CLINICAL PHARMACOLOGY Mechanism of Action:
The mechanism of action of lurasidone, as with other drugs having efficacy in
schizophrenia, is unknown. It has been suggested that the efficacy of lurasidone
in schizophrenia is mediated through a combination of central dopamine Type 2
(D2) and serotonin Type 2 (5HT2A) receptor antagonism.
INDICATIONS AND USAGE
LATUDA is indicated for the treatment of patients with schizophrenia.
The efficacy of LATUDA in schizophrenia was established in four 6-week
controlled studies of adult patients with schizophrenia.
The effectiveness of LATUDA for longer-term use, that is, for more than 6 weeks,
has not been established in controlled studies. Therefore, the physician who
elects to use LATUDA for extended periods should periodically re-evaluate the
long-term usefulness of the drug for the individual patient.
DOSAGE AND ADMINISTRATION Schizophrenia:
The recommended starting dose of LATUDA is 40 mg once daily. Initial dose
titration is not required. LATUDA has been shown to be effective in a dose range
of 40 mg/day to 120 mg/day. In the 6-week controlled trials, there was no
suggestion of added benefit with the 120 mg/day dose, but there was a
dose-related increase in certain adverse reactions. Therefore, the maximum
recommended dose is 80 mg/day.
Administration Instructions: LATUDA should be taken with food
(at least 350 calories)
Renal Dosing
Dosage in Special Populations: Renal Impairment:
It is recommended that LATUDA dose should not exceed 40 mg/day in
patients with moderate and severe renal impairment (Clcr
10 mL/min to < 50
mL/min).
After administration of a single dose of 40 mg LATUDA to patients with
mild, moderate and severe renal impairment, mean Cmax increased by 40%,
92% and 54%, respectively and mean AUC increased by 53%, 91% and 2-
times, respectively compared to healthy matched subjects.
Dose adjustment is recommended in moderate and
severe hepatic impairment patients. The dose in these
patients should not exceed 40 mg/day. Dosing recommendation for patients taking LATUDA concomitantly
with potential CYP3A4 inhibitors: When coadministration of
LATUDA with a moderate CYP3A4 inhibitor such as diltiazem is considered,
the dose should not exceed 40 mg/day. LATUDA should not be used in
combination with a strong CYP3A4 inhibitor (e.g., ketoconazole).
Dosing recommendation for patients taking LATUDA concomitantly
with potential CYP3A4 inducers: LATUDA should not be used in
combination with a strong CYP3A4 inducer (e.g., rifampin).
Hemodialysis
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