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Latuda: 7 things you should know

Written by Carmen Fookes, BPharm on Feb 16, 2021.

1. How it works

  • Latuda is a brand (trade) name for lurasidone which may be used for the treatment of schizophrenia or depressive episodes associated with Bipolar I disorder.
  • The exact way Latuda (lurasidone) works is unknown; however, experts suggest it could be mediated through a combination of central dopamine D2 and serotonin Type 2 (5HT2A) receptor antagonism.
  • Latuda belongs to the class of medicines called atypical antipsychotics. Atypical means it is less likely than older antipsychotics to cause side effects, and more likely to be effective in the treatment of symptoms such as lack of motivation and social withdrawal.

2. Upsides

  • Used to relieve symptoms associated with schizophrenia in adults and adolescents aged 13 through 17 years. The usual starting dose for both age groups is 40mg/day and the maximum recommended dosage is 160 mg/day for adults and 80 mg/day for adolescents.
  • May be used to treat depressive episodes associated with Bipolar I disorder. In adults, Latuda may be given as monotherapy or with lithium or valproate, and the initial starting dosage is 20 mg/day. The dosage range of 20 to 60 mg/day appeared just as effective as a higher dosage range of 80 to 120 mg/day. In adolescents and children aged 10 through 17 years, Latuda should only be given as monotherapy and started at 20 mg/day with a maximum recommended dose of 80 mg/day. It is not known if Latuda is effective for manic episodes associated with bipolar disorder..
  • Generic Latuda is available under the name lurasidone.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Akathisia (an inner restlessness), sedation or somnolence, nausea, vomiting, dyspepsia, extrapyramidal symptoms (such as restlessness, tremor, uncontrolled muscle contractions), dizziness, insomnia, agitation, anxiety, and restlessness are the most common side effects reported. Other reasonably common side effects include dry mouth, nasopharyngitis, and infections.
  • Should not be used for the treatment of dementia-related psychosis in elderly people as associated with a higher risk of death.
  • Many antidepressants and antipsychotics such as Latuda have been associated with an increased risk of suicidal thoughts and behaviors in children and young adults in trials. Closely monitor all people for worsening depression, agitation, or mood changes.
  • May cause a drop in blood pressure on standing, particularly at the start of treatment or following any dosage increases. May not be suitable for people with known cardiovascular disease (history of a heart attack, angina, heart failure, or arrhythmia), stroke, seizure disorders, and people at risk of dehydration.
  • Blood levels may need monitoring as Latuda can cause numbers of white blood cells to decrease and leukopenia/neutropenia have been reported. Risk is higher in those with a pre-existing low WBC or a history of drug-induced leukopenia or neutropenia.
  • May increase blood sugar levels. People with a history of diabetes or at risk of diabetes should be monitored closely. May causes changes in blood cholesterol, lipid levels, or weight gain.
  • Potentially irreversible tardive dyskinesia can develop, even with low dosages used short-term. Symptoms include facial grimacing, repetitive chewing, and tongue thrusting.
  • Rarely, may cause Neuroleptic Malignant Syndrome; symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue immediately and seek urgent medical advice.
  • May interact with several drugs, including benzodiazepines, itraconazole, diltiazem, and verapamil. See prescribing information for a full list of interactions.
  • Latuda may also increase prolactin levels which may be noticed as breast milk secretion in the absence of breastfeeding and an absence of menstrual periods in women, or in men, breast enlargement (gynecomastia) or erectile dysfunction.
  • Should be taken with food (at least 350 calories) because this substantially increases the absorption of Latuda.
  • Latuda may potentially harm an unborn baby. Advise against pregnancy. If a woman inadvertently becomes pregnant then enroll her in the National pregnancy registry for Atypical Antipsychotics at 1-866-961-2388. It is unknown what effects Latuda has on a newborn during breastfeeding.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Latuda is an atypical antipsychotic used for the treatment of schizophrenia and depression associated with bipolar I disorder. Latuda should be taken with food (at least 350 calories).

5. Tips

  • Take Latuda with a meal (at least 350 calories of food). This allows Latuda to be absorbed better.
  • May cause sedation or impair judgment skills and affect your ability to drive or operate machinery. Avoid alcohol.
  • Avoid eating grapefruit or drinking grapefruit juice during treatment with Latuda.
  • Avoid overheating and dehydration.
  • Seek urgent medical advice if you develop unusual body movements, confusion, high fever, lightheadedness, fainting, seizures, have problems controlling your body temperature, or difficulty swallowing.
  • Latuda may make you feel dizzy when going from a sitting or lying down position to standing. This may increase your risk of falls. Stand up slowly and remove any fall hazards from your home (such as loose rugs).
  • Talk with your doctor if you develop any worrying side effects such as uncontrollable facial grimacing, restlessness, severe dizziness, or severe abdominal discomfort.
  • Latuda has been associated in some people with an increased risk of suicidal thoughts and behaviors. Tell your doctor if you or the person you are caring for experience any suicidal thoughts or tendencies.
  • Tell other health professionals that you are being administered Latuda and do not take any other medications or supplements without talking to a doctor or pharmacist first to ensure they are compatible with Latuda.
  • Do not become too hot or dehydrated while taking Latuda because this may increase your risk of side effects. In hot weather stay out of the sun in a cool place and drink plenty of water.
  • Tell your doctor if you are intending to become pregnant and you are taking Latuda as your doctor may wish to change you to a different medication. If you do inadvertently become pregnant then enroll in the National pregnancy registry for Atypical Antipsychotics at 1-866-961-2388. It is unknown what effects Latuda has on a newborn during breastfeeding.

6. Response and Effectiveness

  • At least 5 short-term studies have established the effectiveness of Latuda for schizophrenia. Latuda was superior to placebo in all 5 trials, outcomes measured include BPRSd total score, CGI-S, PANSS, and superior to an active control in three. In adolescents, Latuda was shown to be superior to placebo after 5 weeks at both 40mg/day and 80 mg/day.
  • For depressive episodes associated with Bipolar I disorder, Latuda was superior to placebo at reducing MADRS and CGI-BP_S scores at week 6. The low dose range (20mg to 60mg) provided the same efficacy as the high dose range ( 80 to 120 mg/day). In children aged 10 to 17 years, Latuda was superior to placebo at reducing CDRS-R and CGI-BP-S.
  • Food substantially increases the absorption of Latuda and increases Cmax approximately 3-fold and AUC approximately 2-fold.
  • The effectiveness of Latuda for longer than 6 weeks has not been fully determined. periodically reevaluate the long-term usefulness of the medicine.

7. Interactions

Medicines that interact with Latuda may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Latuda. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Latuda include:

  • anti-anxiety medications such as diazepam and oxazepam
  • anticonvulsants, such as phenytoin
  • antidepressants, such as amitriptyline, imipramine, nortriptyline
  • antifungals, such as itraconazole or ketoconazole
  • antihistamines that cause sedation, such as diphenhydramine
  • bosentan
  • bupropion
  • duloxetine
  • HIV medications such as indinavir and ritonavir
  • monoamine oxidase inhibitors, such as isocarboxazid, or phenelzine
  • opioid analgesics such as oxycodone and morphine
  • modafinil
  • muscle relaxants such as cyclobenzaprine
  • rifampin
  • serotonin modulators, such as nefazodone and trazodone
  • sleeping pills, such as zolpidem
  • some chemotherapy treatments
  • some heart medications, such as diltiazem, or verapamil
  • other medications used to treat mental illness, such as clozapine and thioridazine
  • any medication that inhibits or induces CYP3A4.

Alcohol may worsen the side effects of Latuda such as drowsiness, dizziness, and liver toxicity.

Avoid eating grapefruit or drinking grapefruit juice during treatment with Latuda because it may increase blood levels and increase the risk of side effects such as Parkinsons-like symptoms, seizures, high blood sugar levels, and heat intolerance.

Note that this list is not all-inclusive and includes only common medications that may interact with Latuda. You should refer to the prescribing information for Latuda for a complete list of interactions.

References

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Latuda only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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