8 Lurasidone (Latuda) Interactions to Consider

If you’re taking lurasidone (Latuda) for bipolar disorder or schizophrenia, you’ve probably reviewed the proper dosage and potential side effects with your prescriber. But what do you know about its interactions with other medications?

Drug interactions can affect how well lurasidone works or may increase your risk of side effects. Knowing about them in advance can help you avoid any possible issues and help you get the most from your medication. 

Here, we’ll review eight lurasidone interactions to be aware of. Keep in mind, this isn’t a complete list of all possible interactions. Your healthcare team can identify any additional interactions based on your medical history. 

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1. Antifungals such as ketoconazole

Azole antifungals are medications that treat fungal infections, such as yeast infections or nail fungus. Common examples include ketoconazole, fluconazole (Diflucan), and voriconazole (Vfend). These medications can raise lurasidone levels in the body if they’re taken together. This increases the risk of lurasidone side effects, such as drowsiness, nausea, and uncontrollable body movements.

It’s best to avoid some azole antifungals if you’re taking lurasidone. But it may be OK to take them together if you lower your lurasidone dosage. So be sure to let your prescriber know you’re taking lurasidone if you’re seeking treatment for a fungal infection. They can let you know how to safely combine the medications and make any dosage adjustments if needed.

Good to know: Interactions are more likely with oral antifungal pills than with topical forms (such creams or ointments). But it’s still a good idea to check with your healthcare team before using an over-the-counter (OTC) antifungal cream if you take lurasidone.

2. Macrolide antibiotics such as erythromycin

Clarithromycin (Biaxin XL) and erythromycin (Ery-Tab, Erythrocin, Eryped, E.E.S.) are both macrolide antibiotics. They treat various types of bacterial infections, such as pneumonia. Like azole antifungals, these macrolides can raise lurasidone levels in the body if they’re taken together.

It’s best to avoid clarithromycin while you’re taking lurasidone. But it may be OK to take erythromycin as long as you lower your lurasidone dosage. Be sure to let your infection care team know you’re taking lurasidone. This will help them choose the best option and adjust your lurasidone dosage if needed during treatment.

3. Calcium channel blockers such as diltiazem

Diltiazem (Cardizem) and verapamil (Verelan) belong to a class of medication called calcium channel blockers. They treat high blood pressure and other heart-related health conditions. These two medications interact with lurasidone by increasing its levels in the body.

The manufacturer of lurasidone recommends taking half of the usual dose if you also take diltiazem or verapamil. And if you stop taking diltiazem or verapamil (with a prescriber’s approval), be sure to let your mental healthcare team know. They may need to raise your lurasidone dosage to keep your levels where they should be.

4. Paxlovid

Paxlovid (nirmatrelvir / ritonavir) is an oral antiviral medication that treats COVID-19. It can raise lurasidone levels in the body if they’re taken together. So this combination isn’t recommended.

If you need COVID treatment, let your healthcare team know you’re taking lurasidone. There are other COVID treatments that don’t interact with it, such as remdesivir (Veklury) or molnupiravir (Lagevrio). They can help you decide on the best treatment for your needs.

5. St. John’s wort

St. John’s wort is an OTC dietary supplement that some people take to help with depression symptoms. But it’s well known for its medication interactions. St. John’s wort can decrease levels of lurasidone in the body. This can make lurasidone less effective, which can worsen your mental health symptoms.

It’s best to avoid taking St. John’s wort with lurasidone. If you’re looking for natural ways to help manage depression, then exercise, meditation, and journaling are safer options. Your healthcare team can also suggest supplements that are safe to take with your other medications.

6. Modafinil (Provigil)

Modafinil (Provigil) is a stimulant medication that treats narcolepsy and shift work disorder. It can lower lurasidone levels if they’re taken together.

You may need a higher dose of lurasidone if you take it with modafinil. Your prescriber will help determine the right lurasidone dosage if you’re taking both medications. But be sure to let them know if you’re planning to stop taking modafinil at any point. They may need to lower your lurasidone dosage first to keep your levels stable and avoid unwanted side effects.

7. Certain HIV medications

Several antiviral medications that treat HIV can also interact with lurasidone.

Some, such as ritonavir (Norvir) and atazanavir (Reyataz), can increase lurasidone levels. Others, such as efavirenz and etravirine (Intelence), can lower lurasidone levels. And it’s common for HIV medications to contain a combination of active ingredients, which can make interactions harder to predict.

It’s best to review your medication list with your HIV care team before starting treatment or when making any changes to your prescriptions. They can evaluate all of the possible interactions and decide on the best treatment regimen for your needs. They can also adjust your lurasidone dosage if needed.

8. Certain anti-seizure medications

Anti-seizure (antiepileptic) medications help prevent and treat seizures. Some anti-seizure medications, such as carbamazepine (Tegretol, Carbatrol) and phenytoin (Dilantin, Phenytek), can lower levels of lurasidone in the body, which can make it less effective.

Taking lurasidone with carbamazepine or phenytoin isn’t recommended. Your prescriber may choose an alternative anti-seizure medication that doesn’t interact with lurasidone. Or they may choose a lurasidone alternative if you’re already taking one of these anti-seizure medications and it’s working well for you.

Can you take other mental health medications, such as Wellbutrin or Lamictal, with lurasidone?

Yes, but only if your healthcare team OKs it.

In some cases, one medication isn’t enough to manage your symptoms. So your prescriber may add other medications to your treatment plan that work differently than lurasidone. This may include antidepressants, such as bupropion (Wellbutrin XL). Or it may include a mood stabilizer, such as lamotrigine (Lamictal). 

It’s also common to take lurasidone along with lithium (Lithobid) or valproate medications (valproic acid, Depakote) for bipolar disorder.

Keep in mind that some anti-seizure medications are also prescribed as mood stabilizers. And as mentioned, some anti-seizure medications may interact with lurasidone. Your prescriber will help determine what medications are safe to combine with lurasidone if you need additional treatment.

Can you drink alcohol with lurasidone?

It’s best to avoid alcohol while you’re taking lurasidone. Alcohol can increase the risk of side effects, such as dizziness and drowsiness. Heavy or long-term drinking may also make your medication less effective. What’s more, alcohol can worsen mental health symptoms.

Let your healthcare team know if you’re having trouble avoiding alcohol while taking lurasidone. They can provide resources to help you.

If you or someone you know struggles with alcohol use, help is available. Call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.

When should you seek medical care about lurasidone interactions?

Ideally, your healthcare team will manage most interactions before they happen. Your prescriber and pharmacist should review your current medication list and address any issues that come up. So it’s helpful to let them know if you make any changes to the medications you take, including OTC treatments.

If at any point you notice an increase in lurasidone side effects, or it doesn’t seem to be working as well as it should, an interaction could be to blame. So it’s best to talk to your healthcare team if these issues arise. They can determine the cause and best course of action.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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