lithium, Lithobid (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Many of the gastrointestinal side effects (nausea, taste alterations, diarrhea) often disappear with continued therapy. Additionally, they may be less common if lithium is taken in divided doses with meals. If diarrhea or excessive urination lead to dehydration, lithium toxicity is possible. Lithium also can cause changes in the electrocardiogram, low blood pressure, and decreased heart rate.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Tablets: 300 mg.
  • Tablets (extended release): 300 and 450 mg.
  • Capsules: 150, 300 and 600 mg.
  • Syrup: 300 mg/5 ml

STORAGE: All formulations should be kept at room temperature, 15 C to 30 C (59 F to 86 F).

DOSING: Doses vary widely and are adjusted based on measurements of the levels of lithium in the blood. Recommended blood levels are 0.6-1.2 mEq/L. Early in therapy, dose adjustments are made as often as every 5 to 7 days to establish the correct dose. Most patients require 900-2400 mg daily in 2-4 divided doses depending on the formulation being used. Patients with kidney disease excrete less lithium from the body and, therefore, require lower doses.

DRUG INTERACTIONS: Nonsteroidal anti-inflammatory drugs (NSAIDs), (for example, ibuprofen [Motrin, Advil], naproxen [Naprosyn, Aleve], indomethacin [Indocin], nabumetone [Relafen], diclofenac [Voltaren, Cataflam, Arthrotec], ketorolac [Toradol]), reduce the kidney's ability to eliminate lithium and lead to elevated levels of lithium in the blood andside effects from lithium. Blood concentrations of lithium may need to be measured for 4 to 7 days after an NSAID is either added or stopped during lithium therapy. Aspirin and sulindac (Clinoril) do not appear to affect lithium concentrations in the blood.

Medically Reviewed by a Doctor on 2/24/2015


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