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Lusiax Actions |
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Lusiax is an atypical antipsychotic that is a D2 and 5-HT2A (mixed serotonin and dopamine activity) to improve cognition. It is thought that antagonism of serotonin receptors can improve negative symptoms of psychoses and reduce the extrapyramidal side effects that are often associated with typical antipsychotics.
Take Lusiax only as directed by your doctor even if you feel well. Do not take more of Lusiax and do not take it more often than your doctor ordered. Lusiax works best if there is a constant amount in the blood. To keep blood levels constant, take Lusiax at the same time each day and do not miss any doses.
You must take Lusiax with food (containing at least 350 calories).
The dose of Lusiax will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Lusiax. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of Lusiax, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Lusiax should be taken with food (at least 350 calories).
Use Lusiax regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
Store at room temperature away from moisture and heat.
The mechanism of action of Lusiax in the treatment of schizophrenia and bipolar depression is unknown. However, its efficacy in schizophrenia and bipolar depression could be mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism.
Lusiax is an antagonist with high affinity binding at the dopamine D2 receptors (Ki=1 nM) and the 5-hydroxytryptamine (5-HT, serotonin) receptors 5-HT2A (Ki=0.5 nM) and 5-HT7 (Ki=0.5 nM) receptors. It also binds with moderate affinity to the human α2C adrenergic receptors (Ki=11 nM), is a partial agonist at serotonin 5-HT1A (Ki=6.4 nM) receptors, and is an antagonist at the α2A adrenergic receptors (Ki=41 nM). Lusiax exhibits little or no affinity for histamine H1 and muscarinic M1 receptors (IC50 > 1,000 nM).
ECG Changes
The effects of Lusiax on the QTc interval were evaluated in a randomized, double-blind, multiple-dose, parallel-dedicated thorough QT study in 43 patients with schizophrenia or schizoaffective disorder, who were treated with Lusiax doses of 120 mg daily, 600 mg daily and completed the study. The maximum mean (upper 1-sided, 95% CI) increase in baseline-adjusted QTc intervals based on individual correction method (QTcI) was 7.5 (11.7) ms and 4.6 (9.5) ms, for the 120 mg and 600 mg dose groups respectively, observed at 2 to 4 hours after dosing. In this study, there was no apparent dose (exposure)-response relationship.
In short-term, placebo-controlled studies in schizophrenia and bipolar depression, no post-baseline QT prolongations exceeding 500 msec were reported in patients treated with Lusiax or placebo.
The activity of Lusiax is primarily due to the parent drug. The pharmacokinetics of Lusiax is dose-proportional within a total daily dose range of 20 mg to 160 mg. Steady-state concentrations of Lusiax are reached within 7 days of starting Lusiax.
Following administration of 40 mg of Lusiax, the mean (%CV) elimination half-life was 18 (7) hours.
Absorption and Distribution: Lusiax is absorbed and reaches peak serum concentrations in approximately 1-3 hours. It is estimated that 9-19% of an administered dose is absorbed. Following administration of 40 mg of Lusiax, the mean (%CV) apparent volume of distribution was 6173 (17.2) L. Lusiax is highly bound (~99%) to serum proteins.
In a food effect study, Lusiax mean Cmax and AUC were about 3-times and 2-times, respectively, when administered with food compared to the levels observed under fasting conditions. Lusiax exposure was not affected as meal size was increased from 350 to 1000 calories and was independent of meal fat content.
In clinical studies, establishing the safety and efficacy of Lusiax, patients were instructed to take their daily dose with food.
Metabolism and Elimination: Lusiax is metabolized mainly via CYP3A4. The major biotransformation pathways are oxidative N-dealkylation, hydroxylation of norbornane ring, and S-oxidation. Lusiax is metabolized into two active metabolites (ID-14283 and ID-14326) and two major non-active metabolites (ID-20219 and ID-20220). Based on in vitro studies, Lusiax is not a substrate of CYP1A1, CYP1A2, CYP2A6, CYP4A11, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 or CYP2E1 enzymes. Because Lusiax is not a substrate for CYP1A2, smoking is not expected to have an effect on the pharmacokinetics of Lusiax.
Total excretion of radioactivity in urine and feces combined was approximately 89%, with about 80% recovered in feces and 9% recovered in urine, after a single dose of [14C]-labeled Lusiax.
Following administration of 40 mg of Lusiax, the mean (%CV) apparent clearance was 3902 (18.0) mL/min.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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