Comparative Pharmacology
Head-to-head clinical analysis: INVEGA SUSTENNA versus LATUDA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVEGA SUSTENNA versus LATUDA.
INVEGA SUSTENNA vs LATUDA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Paliperidone is an atypical antipsychotic that acts primarily as a central dopamine type 2 (D2) receptor antagonist and serotonin type 2A (5-HT2A) receptor antagonist. It also blocks α1- and α2-adrenergic receptors and H1 histamine receptors.
Lurasidone is an atypical antipsychotic with high affinity for dopamine D2, serotonin 5-HT2A, and serotonin 5-HT7 receptors, and moderate affinity for serotonin 5-HT1A receptors. It acts as an antagonist at D2 and 5-HT2A receptors, and as a partial agonist at 5-HT1A receptors. The exact mechanism of action in schizophrenia and bipolar depression is unknown but is thought to involve modulation of these receptors.
Initiate with 234 mg intramuscular injection on day 1, then 156 mg on day 8, both deltoid. Maintenance: 117 mg monthly (range 39-234 mg) via deltoid or gluteal injection. Dosing based on paliperidone palmitate.
40 mg orally once daily initially, titrated to 80-160 mg once daily; maximum 160 mg/day. Administer with food (at least 350 calories).
None Documented
None Documented
Terminal elimination half-life ranges from 25 to 49 days (mean ~38 days) for deltoid injection and 30 to 50 days (mean ~45 days) for gluteal injection, supporting monthly dosing.
Terminal elimination half-life is approximately 20–40 hours (mean about 29 hours) in adults, supporting once-daily dosing. Steady-state is reached within 7 days.
Renal: approximately 59-80% as unchanged drug and metabolites, with about 1% unchanged; biliary/fecal: approximately 20-41% primarily as metabolites.
Approximately 80% of the dose is eliminated in feces (mostly as unchanged drug and metabolites) and about 10% in urine. Less than 2% is excreted as unchanged lurasidone in urine.
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic