Latuda: Uses, Dosage & Side Effects
Atypical antipsychotic (lurasidone) for schizophrenia
Quick Facts About Latuda
Key Takeaways About Latuda (Lurasidone)
- Must be taken with food: Lurasidone absorption increases approximately two-fold when taken with a meal of at least 350 calories — taking it on an empty stomach significantly reduces effectiveness
- Favourable metabolic profile: Compared to some other atypical antipsychotics, lurasidone has a lower risk of significant weight gain and metabolic disturbances due to minimal histamine H1 receptor affinity
- Critical drug interactions: Lurasidone must not be taken with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) or strong CYP3A4 inducers (e.g., rifampicin, carbamazepine)
- Available for adolescents: Latuda is approved for schizophrenia in adolescents aged 13–17 years, with a maximum dose of 74 mg/day
- Full effect takes time: While some improvement may be noticed within days, full therapeutic benefit typically requires several weeks of consistent treatment
What Is Latuda and What Is It Used For?
Latuda (lurasidone) is an atypical antipsychotic that blocks dopamine D2 and serotonin 5-HT2A receptors in the brain. It is approved for treating schizophrenia in adults (aged 18 and over) and adolescents (aged 13 to 17 years). In the United States, lurasidone is additionally approved for the treatment of depressive episodes associated with bipolar I disorder.
Lurasidone belongs to the benzisothiazol class of atypical (second-generation) antipsychotics. It was first approved by the U.S. Food and Drug Administration (FDA) in 2010 and subsequently authorised by the European Medicines Agency (EMA). The medication is available under the brand name Latuda and as generic formulations including Lurasidone Accord, Lurasidone Orifarm, and Lurasidon G.L. Pharma.
The pharmacological profile of lurasidone is notable for its high-affinity antagonism at dopamine D2 receptors and serotonin 5-HT2A receptors, combined with antagonism at serotonin 5-HT7 receptors and partial agonism at serotonin 5-HT1A receptors. The 5-HT7 receptor antagonism is thought to contribute to procognitive effects, which distinguishes lurasidone from many other antipsychotics. Importantly, lurasidone has negligible affinity for histamine H1 receptors and muscarinic M1 receptors, which explains its lower propensity for weight gain and anticholinergic side effects compared to agents like olanzapine or clozapine.
Schizophrenia
Schizophrenia is a chronic and often severe psychiatric condition characterised by a constellation of symptoms that can profoundly affect a person's thinking, perception, emotions, and behaviour. The condition typically presents with positive symptoms such as hallucinations (hearing, seeing, or sensing things that are not present), delusions (firmly held false beliefs), and disorganised thinking or speech. Negative symptoms include emotional withdrawal, reduced motivation, flat affect, and social isolation. Cognitive difficulties — including problems with attention, memory, and executive function — are also common and can significantly impair daily functioning.
Lurasidone helps manage these symptoms by modulating neurotransmitter activity in the brain. By blocking dopamine D2 receptors primarily in the mesolimbic pathway, it reduces the overactive dopamine signalling thought to underlie positive psychotic symptoms. Its serotonergic activity may contribute to improvements in negative and cognitive symptoms. A landmark 2019 network meta-analysis published in The Lancet, comparing 32 oral antipsychotics for acute schizophrenia, positioned lurasidone as an effective treatment option with a favourable tolerability profile, particularly regarding metabolic outcomes.
Bipolar depression (selected markets)
In the United States, lurasidone is also FDA-approved for the treatment of depressive episodes associated with bipolar I disorder, both as monotherapy and as adjunctive therapy with lithium or valproate. This indication is based on clinical trials demonstrating statistically significant and clinically meaningful improvements in depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale (MADRS). This indication is not currently approved by the EMA for European markets, where Latuda is authorised only for schizophrenia.
Lurasidone should always be used under the supervision of a psychiatrist or other specialist experienced in treating serious mental health conditions. The medication must be taken with food (at least 350 calories) for adequate absorption. Without food, blood levels of lurasidone may be too low for the medication to be effective. The decision to start, adjust, or stop lurasidone should be made jointly between patient and clinician.
What Should You Know Before Taking Latuda?
Before starting Latuda, tell your doctor about all medical conditions, current medications, and whether you are pregnant or breastfeeding. Lurasidone has important contraindications, particularly regarding concurrent use with strong CYP3A4 inhibitors and inducers. Several medical conditions require careful evaluation before treatment can begin.
Lurasidone is a potent medication that requires careful consideration of individual patient factors before initiation. Your doctor will assess your overall health status, review your complete medication list, and may order baseline blood tests including fasting glucose, lipid panel, and complete blood count. These parameters will be monitored at regular intervals throughout treatment to ensure safety.
Contraindications
You should not take Latuda in the following circumstances:
- Known hypersensitivity to lurasidone or any of the other ingredients in the formulation (including mannitol, pregelatinised starch, croscarmellose sodium, hypromellos, magnesium stearate)
- Concurrent use of strong CYP3A4 inhibitors — including ketoconazole, itraconazole, posaconazole, voriconazole (antifungals); clarithromycin, telithromycin (antibiotics); indinavir, cobicistat, nelfinavir, ritonavir, saquinavir (HIV antivirals); boceprevir, telaprevir (hepatitis C antivirals); nefazodone (antidepressant)
- Concurrent use of strong CYP3A4 inducers — including rifampicin (tuberculosis treatment); carbamazepine, phenobarbital, phenytoin (anticonvulsants); St. John’s wort (Hypericum perforatum)
These contraindications are absolute because strong CYP3A4 inhibitors can dramatically increase lurasidone blood levels, leading to toxicity, while strong CYP3A4 inducers can reduce levels to the point of therapeutic failure.
Warnings and precautions
It is important to understand that lurasidone may take several days to weeks before its full therapeutic effect is achieved. During this period, maintain regular contact with your prescribing doctor. Speak with your doctor or pharmacist before taking Latuda, or during treatment, especially if you:
- Have suicidal thoughts or behaviours — close monitoring is essential, particularly during the initial weeks of treatment
- Have Parkinson’s disease or dementia — antipsychotics may worsen motor symptoms and are associated with increased mortality in elderly patients with dementia-related psychosis
- Have ever been diagnosed with neuroleptic malignant syndrome (NMS) — characterised by high fever, muscle rigidity, altered consciousness, and autonomic instability; this rare but life-threatening condition can be caused by antipsychotics
- Have experienced extrapyramidal symptoms or tardive dyskinesia (involuntary movements of the face, tongue, or limbs) with previous antipsychotic treatment
- Have heart disease or are receiving treatment that could increase the risk of low blood pressure, including medications that prolong the QT interval on ECG
- Have a history of seizures or epilepsy — lurasidone may lower the seizure threshold
- Have a history of blood clots or a family history of venous thromboembolism, as antipsychotics have been associated with clot formation
- Have hormonal disturbances such as gynaecomastia (breast enlargement in males), amenorrhoea (absent menstruation), or erectile dysfunction
- Have diabetes or risk factors for diabetes — monitoring of blood glucose is recommended
- Have impaired kidney or liver function — dose adjustments may be necessary
- Experience orthostatic hypotension (dizziness upon standing) — lurasidone can cause blood pressure drops
- Have opioid dependence (treated with buprenorphine), severe pain (treated with opioids), or depression treated with antidepressants — concurrent use with Latuda may increase the risk of serotonin syndrome, a potentially life-threatening condition
Lurasidone is not approved for use in elderly patients with dementia-related psychosis. Studies with atypical antipsychotics in this population have shown an increased risk of death. Like all antipsychotics, Latuda carries a boxed warning (in the US) regarding this increased mortality risk.
Children and adolescents
Latuda is not recommended for children younger than 13 years of age. For adolescents aged 13 to 17, lurasidone may be prescribed for schizophrenia under specialist supervision, but with specific dosing restrictions — the maximum recommended dose in this age group is 74 mg once daily. Metabolic side effects should be monitored carefully, as younger patients may be more vulnerable to weight gain and lipid changes.
Pregnancy and breastfeeding
If you are pregnant, think you may be pregnant, or are planning to become pregnant, consult your doctor before taking Latuda. Lurasidone should not be used during pregnancy unless your doctor has determined that the potential benefit of treatment outweighs the risks to the unborn child.
If your doctor considers it necessary to continue treatment during pregnancy, the baby will be closely monitored after birth. Newborns whose mothers received antipsychotics during the third trimester may experience withdrawal symptoms including:
- Tremor, muscle rigidity or weakness
- Drowsiness, agitation
- Breathing difficulties
- Feeding problems
Contact your doctor immediately if your newborn develops any of these symptoms.
It is not known whether lurasidone is excreted in human breast milk. Breastfeeding is not recommended during treatment with Latuda. Discuss alternative infant feeding options with your doctor if you need to continue the medication.
Driving and operating machinery
Drowsiness, dizziness, and visual disturbances can occur during treatment with lurasidone. Do not drive, cycle, or operate machinery until you know how this medication affects you. These effects are more likely during the initial weeks of treatment or after dose adjustments.
Lurasidone must be taken with food or shortly after eating. The bioavailability of lurasidone increases approximately two-fold when administered with food compared to fasting conditions. A meal containing at least 350 calories is recommended. Additionally, grapefruit juice must be avoided as it inhibits CYP3A4 and can increase lurasidone levels.
How Does Latuda Interact with Other Drugs?
Lurasidone is primarily metabolised by the CYP3A4 enzyme. Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) and strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin) are contraindicated. Moderate CYP3A4 inhibitors (diltiazem, erythromycin, fluconazole) may require lurasidone dose reductions. Grapefruit juice must be avoided.
Drug interactions with lurasidone are primarily mediated through the cytochrome P450 3A4 (CYP3A4) enzyme system. Since lurasidone is extensively metabolised by CYP3A4, any drug that significantly inhibits or induces this enzyme will affect lurasidone blood levels. Additionally, pharmacodynamic interactions may occur with medications that act on the central nervous system or affect blood pressure. It is essential that your doctor and pharmacist are aware of all medications you take, including prescription drugs, over-the-counter products, and herbal supplements.
Contraindicated combinations (must not be used together)
| Drug | Type | Effect on Lurasidone | Risk |
|---|---|---|---|
| Ketoconazole, Itraconazole, Posaconazole, Voriconazole | Antifungals (strong CYP3A4 inhibitors) | Dramatically increases levels | Severe toxicity |
| Clarithromycin, Telithromycin | Antibiotics (strong CYP3A4 inhibitors) | Dramatically increases levels | Severe toxicity |
| Ritonavir, Indinavir, Nelfinavir, Saquinavir, Cobicistat | HIV antivirals (strong CYP3A4 inhibitors) | Dramatically increases levels | Severe toxicity |
| Nefazodone | Antidepressant (strong CYP3A4 inhibitor) | Dramatically increases levels | Severe toxicity |
| Rifampicin | Anti-tuberculosis (strong CYP3A4 inducer) | Dramatically decreases levels | Therapeutic failure |
| Carbamazepine, Phenobarbital, Phenytoin | Anticonvulsants (strong CYP3A4 inducers) | Dramatically decreases levels | Therapeutic failure |
| St. John’s wort | Herbal supplement (strong CYP3A4 inducer) | Dramatically decreases levels | Therapeutic failure |
Moderate interactions (may require dose adjustment)
The following moderate CYP3A4 inhibitors can increase lurasidone blood levels. When used concomitantly, the lurasidone dose should generally not exceed 37 mg/day:
| Drug | Category | Effect | Action Required |
|---|---|---|---|
| Diltiazem | Antihypertensive / anti-anginal | Increases lurasidone levels | Limit lurasidone to 37 mg/day |
| Erythromycin | Antibiotic | Increases lurasidone levels | Limit lurasidone to 37 mg/day |
| Fluconazole | Antifungal | Increases lurasidone levels | Limit lurasidone to 37 mg/day |
| Verapamil | Antihypertensive / anti-anginal | Increases lurasidone levels | Limit lurasidone to 37 mg/day |
The following moderate CYP3A4 inducers may decrease lurasidone blood levels, potentially reducing its effectiveness:
- Amprenavir, Efavirenz, Etravirine (HIV antivirals)
- Aprepitant (anti-emetic)
- Armodafinil, Modafinil (wakefulness promoters)
- Bosentan (pulmonary hypertension treatment)
- Nafcillin (antibiotic)
- Prednisone (corticosteroid)
- Rufinamide (anticonvulsant)
Your doctor may need to increase the lurasidone dose when these medications are used concurrently.
Other important interactions
Alcohol: Do not consume alcohol while taking Latuda. Alcohol enhances the sedative effects of lurasidone and may increase the risk of dizziness, drowsiness, and impaired judgement.
Blood-pressure-lowering medications: Lurasidone can cause orthostatic hypotension (a drop in blood pressure when standing up). Combined use with antihypertensives may increase this risk. Blood pressure monitoring is advisable, especially during the initial treatment period.
Dopamine agonists and levodopa: Lurasidone may reduce the effect of these medications used for Parkinson’s disease and restless legs syndrome, as it blocks dopamine receptors.
Serotonergic drugs: Concurrent use of lurasidone with opioids (including buprenorphine), certain antidepressants (SSRIs, SNRIs, tricyclics, MAOIs such as moclobemide or tranylcypromine), or other serotonergic medications may increase the risk of serotonin syndrome. Symptoms include involuntary muscle jerking, agitation, hallucinations, coma, excessive sweating, tremor, hyperreflexia, muscle rigidity, and body temperature above 38°C. Contact your doctor immediately if you experience these symptoms.
Grapefruit juice: Must be avoided during treatment as it inhibits CYP3A4 and can increase lurasidone blood levels, potentially causing adverse effects.
What Is the Correct Dosage of Latuda?
The recommended starting dose of Latuda for adults with schizophrenia is 37 mg once daily, taken with food. The dose can be adjusted within the range of 18.5 mg to 148 mg/day based on clinical response. For adolescents (13–17 years), the starting dose is 37 mg/day with a maximum of 74 mg/day. Always take Latuda exactly as prescribed by your doctor.
The dose of lurasidone is individualised by your prescribing doctor based on your specific condition, symptom severity, other medications, kidney and liver function, and overall health. Lurasidone should be taken once daily at the same time each day, with food or shortly after eating. Taking the medication with food is not optional — it is essential for adequate absorption, as bioavailability approximately doubles compared to fasting conditions.
Adults (aged 18 and over)
| Parameter | Dose | Notes |
|---|---|---|
| Starting dose | 37 mg once daily | Taken with food (≥350 calories) |
| Dose range | 18.5 mg – 148 mg once daily | Adjusted based on clinical response and tolerability |
| Maximum dose | 148 mg once daily | Higher doses not shown to provide additional benefit |
| With moderate CYP3A4 inhibitors | Maximum 37 mg once daily | e.g., diltiazem, erythromycin, fluconazole |
Adolescents (aged 13 to 17 years)
Adolescent dosing
Starting dose: 37 mg lurasidone once daily
Dose range: 37 mg to 74 mg once daily
Maximum dose: 74 mg once daily — the maximum daily dose must not exceed 74 mg in this age group
As with adults, the medication must be taken with food. Dose adjustments should be made by the prescribing specialist, typically a child and adolescent psychiatrist.
Patients with kidney impairment
No dose adjustment is generally required for mild renal impairment. For moderate to severe kidney impairment, the starting dose should be 18.5 mg/day and the maximum dose should not exceed 74 mg/day. Your doctor will determine the appropriate dose based on your kidney function tests.
Patients with liver impairment
For patients with moderate hepatic impairment, the starting dose should be 18.5 mg/day and the dose should not exceed 74 mg/day. For severe hepatic impairment, the starting dose should be 18.5 mg/day and the dose should not exceed 37 mg/day. Your doctor will assess your liver function before and during treatment.
How to take Latuda
Swallow the tablet(s) whole with water to avoid the bitter taste. Take your dose at the same time each day to help you remember. Always take this medication with food or shortly after eating — this is essential for the body to absorb the medication properly and for it to work effectively. A meal of at least 350 calories is recommended.
Missed dose
If you forget to take a dose, do not take a double dose to compensate. If you miss one dose, take the next dose the following day at your regular time. If you miss two or more consecutive doses, contact your doctor for advice on how to resume treatment.
Overdose
If you take more Latuda than prescribed, contact your doctor or emergency services immediately. Symptoms of overdose may include excessive drowsiness, fatigue, abnormal involuntary movements, difficulty standing and walking, dizziness from low blood pressure, and abnormal heart rhythm. There is no specific antidote for lurasidone; treatment is supportive and symptomatic.
Stopping treatment
Do not stop taking Latuda without consulting your doctor, even if you feel better. If you discontinue the medication, the therapeutic effects will be lost and your symptoms may return. Your doctor will advise you on how to safely reduce and stop the medication when appropriate.
What Are the Side Effects of Latuda?
The most common side effects of Latuda in adults include akathisia (restlessness), nausea, and insomnia. Common side effects also include parkinsonism, drowsiness, dizziness, agitation, and elevated creatine phosphokinase levels. Lurasidone generally has a more favourable metabolic profile than several other antipsychotics, with lower risks of significant weight gain and metabolic disturbances.
Like all medications, lurasidone can cause side effects, although not everyone experiences them. The side effects described below are based on data from clinical trials and post-marketing surveillance. Some side effects are serious and require immediate medical attention, while others are more common and usually manageable.
Severe allergic reaction (common: up to 1 in 10): fever, swelling of the mouth, face, lips or tongue, difficulty breathing, itching, rash, and sometimes a drop in blood pressure.
Stevens-Johnson syndrome (frequency unknown): severe blistering rash affecting the skin, mouth, eyes, and genitals.
Neuroleptic malignant syndrome (NMS) (rare: up to 1 in 1,000): fever, sweating, muscle rigidity, and reduced consciousness — a potentially life-threatening condition.
Blood clots: swelling, pain, and redness in a leg (deep vein thrombosis) which may travel to the lungs causing chest pain and breathing difficulty (pulmonary embolism).
Side effects in adults
Very Common
May affect more than 1 in 10 people
- Akathisia (restlessness and inability to sit still)
- Nausea
- Insomnia (difficulty sleeping)
Common
May affect up to 1 in 10 people
- Parkinsonism (tremor, muscle stiffness, slow movements, reduced facial expression, shuffling gait)
- Speech difficulties, unusual muscle movements (extrapyramidal symptoms)
- Rapid heartbeat (tachycardia)
- Increased blood pressure
- Dizziness
- Muscle spasms and stiffness
- Vomiting, diarrhoea
- Back pain
- Skin rash and itching
- Indigestion, dry mouth or increased salivation
- Abdominal pain
- Drowsiness, fatigue, agitation and anxiety
- Weight gain
- Increased creatine phosphokinase (muscle enzyme) in blood tests
- Increased creatinine (kidney marker) in blood tests
- Decreased appetite
Uncommon
May affect up to 1 in 100 people
- Slurred speech, nightmares, difficulty swallowing
- Gastric irritation, sudden anxiety, seizures
- Chest pain, muscle pain, joint pain
- Loss of consciousness, spinning sensation
- Abnormal heart rhythm (slow or fast heartbeat)
- Difficulty walking, stiff posture
- Elevated prolactin, elevated blood glucose, elevated liver enzymes (blood tests)
- Blood pressure drop upon standing (orthostatic hypotension)
- Blurred vision, excessive sweating
- Hot flushes, painful urination
- Tardive dyskinesia (involuntary movements of mouth, tongue or limbs)
- Low sodium levels (hyponatraemia)
- Lethargy, flatulence, neck pain
- Erectile dysfunction, painful or absent menstruation
- Decreased red blood cell count
Rare
May affect up to 1 in 1,000 people
- Rhabdomyolysis (breakdown of muscle fibres — presents as muscle pain, nausea, confusion, dark urine)
- Increased eosinophils (a type of white blood cell)
- Angioedema (swelling beneath the skin)
- Deliberate self-harm
- Cerebrovascular event (stroke)
- Kidney failure
- Decreased white blood cell count
- Breast pain, milk discharge from breasts
- Sudden death
Not Known
Frequency cannot be estimated from available data
- Decreased neutrophils (a group of white blood cells)
- Sleep disturbances
- Neonatal symptoms: agitation, increased or decreased muscle tone, tremor, drowsiness, breathing difficulties, feeding problems
- Abnormal breast enlargement
Side effects in adolescents (13–17 years)
Adolescents may experience similar side effects to adults, but some occur more frequently in this age group. The most common side effects reported in adolescents include:
- Very common: Akathisia, headache, drowsiness, nausea
- Common: Decreased or increased appetite, nightmares, insomnia, agitation, anxiety, irritability, fatigue, depression, Parkinsonism, abnormal involuntary movements (dystonia, dyskinesia), rapid heartbeat, vomiting, constipation, dry mouth, sweating, muscle stiffness, erectile dysfunction, weight gain or loss, elevated creatine phosphokinase, elevated prolactin
Additional uncommon side effects in adolescents include hypothyroidism, thyroid inflammation, aggressive behaviour, impulsive behaviour, confusion, hallucinations, suicidal thoughts, panic attacks, restless legs syndrome, taste changes, memory impairment, migraine, palpitations, blood pressure changes, hair loss, urticaria (hives), joint pain, Tourette syndrome, chills, fever, and various laboratory abnormalities including changes in cholesterol, triglycerides, blood glucose, insulin, liver enzymes, and thyroid function.
In elderly patients with dementia, a small increase in the number of deaths has been reported for those taking antipsychotic medications compared to those not taking these medications. This is a class-wide warning that applies to all antipsychotics including lurasidone.
How Should You Store Latuda?
Store Latuda in its original packaging, protected from light, and keep it out of the sight and reach of children. Do not use the medication after the expiry date printed on the packaging.
Proper storage of lurasidone is important to maintain the medication’s effectiveness and safety. Follow these storage guidelines:
- Keep out of the sight and reach of children — store in a secure location
- Store in the original packaging — lurasidone is light-sensitive and must be protected from light exposure
- Check the expiry date — do not use the medication after the expiry date (marked “EXP” on the carton and blister pack). The expiry date refers to the last day of that month
- Do not dispose of in wastewater or household waste — return unused or expired medication to a pharmacy for proper disposal to protect the environment
What Does Latuda Contain?
Each Latuda tablet contains lurasidone hydrochloride as the active ingredient, available in 18.5 mg, 37 mg, and 74 mg strengths. The tablets also contain inactive ingredients including mannitol, pregelatinised starch, croscarmellose sodium, and hypromellose.
Active ingredient
The active substance is lurasidone, present as lurasidone hydrochloride:
- Each 18.5 mg tablet contains lurasidone hydrochloride equivalent to 18.6 mg lurasidone
- Each 37 mg tablet contains lurasidone hydrochloride equivalent to 37.2 mg lurasidone
- Each 74 mg tablet contains lurasidone hydrochloride equivalent to 74.5 mg lurasidone
Inactive ingredients (excipients)
The tablets also contain: mannitol, pregelatinised starch, croscarmellose sodium, hypromellose 2910, magnesium stearate (E 470b), titanium dioxide (E171), macrogol, yellow iron oxide (E172) (in 74 mg tablets), indigotine (E132) (in 74 mg tablets), and carnauba wax (E903).
Tablet appearance
| Strength | Colour | Shape | Imprint |
|---|---|---|---|
| 18.5 mg | White to off-white | Round | LA |
| 37 mg | White to off-white | Round | LB |
| 74 mg | Pale green | Oval | LD |
Latuda is available in perforated aluminium/aluminium unit dose blisters in pack sizes of 14, 28, 30, 56, 60, 90, or 98 film-coated tablets. Not all pack sizes may be available in all markets.
This medication contains less than 1 mmol (23 mg) sodium per tablet, and is essentially “sodium-free”.
Frequently Asked Questions About Latuda
Latuda (lurasidone) is an atypical antipsychotic medication approved for treating schizophrenia in adults (18 years and older) and adolescents (13–17 years). It helps reduce symptoms such as hallucinations, delusions, disorganised thinking, and emotional withdrawal by blocking dopamine and serotonin receptors in the brain. In the United States, it is additionally approved for bipolar I depression.
Yes, Latuda must always be taken with food or shortly after eating. A meal containing at least 350 calories is recommended. Food approximately doubles the absorption of lurasidone. Taking it on an empty stomach may result in blood levels that are too low for the medication to work effectively.
The most common side effects (affecting more than 1 in 10 people) are akathisia (restlessness and inability to sit still), nausea, and insomnia. Common side effects (up to 1 in 10 people) include drowsiness, dizziness, parkinsonism (tremor, slow movements, muscle stiffness), agitation, vomiting, weight gain, and back pain. Lurasidone generally has a more favourable metabolic profile than some other antipsychotics.
Weight gain is listed as a common side effect of Latuda, but clinical evidence suggests that lurasidone causes less weight gain compared to many other antipsychotics. This is because lurasidone has very low affinity for histamine H1 receptors, which are strongly linked to appetite stimulation and weight gain. However, individual responses vary, and regular weight monitoring remains recommended.
Lurasidone is metabolised by the CYP3A4 enzyme. Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) and strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, St. John’s wort) must not be used with Latuda. Moderate CYP3A4 inhibitors (diltiazem, erythromycin, fluconazole) require limiting the lurasidone dose to 37 mg/day. Grapefruit juice must also be avoided. Always tell your doctor about all medications you are taking.
Latuda should only be used during pregnancy if the expected benefit to the mother outweighs the potential risk to the baby. Newborns exposed to antipsychotics during the third trimester may experience withdrawal symptoms including tremor, muscle problems, drowsiness, breathing difficulties, and feeding issues. Women who are pregnant or planning pregnancy should discuss their treatment with their doctor. Breastfeeding is not recommended while taking Latuda.
References
This article is based on the following peer-reviewed sources and regulatory documents:
- European Medicines Agency (EMA). Summary of Product Characteristics: Latuda (lurasidone hydrochloride). EMA/EPAR. 2024. Available at: ema.europa.eu
- U.S. Food and Drug Administration (FDA). Prescribing Information: Latuda (lurasidone hydrochloride) tablets. FDA. 2024.
- National Institute for Health and Care Excellence (NICE). Clinical Guideline CG178: Psychosis and Schizophrenia in Adults: Prevention and Management. NICE. Updated 2024.
- Huhn M, Nikolakopoulou A, Schneider-Thoma J, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. The Lancet. 2019;394(10202):939–951. doi:10.1016/S0140-6736(19)31135-3
- Citrome L. Lurasidone for the treatment of schizophrenia: a review of the evidence. Expert Opinion on Pharmacotherapy. 2021;22(15):2019–2033.
- Loebel A, Cucchiaro J, Sarma K, et al. Efficacy and safety of lurasidone 80 mg/day and 160 mg/day in the treatment of schizophrenia: a randomized, double-blind, placebo- and active-controlled trial. Schizophrenia Research. 2013;145(1–3):101–109.
- Nasrallah HA, Silva R, Phillips D, et al. Lurasidone for the treatment of acutely psychotic patients with schizophrenia: a 6-week, randomized, placebo-controlled study. Journal of Psychiatric Research. 2013;47(5):670–677.
- Meyer JM, Mao Y, Pikalov A, et al. Weight change during long-term treatment with lurasidone: pooled analysis of studies in patients with schizophrenia. International Clinical Psychopharmacology. 2015;30(6):342–350.
- British National Formulary (BNF). Lurasidone hydrochloride monograph. NICE BNF. 2025.
- World Health Organization (WHO). Model List of Essential Medicines – 23rd List. WHO. 2023.
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in clinical pharmacology and psychiatry.
iMedic Medical Editorial Team — specialists in clinical pharmacology, psychiatry, and evidence-based medicine. All content is based on international guidelines (EMA, FDA, NICE, BNF) and peer-reviewed research.
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