LurasidoneLurasidone Hydrochloride

About Lurasidone

Lurasidone is an atypical antipsychotic that, like others in its group, blocks dopamine D2 receptors. Its label covers schizophrenia in adults and adolescents aged 13 to 17, and depressive episodes of bipolar I disorder (bipolar depression), on its own in adults and in children aged 10 to 17, or together with lithium or valproate in adults. It is taken once a day with food of at least 350 calories, and no gradual build-up is needed at the start. For schizophrenia the start is 40 mg, within a range of 40 to 160 mg for adults and 40 to 80 mg for adolescents; for bipolar depression it starts at 20 mg, up to 120 mg in adults and 80 mg in children and adolescents.

The boxed warnings say older people with dementia-related psychosis treated with antipsychotics have a higher risk of death, and lurasidone is not approved for them; and that antidepressants increased suicidal thoughts and behaviors in children and young adults in short-term studies, so patients are monitored for worsening and suicidal thinking. Other warnings cover stroke in older people with dementia, neuroleptic malignant syndrome, tardive dyskinesia, rises in blood sugar, cholesterol and weight, raised prolactin, low white blood cell counts, dizziness or fainting on standing, falls, seizures, impaired thinking and motor skills, overheating, triggering of mania, trouble swallowing, and neurological reactions in Parkinson’s disease or dementia with Lewy bodies. It must not be taken with strong CYP3A4 inhibitors such as ketoconazole, clarithromycin, ritonavir or voriconazole, or strong inducers such as rifampin, St. John’s wort, phenytoin or carbamazepine. Sleepiness, restlessness (akathisia), other movement symptoms and nausea are the common side effects; children with bipolar depression most often had nausea, weight gain and trouble sleeping.

Dose limits are part of everyday use. With a moderate CYP3A4 inhibitor such as diltiazem, erythromycin, fluconazole or verapamil, the dose is halved, or started at 20 mg with a maximum of 80 mg; a moderate inducer may call for a higher dose after a week or more. Moderate or severe kidney impairment and moderate liver impairment mean a 20 mg start and at most 80 mg a day, and severe liver impairment at most 40 mg. Weight is checked, fasting blood sugar is tested at the start and periodically in people at risk of diabetes, and a low white cell count calls for frequent blood counts in the first months. Babies exposed in the last three months of pregnancy may have movement or withdrawal symptoms after birth, and a pregnancy registry follows outcomes.

Taking Lurasidone

How to take it

Once a day with food of at least 350 calories, at the dose the prescriber sets; the label does not call for a gradual build-up at the start.

If you miss a dose

Take it as soon as you can, but skip the missed dose if it is almost time for the next one. Do not take two doses at one time.

Storage

At room temperature, away from moisture and heat, out of reach of children.

Interactions to know about

Strong CYP3A4 inhibitors and inducers must not be taken with it, and moderate inhibitors such as diltiazem, erythromycin, fluconazole and verapamil limit the dose. Avoid grapefruit products and alcohol, avoid becoming overheated or dehydrated, and do not drive until you know how it affects you.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Lurasidone differs from pharmacy to pharmacy

Generic lurasidone has many makers, so quotes for the same tablet differ mainly by each pharmacy’s purchase cost, markup and dispensing fee, and the five strengths are not priced evenly. A prescription that names Latuda and blocks substitution is quoted at a brand price. Most doses are a single tablet a day, so a ninety-day fill spreads one dispensing fee over more tablets.

Ways to pay less for Lurasidone without insurance

• Ask for generic substitution, and make sure the prescription does not name Latuda only.
• Ask for your dose as a single tablet where one strength covers it, such as one 80 mg tablet rather than two 40 mg tablets.
• Once your dose is stable, ask for a ninety-day supply, and compare more than one pharmacy.
• Ask whether lurasidone is on the pharmacy’s flat-price generic list.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Lurasidone

1. 1.What counts as enough food to take my dose with?
2. 2.Do my antibiotics, antifungals or heart medicines change how much lurasidone I can take?
3. 3.Which restlessness, movement symptoms, fever or stiffness should I report straight away?
4. 4.When will my weight, blood sugar and cholesterol be checked?

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