Lurasidone Hydrochloride and Verelan PM

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Verapamil may significantly increase the blood levels of lurasidone. This may increase the risk of side effects such as Parkinson-like symptoms, abnormal muscle movements, seizures, high blood sugar, diabetes, high cholesterol, sex hormone irregularities, and heat-related disorders such as heat intolerance or heat stroke. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Combining these medications may also have additive effects on lowering your blood pressure. You may experience dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with moderate inhibitors of CYP450 3A4 such as diltiazem and verapamil may significantly increase the plasma concentrations of lurasidone and its active metabolite, both of which are primarily metabolized by the isoenzyme. In a pharmacokinetic study, administration of a single 20 mg dose of lurasidone with the moderate CYP450 3A4 inhibitor diltiazem (extended release formulation 240 mg/day for 5 days) resulted in a 2.1-fold increase in lurasidone peak plasma concentration (Cmax) and a 2.2-fold increase in systemic exposure (AUC) compared to administration alone. The AUC of lurasidone's active metabolite increased by 2.4-fold. The use of an immediate release formulation of diltiazem could result in a greater magnitude of interaction.

MONITOR CLOSELY: Lurasidone may potentiate the hypotensive effects of diltiazem and verapamil secondary to its peripheral alpha-1 adrenergic blocking activity. Orthostatic hypotension and syncope associated with vasodilation may occur, particularly during initiation of lurasidone therapy and following an increase in dosage.

MANAGEMENT: Lurasidone dosage should start at 20 mg/day and not exceed 80 mg/day when coadministered with moderate CYP450 3A4 inhibitors such as diltiazem and verapamil. If diltiazem or verapamil is added to existing lurasidone therapy, the lurasidone dosage should be reduced by half. Close clinical monitoring for development of hypotension is recommended. Patients should be advised to avoid rising abruptly from a sitting or recumbent position, and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Patients should also avoid driving or operating hazardous machinery until they know how the medications affect them.

Lurasidone Hydrochloride

Generic Name: lurasidone

Brand name: Latuda

Synonyms: Lurasidone

What is Lurasidone Hydrochloride?

Verelan PM

Generic Name: verapamil

Brand name: Verelan PM, Calan, Calan SR, Isoptin SR, Verelan, Isoptin, Isoptin IV, Covera-HS

Synonyms: n.a.

What is Verelan PM?