high blood sugar in yourself or kin;
• seizures;
• liver or kidney problems;
• low white blood cell counts;
• unusual hormone test results (thyroid or pituitary);
• breast cancer;
• suicidal thoughts or behaviors.

Some patients develop suicidal inclinations while on lurasidone. Your doctor will monitor your status during regular checkups. Loved ones or caregivers should also watch for changes in your mood or behavior.

Using antipsychotics in the final trimester of pregnancy might lead to newborn issues like respiratory distress, feeding troubles, or withdrawal signs. If you conceive, notify your doctor at once. Don’t stop lurasidone without medical guidance. Pregnant individuals may be enrolled in a registry to monitor lurasidone’s impact on the child. Breastfeeding while on this drug could be risky—consult your doctor about potential hazards.

Latuda isn’t approved for schizophrenia in those under 13 or for bipolar depression in those under 10 years of age.
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How should I take it?

Adhere strictly to your doctor’s instructions when taking Latuda. Make sure to follow the guidance on your prescription label and review any provided medication guides or instruction sheets. Consume Latuda alongside a meal that contains a minimum of 350 calories.

Regular blood tests might be necessary. Symptom improvement might not be immediate and could take a few weeks. Continue taking the medication as prescribed.

If you notice no change in your symptoms or if they worsen, contact your doctor. Avoid discontinuing this medication abruptly, as doing so might lead to additional issues. While on Latuda, there’s an increased risk of overheating and dehydration.

Ensure you stay well-hydrated, particularly during warm weather or physical activity. You might also find yourself more reactive to extreme temperatures, whether hot or cold. Keep the medication at room temperature, ensuring it’s protected from moisture and heat.

What Happens if I miss a dose?

If you happen to miss a dose, take it immediately when you remember. However, if your next scheduled dose is near, omit the missed one. Never double up on doses. Make sure to refill your prescription before your supply depletes.

What Happens if I overdose?

In case of an overdose, immediately seek medical help or contact the Poison Help line at 1-800-222-1222.

What to avoid when you take Latuda?

Refrain from alcohol consumption, as it may trigger hazardous side effects. Do not drive or handle machinery until you’re aware of how Latuda impacts you. Be cautious, as dizziness or sleepiness can result in falls, mishaps, or serious injuries. Additionally, grapefruit and its juice can interact with lurasidone, causing adverse effects, so avoid grapefruit products during your treatment.

Side Effects

If you experience symptoms of an allergic reaction, such as hives, breathing difficulties, or swelling in your face, lips, tongue, or throat, seek immediate medical assistance.

Inform your doctor of any new or intensifying symptoms, including alterations in mood or behavior, anxiety, panic episodes, sleep disturbances, impulsiveness, irritability, agitation, hostility, aggression, restlessness, hyperactivity (either mentally or physically), increased depression, or thoughts of self-harm or suicide.

Prolonged use or high dosages of Latuda might lead to a severe, potentially irreversible movement disorder. Signs include involuntary muscle movements in areas like your lips, tongue, eyes, face, arms, or legs. The risk increases with extended use, particularly for women and older adults.

Contact your doctor immediately if you notice:

• Any uncontrollable or unusual muscle movements;
• A sensation of lightheadedness as if you might faint;
• Seizures;
• For women, changes in menstrual cycles, alterations in breast or vaginal areas, or nipple discharge;
• For men, breast enlargement or erectile dysfunction;
• Swallowing difficulties;
• Manic symptoms such as rapid thoughts, heightened energy, reduced sleep need, engaging in risky behaviors, or being unusually agitated or talkative;
• Low white blood cell indicators like fever, chills, sores in the mouth or on the skin, sore throat, coughing, or breathing issues;
• Elevated blood sugar signs such as excessive thirst, frequent urination, hunger, dry mouth, or breath that smells fruity;
• A severe reaction in the nervous system characterized by muscle rigidity, high fever, profuse sweating, confusion, irregular heartbeats, tremors, or a feeling of impending fainting.

Frequently observed side effects of Latuda might encompass:

• Sleepiness;
• Increased weight;
• Shaking, muscle rigidity, or slowed muscle actions;
• Restlessness or an inability to remain seated;
• Nausea or vomiting;
• A runny nose;
• Difficulties with sleep (insomnia).

Note that this isn’t an exhaustive list of possible side effects; others might arise. Consult your doctor for guidance on side effects. To report side effects, contact the FDA at 1-800-FDA-1088.

Interactions with other drugs

CYP3A4 Inhibitor Interactions

Strong CYP3A4 inhibitors

• Contraindicated – Do not use Latuda with strong CYP3A4 inhibitors
• These inhibitors dramatically increase Latuda blood levels (up to 9.3-fold)
• Examples: clarithromycin, ketoconazole, voriconazole, ritonavir
• Risk of significant adverse effects and toxicity

Moderate CYP3A4 inhibitors

• Require dosage adjustment rather than complete avoidance
• Increase Latuda blood levels by about 2-fold
• Dosage recommendations:
  • If already on Latuda: Reduce Latuda dose to 50% of original
  • If starting Latuda: Begin with 20mg daily (maximum 80mg daily)
• Examples: atazanavir, diltiazem, erythromycin, fluconazole, verapamil

CYP3A4 inducer interactions

Strong CYP3A4 inducers

• Contraindicated – Do not use with Latuda
• Dramatically decrease Latuda concentration (to approximately 1/5 of normal)
• Risk of treatment failure and symptom return
• Examples: rifampin, carbamazepine, phenytoin, St. John’s wort

Moderate CYP3A4 inducers

• May require increased Latuda dosage after 7+ days of combined use
• Monitoring for reduced effectiveness recommended
• Dose adjustments based on clinical response

Psychiatric medications

• No significant interactions with lithium or valproate (no dosage adjustments needed)
• Potential interactions with: Abilify, Adderall, Cymbalta, Klonopin, Lamictal, Lexapro, Prozac, Seroquel, Zoloft
• Severity varies from minor to major

Other medications

• Weak effect on digoxin levels (9-13% increase) – no dosage adjustment needed
• Minor effect on midazolam (21-44% increase) – generally manageable
• No significant effect on hormonal contraceptives

What other drugs will affect Latuda?

Combining Latuda with medications that depress breathing can lead to perilous side effects or even fatality. Before using opioids, sleeping aids, muscle relaxants, or drugs for anxiety or seizures, consult your doctor. Disclose all your current medications to your doctor, as numerous drugs can interact with lurasidone, particularly those for:

• Depressive or psychotic conditions;
• Insomnia;
• Hypertension or heart rhythm issues;
• Inflammation or swelling;
• Seizures;
• Parkinson’s disease.

This isn’t a comprehensive list, and many other medications, including prescription, over-the-counter, vitamins, and herbal supplements, may interact with lurasidone. Not every potential interaction is detailed here.

Food and alcohol considerations

• Latuda should be taken with food to enhance absorption
• Avoid alcohol while taking Latuda (increased sedation and impairment)

Hepatic impairment

• Increases Latuda blood levels significantly
• Dosage adjustments required for moderate to severe impairment

Renal impairment

• Moderate to severe impairment increases Latuda exposure by 53-200%
• Dosage adjustments recommended for creatinine clearance <50 mL/minute

Important disease interactions

• Increased risk or monitoring needed with:
  • Dementia (boxed warning for elderly patients)
  • Seizure disorders
  • Metabolic conditions (diabetes, lipid disorders)
  • Suicidality
  • Neuroleptic malignant syndrome
  • Hypotension
  • Weight gain
  • Hyperprolactinemia
  • Tardive dyskinesia

Clinical management strategies

• Avoid contraindicated combinations
• Make recommended dosage adjustments
• Monitor for both effectiveness and side effects
• Consider alternative medications when interactions cannot be avoided

Sources and publications:

• https://pubmed.ncbi.nlm.nih.gov/24825095/
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/200603s001lbl.pdf
• https://www.medcentral.com/drugs/monograph/155126-311013/lurasidone-oral
• https://www.degruyter.com/document/doi/10.1515/dmdi-2014-0005/html?lang=en
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/200603lbls10s11.pdf
• https://www.latuda.com/LatudaPrescribingInformation.pdf
• https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.13466
• https://www.rxlist.com/latuda-drug.htm
• https://go.drugbank.com/drugs/DB08815
• https://www.ema.europa.eu/en/medicines/human/EPAR/latuda
• https://www.ncbi.nlm.nih.gov/books/NBK541057/