What to Know About Caplyta (Lumateperone)

Caplyta (lumateperone) is an atypical antipsychotic medication that is used for the treatment of schizophrenia in adults. Schizophrenia is a lifelong brain disorder that causes symptoms such as delusions, hallucinations, disorganized speech, and changes in emotional expression.

Caplyta is taken as a capsule one time each day. The exact mechanism of action is not fully understood, but the medication is believed to act as an antagonist on certain serotonin and dopamine receptors. In clinical trials, the drug was shown to improve symptoms of schizophrenia. There is no generic version of the medication available.

Caplyta Uses

Caplyta is approved for the treatment of schizophrenia in adults. Caplyta works by affecting dopamine, serotonin, and glutamate in order to improve symptoms that affect mood, thoughts, and behaviors.

The medication may help with some of the symptoms of schizophrenia, which can improve functioning in daily life. Some of the symptoms of schizophrenia include:

• Agitation
• Delusions
• Disorganized behavior
• Disorganized thinking
• Hallucinations
• Lack of emotional expression

It was first approved by the Food and Drug Administration for the treatment of schizophrenia on December 20, 2019.

Off-Label Uses

Caplyta may also be prescribed off-label to treat some other mental health conditions. When a medication is prescribed off-label, it means that it has not been FDA-approved for that use. However, your doctor may choose to prescribe the medication if they believe it may provide some benefits for your condition. 

For example, some other atypical antipsychotics are sometimes prescribed off-label to treat conditions such as bipolar disorder, attention-deficit hyperactivity disorder (ADHD), anxiety, and depression.

Before Taking Caplyta

If you think that Caplyta might be right for you, it is important to talk to your doctor. Before prescribing this medication, your doctor will first need to evaluate your symptoms and make a diagnosis. This also means that your doctor will need to rule out other conditions that may be causing your symptoms. 

Your doctor may make the decision to prescribe Caplyta based on your individual symptoms, the potential side effects, and your past response to other schizophrenia medications. 

Be sure to also talk to your doctor about any other medications or supplements that you are currently taking. Some may have the potential to cause drug interactions that may be dangerous or impact the efficacy of either medication.

Precautions and Contraindications

People who have a known sensitivity to lumateperone or other components of Caplyta should not take this medication. It should also not be used to treat dementia-related psychosis. 

Antipsychotic drugs such as Caplyta may also increase the risk of neuroleptic malignant syndrome (NMS), which can be potentially fatal and cause symptoms including autonomic instability, delirium, hyperpyrexia, and muscle rigidity.

If a person experiences such symptoms, the use of Caplyta should be discontinued immediately and they should be closely monitored and treated for associated symptoms.

Caplyta Dosage 

According to the prescribing information, Caplyta is available as a 42 milligram (mg) strength capsule. All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store

It should be taken once each day with food. The medication should be stored at room temperature between 68°F to 77°F. The drug can be taken while traveling but should be kept between 59°F to 86°F during outings.

If you forget to take the medication, take it as soon as you can but skip the missed dose if it is almost time for your next one. Do not take two doses at the same time.

Caplyta Side Effects

Caplyta has the potential to cause some side effects. 

Common

The two most common side effects of Caplyta are dry mouth and sleepiness.

Severe  

Some of the more serious adverse effects that may occur while taking Caplyta include:

• Decreased blood pressure upon standing which may lead to loss of consciousness
• Impaired ability to operate vehicles or heavy equipment
• Increased risk of falls
• Increased risk of stroke and death in older individuals who have dementia-related psychosis
• Low white blood cell counts
• Seizures
• Tardive dyskinesia, which involves the uncontrolled movements of the face and body
• Weight gain and high blood glucose

Some people may also experience problems with temperature regulation. Caution should be used during strenuous exercise and care should be taken to avoid dehydration and heat exposure.

Warnings and Interactions

Antipsychotic drugs such as Caplyta have been associated with metabolic changes such as diabetes mellitus and hyperglycemia. In one trial, approximately 4.7% of patients who were taking Caplyta experienced increases in A1C levels.

You should be monitored for symptoms of hyperglycemia, diabetes mellitus, dyslipidemia, and weight gain when you begin taking the medication and checked periodically during long-term treatment.

Leukopenia and neutropenia, which involve decreases in white blood cells needed to fight infections, may also occur during treatment with Caplyta and other antipsychotic medications. Fatal cases of agranulocytosis, which involves decreases in white blood cells called granulocytes, have also been reported with other medications in this same class. 

Individuals who have a history of low white blood cell counts (WBC) should be monitored and the use of Caplyta should be discontinued if there is a significant drop in WBC.

Caplyta carries a black box warning for adverse cerebrovascular reactions, which may include stroke, in elderly patients who have dementia-related psychosis. 

You should avoid taking Caplyta with CYP3A4 inducers, moderate or strong CYP3A4 inhibitors, and UGT inhibitors. Taking these medications together can increase the risk for adverse reactions. Drugs that may lead to interactions include:

• Amprenavir
• Ciprofloxacin
• Erythromycin
• Fluvoxamine
• Clarithromycin
• Nefazodone
• Modafinil
• Prednisone
• Valproic acid 

You should also avoid taking Caplyta with grapefruit juice and St. John's wort. Avoid using drugs or alcohol while you are taking Caplyta as these substances may decrease the effectiveness of your medication and increase the risk of experiencing adverse effects such as sedation.

Taking Caplyta during the third trimester of pregnancy may lead to withdrawal or extrapyramidal symptoms in the infant. There is no estimate of the risk of miscarriage or birth defects that may result from taking Caplyta. You should discuss the risks and benefits of taking this medication during pregnancy with your doctor.

Always take your medication as directed by your doctor. Do not stop taking your medication, even if you are feeling better. If you are concerned about side effects or some other aspect of your medication, talk to your doctor first before you stop taking or change the dosage.