Dosing Lurasidone at 30mg Daily
Lurasidone cannot be dosed at 30mg daily because the medication is only available in tablet strengths of 20mg, 40mg, 60mg, 80mg, and 120mg, with the recommended starting dose being 40mg once daily. 1, 2
Available Dosage Forms and Strengths
Lurasidone (Latuda) is available in the following tablet strengths:
- 20mg
- 40mg
- 60mg
- 80mg
- 120mg
Standard Dosing Recommendations
- For schizophrenia: The recommended starting dose is 40mg once daily, with an approved dosing range of 40-160mg once daily 1
- For bipolar depression: The dosing range is 20-120mg once daily 2
- Lurasidone should always be administered with food (≥350 calories) to optimize absorption 2, 3
- No initial dose titration is required when starting lurasidone 1
Why 30mg Daily Is Not Possible
There are several reasons why dosing lurasidone at 30mg daily is not feasible:
- No 30mg tablet exists - The medication is not manufactured in a 30mg strength 1, 2
- Tablets should not be split - There is no information supporting that lurasidone tablets are scored or designed to be split
- Pharmacokinetic considerations - Lurasidone's pharmacokinetics have been studied at the approved doses, and efficacy has been established at doses starting at 40mg for schizophrenia and 20mg for bipolar depression 2
Alternative Dosing Options
If a dose lower than 40mg is needed:
- For patients with schizophrenia who cannot tolerate 40mg, consider using the 20mg tablet (the lowest available strength) 1
- For patients with bipolar depression, the 20mg tablet is already within the approved dosing range 2
Clinical Considerations
- Lurasidone has a favorable metabolic profile with minimal weight gain and no clinically meaningful alterations in glucose, lipids, or QTc interval 1, 3, 4
- Most common adverse events include somnolence, akathisia, nausea, and parkinsonism 1, 3
- Unlike some antipsychotics, lurasidone is not associated with significant antihistaminic or anticholinergic effects 2
- Lurasidone is primarily metabolized by CYP3A4 and should not be co-administered with strong CYP3A4 inducers or inhibitors 2
Conclusion
For patients requiring a dose lower than the standard 40mg starting dose, the 20mg tablet is the only available option. There is no approved or practical way to administer lurasidone at 30mg daily based on the available tablet strengths and dosing recommendations.