[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Second-generation antipsychotics](https://durgical.com/en/pharmacology/classes/second-generation-antipsychotics/) › Lurasidone

# Lurasidone

## Second-generation antipsychotics?

Second-generation antipsychotics

A second-generation antipsychotic for schizophrenia and bipolar depression. It must be taken with a meal and cannot be combined with strong CYP3A4 drugs.

Updated Nov 12, 2026

## Quick facts

**Group**
[Second-generation antipsychotics](https://durgical.com/en/pharmacology/classes/second-generation-antipsychotics/)

**Target**
Dopamine D2 and serotonin 5-HT2A and 5-HT7 receptors

**Used for**
Schizophrenia in adults and adolescents

**Key effects**
Akathisia · Sleepiness · Nausea

**Monitor**
Weight · Akathisia and other movement disorders

**ATC**
N05AE05

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Dopamine D2 and serotonin 5-HT2A and 5-HT7 receptors**Lurasidone

ⓘ The figure shows risperidone in the human D2 receptor; lurasidone blocks the same receptor site (no lurasidone-bound structure is available).

**Target in 3D:** Dopamine D2 and serotonin 5-HT2A and 5-HT7 receptors. PDB structure 6CM4 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6CM4) · Drag to rotate · pinch to zoom

Lurasidone blocks dopamine D2 and serotonin 5-HT2A receptors, the shared action of second-generation antipsychotics, and also blocks 5-HT7 receptors. 5-HT7 antagonism is one proposed explanation for its antidepressant effect in bipolar depression. Akathisia is a common adverse effect.

- Blocks D2 and 5-HT2A receptors
- Also blocks 5-HT7 receptors
- Treats psychosis and bipolar depression
- Common motor effect: akathisia

## Indications

- Schizophrenia in adults and adolescents [Schizophrenia →](https://durgical.com/en/conditions/schizophrenia/)
- Depressive episodes of bipolar I disorder (alone, or with lithium or valproate in adults) [Bipolar disorder →](https://durgical.com/en/conditions/bipolar-disorder/)

## Adverse effects

### Common

- Akathisia (restlessness) and other extrapyramidal symptoms
- Sleepiness
- Nausea
- Raised prolactin: breast changes, missed periods

### Serious (rare, important)

- Higher death and stroke risk in older people with dementia (boxed warning)
- Suicidal thoughts in young people treated for depression (boxed warning)
- Neuroleptic malignant syndrome; tardive dyskinesia
- High blood sugar, which can progress to ketoacidosis

## Contraindications

- Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir)
- Strong CYP3A4 inducers (rifampicin, St John's wort, phenytoin, carbamazepine)
- Hypersensitivity to lurasidone

## Key interactions

**Strong CYP3A4 inhibitors**
Large rise in lurasidone levels and toxicity; contraindicated.

**Strong CYP3A4 inducers**
Levels fall so much that it stops working; contraindicated.

**Grapefruit juice**
Large amounts can raise levels; avoided.

## What is monitored

- Weight, glucose and lipids
- Akathisia and other movement disorders
- Mood and suicidal thoughts in bipolar depression
- Liver and kidney function (doses are lower in impairment)

## Administration and safety

- Oral tablet once a day with a meal (a real meal, not a snack).
- Every new prescription is checked for strong CYP3A4 inhibitors or inducers before starting.
- The dose is lowered in moderate or severe liver or kidney impairment.

## Pregnancy and breastfeeding

Newborns exposed in the third trimester may have extrapyramidal or withdrawal symptoms; use weighs benefit and risk.

## Nursing care

- Before: record weight, glucose and lipids; review all medicines and herbal products.
- During: ask about restlessness and inability to sit still; report it.
- Watch mood and suicidal thoughts.
- Teach to take it with food and to avoid grapefruit and alcohol.

## Pharmacokinetics

**Absorption**
Oral; food greatly increases absorption, so it is taken with a meal.

**Metabolism**
Liver, by CYP3A4.

## Memory aid

LURasidone is LURED by food: no meal, no absorption.

## Test yourself

Think of the answer, then tap the question to see it.

## Why must lurasidone be taken with food?

Food greatly increases its absorption; on an empty stomach levels are too low.

## Why are rifampicin and ketoconazole contraindicated with lurasidone?

Lurasidone depends on CYP3A4: the inducer makes it ineffective and the inhibitor makes it toxic.

## Which movement side effect is especially common with lurasidone?

Akathisia (inner restlessness).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lurasidone/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Quetiapine](https://durgical.com/en/pharmacology/quetiapine/)
- [Aripiprazole](https://durgical.com/en/pharmacology/aripiprazole/)
- [Ziprasidone](https://durgical.com/en/pharmacology/ziprasidone/)

## Related conditions 2

- [Schizophrenia](https://durgical.com/en/conditions/schizophrenia/)
- [Bipolar disorder](https://durgical.com/en/conditions/bipolar-disorder/)

[← Back to the class: Second-generation antipsychotics](https://durgical.com/en/pharmacology/classes/second-generation-antipsychotics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Lurasidone: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a611016.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [LURASIDONE HYDROCHLORIDE tablet, film coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=083a1a52-5a13-4e28-8ef2-127ac4ce5b2d) (DailyMed (U.S. National Library of Medicine), 2026); [Structure of the D2 Dopamine Receptor Bound to the Atypical Antipsychotic Drug Risperidone](https://www.rcsb.org/structure/6CM4) (RCSB Protein Data Bank, 2018); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N05AE05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/lurasidone/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/lurasidone/