Lurasidone belongs to the group of medications called atypical antipsychotics. It is used to treat symptoms of schizophrenia for adults and adolescents (aged 15 to 17 years). Symptoms of schizophrenia are believed to be caused by an imbalance of certain chemicals in the brain known as neurotransmitters. This medication works by affecting the actions of these neurotransmitters. Lurasidone is also used to treat the symptoms of depression associated with bipolar disorder for adults and adolescents 13 years of age and older.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

For the treatment of schizophrenia, the usual recommended starting dose is 40 mg once a day. Your dose may be increased depending on how you respond to the medication. Many people experience benefit from this medication at 40 mg or 80 mg daily. The maximum recommended dose for adolescents is 80 mg daily.

For the treatment of depression associated with bipolar disorder, the usual recommended starting dose is 20 mg once daily. Your doctor may increase your dose depending on how well you respond to treatment. Many people experience benefit from this medication at doses of 20 mg to 60 mg daily. The maximum recommended dose for adolescents is 80 mg daily.

Lurasidone should be taken with food (at least 350 calories) and swallowed whole with water at approximately the same time each day. Do not stop taking this medication or change the time of the day you take it without consulting your doctor. Do not crush or cut the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor to ensure that you are getting the maximum benefit from the medication. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

20 mg
Each white-to-off-white, round tablet, debossed with "L20" on one side, contains 20 mg of lurasidone hydrochloride. Nonmedicinal ingredients: carnauba wax, croscarmellose sodium, hypromellose, magnesium stearate, mannitol, pregelatinized starch, and Opadry (hypromellose, titanium dioxide, and polyethylene glycol).

40 mg
Each white-to-off-white, round tablet, debossed with "L40" on one side, contains 40 mg of lurasidone hydrochloride. Nonmedicinal ingredients: carnauba wax, croscarmellose sodium, hypromellose, magnesium stearate, mannitol, pregelatinized starch, and Opadry (hypromellose, titanium dioxide, and polyethylene glycol).

60 mg
Each white-to-off-white, capsule-shaped tablet, debossed with "L60" on one side, contains 60 mg of lurasidone hydrochloride. Nonmedicinal ingredients: carnauba wax, croscarmellose sodium, hypromellose, magnesium stearate, mannitol, pregelatinized starch, and Opadry (hypromellose, titanium dioxide, and polyethylene glycol).

80 mg
Each pale green, oval tablet, debossed with "L80" on one side, contains 80 mg of lurasidone hydrochloride. Nonmedicinal ingredients: carnauba wax, croscarmellose sodium, FD&C Blue No. 2 Aluminum Lake, hypromellose, magnesium stearate, mannitol, pregelatinized starch, Opadry (hypromellose, titanium dioxide, and polyethylene glycol), and yellow ferric oxide.

120 mg
Each white-to-off-white, oval tablet, debossed with "L120" on one side, contains 120 mg of lurasidone hydrochloride. Nonmedicinal ingredients: carnauba wax, croscarmellose sodium, hypromellose, magnesium stearate, mannitol, pregelatinized starch, and Opadry (hypromellose, titanium dioxide, and polyethylene glycol).

Do not take lurasidone if you:

• are allergic to lurasidone or any ingredients of the medication
• are taking certain medications that interact with lurasidone (e.g., ketoconazole or rifampin)

For a complete list of interactions, see the "What other drugs could interact with this medication?" section.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• drowsiness or sleepiness
• nausea
• restlessness
• tremor, muscle stiffness, slowing of movement
• trouble sleeping
• vomiting
• weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• constipation (new or worsening)
• decreased sexual function (men)
• difficulty swallowing
• feeling faint or dizzy, losing consciousness, or feeling a change in the way your heart beats (palpitations)
• involuntary movements mainly of your face or tongue
• menstrual changes
• production of breast milk (women)
• swelling of the breasts
• symptoms of an infection (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• symptoms of blood clots (e.g., swelling, pain, and redness in an arm or leg that can be warm to touch, or sudden chest pain and difficulty breathing)
• symptoms of decreased blood pressure (e.g., lightheadedness or fainting when rising too quickly from a sitting or lying position)
• symptoms of increased blood sugar (e.g., feeling very thirsty, feeling very hungry, needing to urinate more than usual, weakness or tiredness, feeling sick to your stomach, confusion, fruity-smelling breath)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• long-lasting (greater than 4 hours in duration) and painful erection of the penis
• seizure
• signs of neuroleptic malignant syndrome (e.g., pronounced muscle stiffness or inflexibility with high fever, rapid or irregular heartbeat, sweating, confusion, or reduced consciousness)
• symptoms of a severe allergic reaction such as swelling of the mouth, face, lips, or tongue, possibly with difficulty breathing
• symptoms of serious skin rash with fever, liver, kidney, or other organ system damage
• symptoms of a stroke (e.g., sudden weakness or numbness of the face, arms, or legs; dizziness; headache; difficulty speaking; vision problems), even if they occur for a short period of time
• very dark ("tea-coloured") urine, muscle tenderness, aching

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clots: Lurasidone may increase the risk of blood clots, especially in the lower leg. Talk to your doctor or pharmacist if you have risk factors for developing blood clots (e.g., a family history of blood clots, recent major surgery, immobility due to air travel or other reason). Contact your doctor immediately if you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking.

Body temperature: This medication, like other antipsychotic medications, can disrupt the body's ability to control body temperature. People who exercise vigorously, who are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., benztropine, oxybutynin) are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool.

Diabetes: Lurasidone, like other similar medications, can increase blood sugar levels. If you have diabetes or are at risk for diabetes (e.g., family history of diabetes, obesity), discuss with your doctor how this medication may affect your medical condition and whether any special monitoring is needed. If you develop symptoms of high blood sugar (e.g., excessive thirst or hunger, weakness, confusion, weight loss), contact your doctor.

Drowsiness/reduced alertness: Lurasidone may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.

Falls: Some of the side effects of lurasidone can contribute to falls. Pay attention to the side effects that you experience and talk to your doctor or pharmacist about ways to reduce the risk of falling.

Heart conditions: Do not take lurasidone if you have a history of abnormal heart rhythms (including QT prolongation), slow heartbeat, or low potassium or magnesium levels, or if you are taking a medication that can cause QT prolongation (e.g., procainamide, amiodarone, moxifloxacin). If you are at risk for heart rhythm problems (e.g., people with heart failure, angina, low potassium or magnesium levels), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hypersensitivity reaction: Rarely, people taking lurasidone report a severe skin reaction. In rare cases, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS syndrome) may occur. This reaction involves symptoms including fever, swollen glands, yellowing of the skin or eyes, flu-like symptoms with skin rash or blistering, or other organ involvement. These reactions are medical emergencies. Get immediate medical attention if you have symptoms of a severe allergic reaction. If you experience any unusual symptoms, contact your doctor.

Kidney function: If you have kidney problems or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood pressure: Lurasidone may cause a lowering of blood pressure when rising from a sitting or lying position, or a racing heart rate, especially during the few weeks of treatment. If you feel dizzy or lightheaded or feel your pulse is racing, and this feeling does not go away after a few minutes, call your doctor. Because this medication can cause dizziness or lightheadedness, do not get up too quickly after you have been sitting or lying for prolonged periods. If you have heart disease (e.g., heart failure, heart attack) or are taking medications that lower blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Movement disorders: There is a risk of developing tardive dyskinesia (TD), while taking lurasidone. TD is a potentially irreversible syndrome of involuntary, repetitive, and purposeless movements of the face and tongue muscles (such as grimacing; tongue protrusion; lip smacking; puckering; rapid eye blinking; rapid movements of the arms, legs, and torso). Although TD appears most commonly in seniors,  it is impossible to predict who will develop it. The risk of developing TD increases with higher doses and long-term treatment. If you experience muscle twitching or abnormal movements of the face or tongue, contact your doctor as soon as possible.

Neuroleptic malignant syndrome (NMS): A risk of developing this condition has been associated with antipsychotic medications, including lurasidone. If you experience increased sweating and sensations of warmth, muscle stiffness, emotional and behavioural changes, or irregular heartbeat, contact your doctor immediately. People taking this medication should take care to avoid becoming overheated or dehydrated.

Prolactin levels: As with other antipsychotics, lurasidone can elevate levels of the hormone prolactin. This may lead to symptoms such as spontaneous flow of milk from the breast, irregular menstruation, breast enlargement in males, diminished sexual function in males, and decreased bone strength. If you experience any of these symptoms, contact your doctor.

Seizures: Lurasidone may reduce seizure control for people with a history of seizures or those who are at risk of developing seizures. If you have a history of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Suicidal behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Weight gain: Lurasidone may cause weight gain. Consult your doctor or pharmacist if you find the change to be of concern.

White blood cells: As with other antipsychotics, lurasidone can lower the number of infection-fighting white blood cells in your blood. This can increase your risk of infections. If you experience frequent colds or other infections, contact your doctor. Your doctor will monitor your white blood cell levels with blood tests during treatment with lurasidone.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Babies born to people that take this medication in the last 3 months of pregnancy may experience withdrawal symptoms after they are born, including breathing problems, difficulty feeding, or irritability. If you have been taking this medication during pregnancy, make sure that everyone involved in caring for you and your baby are aware.

Breast-feeding: It is not known if lurasidone passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using lurasidone for the treatment of schizophrenia has not been established for children less than 15 years of age. The safety and effectiveness of using lurasidone for the treatment of depression associated with bipolar disorder has not been established for children less than 13 years of age.

Seniors: Seniors with dementia who take lurasidone or other similar medications are at an increased risk of dying. There may be a higher risk of liver, kidney, and heart problems, and a higher risk of drug interactions for seniors. Talk to your doctor about the risks and benefits of using this medication.

There may be an interaction between lurasidone and any of the following:

• alcohol
• aldesleukin
• aliskiren
• alpha-agonists (e.g., clonidine, methyldopa)
• alpha adrenergic blockers (e.g., doxazosin, prazosin, tamsulosin)
• amiodarone
• amphetamines (e.g., amphetamine, dextroamphetamine, lisdexamfetamine)
• angiotensin-converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
• angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
• antihistamines (e.g., azelastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, rupatadine)
• anti-Parkinsons medications (e.g., amantadine, apomorphine, bromocriptine, entacapone, levodopa, pramipexole, ropinirole, rotigotine)
• antipsychotics (e.g., aripiprazole, cariprazine, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• apalutamide
• aprepitant
• "azole" antifungals (e.g., ketoconazole, fluconazole, itraconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• bosentan
• brimonidine
• buprenorphine
• bupropion
• butorphanol
• cabergoline
• caffeine, cola products
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• cannabis
• chloral hydrate
• cobicistat
• cyclosporine
• diabetes medications (e.g., acarbose, canagliflozin, glyburide, insulin, linagliptin, liraglutide, lixisenatide, metformin, rosiglitazone)
• dimenhydrinate
• diuretics (e.g., amiloride, furosemide, hydrochlorothiazide)
• donepezil
• dronedarone
• efavirenz
• elagolix
• enzalutamide
• eplerenone
• esketamine
• etravirine
• finerenone
• flibanserin
• galantamine
• general anesthetics (medications used to put people to sleep before surgery)
• guanfacine
• grapefruit juice
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• hydralazine
• iodinated contrast agents
• kava kava
• lemborexant
• lenacapavir
• letermovir
• linezolid
• lithium
• lomitapide
• lumacaftor and ivacaftor
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• methadone
• methylphenidate
• metoclopramide
• mifepristone
• minocycline
• mirtazapine
• mitotane
• modafinil
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone, tapentadol, tramadol)
• nirmatrelvir and ritonavir
• nitrates (e.g., nitroglycerin, isosorbide dinitrate)
• perampanel
• pizotifen
• polyethylene glycol electrolyte solution
• pomalidomide
• pregabalin
• procainamide
• protein kinase inhibitors (e.g., ceritinib, dabrafenib, nilotinib)
• rifabutin
• rifampin
• riociguat
• rivastigmine
• sacubitril
• seizure medications (e.g., carbamazepine, clobazam, gabapentin, levetiracetam, phenytoin, rufinamide, topiramate, valproic acid)
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline, vortioxetine)
• serotonin-norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• simvastatin
• sirolimus
• sodium oxybate
• sodium phosphates
• spironolactone
• stiripentol
• tacrolimus
• tetrabenazine
• tetrahydrocannabinol
• thalidomide
• theophyllines (e.g., aminophylline, theophylline)
• trazodone
• tretinoin
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• tryptophan
• ubrogepant
• valerian
• vilazodone
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.