Maximum Dose of Latuda in Renal Impairment
For patients with moderate to severe renal impairment, the maximum recommended dose of Latuda (lurasidone) is 80 mg per day, with a starting dose of 20 mg per day. 1
Dosing by Renal Function Status
Normal Renal Function
- Standard maximum dose: 120 mg per day for adults with bipolar depression 1
- Starting dose: 20 mg per day 1
- Must be taken with food (at least 350 calories) to ensure adequate absorption 1
Moderate to Severe Renal Impairment
- Maximum dose is reduced to 80 mg per day 1
- Starting dose: 20 mg per day 1
- This represents a 40 mg reduction from the standard maximum dose for bipolar depression 1
Pediatric Patients (10-17 years) with Bipolar Depression
- Standard maximum: 80 mg per day 1
- With renal impairment: Maximum remains 80 mg per day (same as adult renal impairment dosing) 1
Critical Administration Requirements
Latuda must always be administered with food containing at least 350 calories to substantially increase absorption, regardless of renal function status 1. Failure to take with adequate food significantly reduces bioavailability and therapeutic effectiveness 1, 2.
Drug Interaction Considerations Affecting Maximum Dose
When patients with renal impairment are also taking moderate CYP3A4 inhibitors (such as diltiazem):
- Reduce dose to half the original level 1
- Maximum dose becomes 40 mg per day (half of the 80 mg renal impairment maximum) 1
- Starting dose: 20 mg per day 1
Strong CYP3A4 inhibitors (ketoconazole) and strong inducers (rifampin) are contraindicated with lurasidone 3.
Common Pitfall to Avoid
Do not assume that higher doses provide greater efficacy. Doses above 80 mg per day in the general population do not confer additional therapeutic benefit and increase adverse effects such as somnolence and akathisia 4, 3. In renal impairment, the 80 mg maximum is both a safety and efficacy ceiling.