AdultPediatricDosage Forms & Strengths tablet 20mg 40mg 60mg 80mg 120mg Schizophrenia Indicated for schizophrenia 40 mg PO qDay initially; not to exceed 160 mg/day Initial dose titration is not required; shown to be effective in a dose range of 40-160 mg/day Bipolar Depression Monotherapy Indicated as monotherapy for adults with major depressive episode associated with bipolar I disorder (bipolar depression) 20 mg PO qDay initially; may increase dose if needed, not to exceed 120 mg/day In monotherapy study, higher dose range (80-120 mg/day) did not provide additional efficacy compared to the lower dose range (20-60 mg/day) Adjunctive therapy Indicated as adjunctive therapy for major depressive episodes associated with bipolar I disorder with lithium or valproate 20 mg PO qDay initially; may increase dose if needed, not to exceed 120 mg/day Dosage Modifications CYP3A4 inhibitors or inducers Coadministration with CYP3A4 inhibitors Strong CYP3A4 inhibitor: Contraindicated; do not coadminister (see Contraindications) Moderate CYP3A4 inhibitor (eg, diltiazem, atazanavir, erythromycin, fluconazole, verapamil): Reduce dose to 50% of original dose, not to exceed 80 mg/day; starting dose is 20 mg/day Grapefruit and grapefruit juice: Avoid coadministration Coadministration with CYP3A4 inducers Strong CYP3A4 inducer: Contraindicated; do not coadminister (see Contraindications) Moderate CYP3A4 inducer (eg, bosentan, efavirenz, etravirine, modafinil, nafcillin): It may be necessary to increase lurasidone dose after chronic treatment (ie, ≥7 days) with the inducer Renal impairment Mild (CrCl ≥50 mL/min): No dosage adjustment required Moderate-to-severe (CrCl <50 mL/min): 20 mg/day initially; not to exceed 80 mg/day Hepatic impairment Mild (Child-Pugh class A): No dosage adjustment necessary Moderate (Child-Pugh class B [Score 7-9]): 20 mg/day initially; not to exceed 80 mg/day Severe (Child-Pugh class C [Score 10-15]): 20 mg/day initially; not to exceed 40 mg/day Dosing Considerations Effectiveness for longer-term use (ie, >6 weeks) has not been established in controlled studies; therefore, the physician who elects to use lurasidone for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patientDosage Forms & Strengths tablet 20mg 40mg 60mg 80mg 120mg Schizophrenia Indicated for treatment of schizophrenia in adolescents aged 13-17 years <13 years: Safety and efficacy not established 13-17 years Starting dose: 40 mg PO qDay; initial dose titration is not required Effective dosage range: 40-80 mg/day; not to exceed 80 mg/day Bipolar Depression Indicated as monotherapy for major depressive episode associated with bipolar I disorder (bipolar depression) in adolescents aged 10-17 yr 20 mg PO qDay; initial dose titration is not required May increase dose after 1 week based on clinical response; not to exceed 80 mg qDay Effective dose range is 20-80 mg/day Clinical studies found most patients (67%) received 20-40 mg/day Dosage Modifications CYP3A4 inhibitors or inducers Coadministration with CYP3A4 inhibitors Strong CYP3A4 inhibitor: Contraindicated; do not coadminister (see Contraindications) Moderate CYP3A4 inhibitor (eg, diltiazem, atazanavir, erythromycin, fluconazole, verapamil): Reduce dose to 50% of original dose, not to exceed 80 mg/day; starting dose is 20 mg/day Grapefruit and grapefruit juice: Avoid coadministration Coadministration with CYP3A4 inducers Strong CYP3A4 inducer: Contraindicated; do not coadminister (see Contraindications) Moderate CYP3A4 inducer (eg, bosentan, efavirenz, etravirine, modafinil, nafcillin): It may be necessary to increase lurasidone dose after chronic treatment (ie, ≥7 days) with the inducer Renal impairment Mild (CrCl ≥50 mL/min): No dosage adjustment required Moderate-to-severe (CrCl <50 mL/min): 20 mg/day initially; not to exceed 80 mg/day Hepatic impairment Mild (Child-Pugh class A): No dosage adjustment necessary Moderate (Child-Pugh class B [Score 7-9]): 20 mg/day initially; not to exceed 80 mg/day Severe (Child-Pugh class C [Score 10-15]): 20 mg/day initially; not to exceed 40 mg/day Dosing Considerations Effectiveness for longer-term use (ie, >6 weeks) has not been established in controlled studies; therefore, the physician who elects to use lurasidone for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patientInteraction CheckerEnter a drug name and lurasidoneNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (43)amisulprideamisulpride, lurasidone. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.carbamazepinecarbamazepine decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated; decreases lurasidone Cmax by ~85%.ceritinibceritinib will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.chloramphenicolchloramphenicol increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.clarithromycinclarithromycin increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.cobicistatcobicistat will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Potential for increased systemic exposure of lurasidone resulting in increased risk for QT prolongation.conivaptanconivaptan increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.darunavirdarunavir increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.dexamethasonedexamethasone decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated; decreases lurasidone Cmax by ~85%.dopaminedopamine increases toxicity of lurasidone by Other (see comment). Contraindicated. Comment: Interaction applies only in setting of acute lurasidone overdose. Epinephrine may enhance hypotensive effects of lurasidone in overdose setting.elvitegravir/cobicistat/emtricitabine/tenofovir DFelvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.epinephrineepinephrine increases toxicity of lurasidone by pharmacodynamic synergism. Contraindicated. Interaction applies only in setting of acute lurasidone overdose. Epinephrine may enhance hypotensive effects of lurasidone in overdose setting.eslicarbazepine acetateeslicarbazepine acetate will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.fosamprenavirfosamprenavir increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.fosphenytoinfosphenytoin decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated; decreases lurasidone Cmax by ~85%.idelalisibidelalisib will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.imatinibimatinib increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.indinavirindinavir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.isoniazidisoniazid will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.itraconazoleitraconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.ketoconazoleketoconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.levoketoconazolelevoketoconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.metoclopramidemetoclopramide increases toxicity of lurasidone by antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Contraindicated. Concomitant use of metoclopramide and antipsychotics is contraindicated by the manufacturer of metoclopramide; increased risk of extrapyramidal effects. .nefazodonenefazodone increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.nelfinavirnelfinavir increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.nevirapinenevirapine decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.nicardipinenicardipine increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.nirmatrelvirnirmatrelvir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.nirmatrelvir/ritonavirnirmatrelvir/ritonavir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.oxcarbazepineoxcarbazepine decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.pentobarbitalpentobarbital decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.phenobarbitalphenobarbital decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.phenytoinphenytoin decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.posaconazoleposaconazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.primidoneprimidone decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.rifabutinrifabutin decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.rifampinrifampin decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone with strong CYP3A4 inducers is contraindicated.rifapentinerifapentine decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.ritonavirritonavir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.saquinavirsaquinavir increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.St John's WortSt John's Wort decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated.tipranavirtipranavir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.voriconazolevoriconazole increases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lurasidone and strong CYP3A4 inhibitors is contraindicated.Serious - Use Alternative (22)abametapirabametapir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.amobarbitalamobarbital will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.apalutamideapalutamide will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, lurasidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.enzalutamideenzalutamide will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.fexinidazolefexinidazole will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.grapefruitgrapefruit will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid grapefruit and grapefruit juice when taking lurasidone.hydrocodonehydrocodone, lurasidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.ivosidenibivosidenib will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.levodopa inhaledlurasidone decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .lonafarniblurasidone will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.lopinavirlopinavir will increase the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.lorlatiniblorlatinib will decrease the level or effect of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.metoclopramide intranasallurasidone, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: