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Lurasidone Dosage

Applies to the following strength(s): 20 mg ; 40 mg ; 60 mg ; 80 mg ; 120 mg

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Schizophrenia

Initial dose: 40 mg orally once a day
Maintenance dose: 40 to 160 mg orally per day
Maximum dose: 160 mg per day

Comments:
-Initial dose titration is not needed.
-This drug should be taken with food (at least 350 calories); drug exposure is expected to be significantly lower if not taken with food.

Use: For the treatment of schizophrenia.

Usual Adult Dose for Bipolar Disorder

Initial dose: 20 mg orally once a day
Maintenance dose: 20 mg to 120 mg orally once a day
Maximum dose: 120 mg per day

Comments:
-Initial dose titration is not needed; this drug should be taken with food (at least 350 calories) drug exposure is expected to be significantly lower if not taken with food.
-Initial and maintenance doses are the same for monotherapy and for adjunctive therapy; in monotherapy studies, efficacy in the lower dose range of 20 to 60 mg per day was, on average, comparable to higher doses of 80 mg to 120 mg.
-The efficacy in the treatment of mania has not been established.

Uses:
-As monotherapy or adjunctive therapy with either lithium or valproate for the treatment of major depressive disorder associated with bipolar disorder (bipolar depression).

Renal Dose Adjustments

Mild Renal Impairment (CrCl 50 mL/min or greater): No dose adjustment recommended
Moderate to Severe Renal Impairment (CrCl less than 50 mL/min): Initial dose 20 mg orally once a day; Maximum dose: 80 mg per day

Liver Dose Adjustments

-Mild Hepatic Impairment: No dose adjustment recommended
-Moderate (Child-Pugh Score 7 to 9): Initial dose 20 mg orally once a day; Maximum dose: 80 mg per day
-Severe Hepatic Impairment (Child-Pugh Score 10 to 15): Initial dose 20 mg orally once a day; Maximum dose: 40 mg per day

Dose Adjustments

-Patients who are antipsychotic naive and patients with a history of cardiovascular or cerebrovascular disease: Consider a lower starting dose and a slower titration due to risk of orthostatic hypotension and syncope.

Concomitant Use CYP450 3A4 Inhibitors:
-Use with strong inhibitors is contraindicated.
-If a moderate CYP450 3A4 inhibitor is to be given concomitantly with lurasidone, the lurasidone dose should be reduced by one-half.
-Grapefruit and grapefruit juice should be avoided.

Concomitant Use with CYP450 3A4 Inducers:
-Use with strong inducers is contraindicated.
-If a moderate CYP450 3A4 inducer is to be given concomitantly with lurasidone, the lurasidone dose may need to be increased after chronic treatment of 7 or more days.

Precautions

US BOXED WARNINGS: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS:
-Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.
-This drug is not approved for use in patients with dementia-related psychosis.
SUICIDAL THOUGHTS AND BEHAVIORS:
-Antidepressants may increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. There was no increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24 and there was a reduction in risk with antidepressant use in patients aged 65 and older.
-Patients of all ages who are started on antidepressant therapy should be monitored for suicidal thoughts and behaviors; families and caregivers should be advised of the need for vigilance.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available.

Other Comments

Administration advice:
-Take orally with food (at least 350 calories)

General:
-Controlled clinical trials assessing long-term use are not available; the physician who prescribes this drug should periodically re-evaluate the long-term risks and benefits for the individual patient.

Monitoring:
-Cardiovascular: Orthostatic vital signs in at-risk patients
-Hematologic: CBC frequently during the first few months in patients with preexisting low WBC and/or a prior history of drug-induced leukopenia or neutropenia.
-Metabolic: Monitor for increases in blood sugar, weight, and lipids


Patient advice:
-Patients, families, and caregivers should be educated on the risks of suicidal thoughts and behaviors, as well as the risk of mania and hypomania; what to watch for and when to seek medical advice.
-This drug may impair judgment, thinking, or motor skills; have patient avoid driving or operating machinery until adverse effects are determined.
-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.
-Advise patient that this drug may cause metabolic changes such as increases in blood sugar, body weight and lipids.
-Patients should avoid overheating and dehydration.
-Patients should speak with their healthcare provider if they are taking, or plan to take any new prescription or over the counter medications because there is a potential for drug interactions; patients should be advised to avoid alcohol as it may make some side effects worse.

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