lithium, Lithobid (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
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.
Diuretics (water pills) should be used cautiously in patients receiving lithium. Diuretics that act at the distal renal tubule, (for example, hydrochlorothiazide [Hydrodiuril], spironolactone [Aldactone], triamterene [Dyrenium; Dyazide, Maxzide]), can increase blood concentrations of lithium. Diuretics that act at the proximal tubule, (for example, acetazolamide [Diamox]), are more likely to reduce blood concentrations of lithium. Diuretics such as furosemide (Lasix) and bumetanide (Bumex) may have no affect on lithium concentrations in blood.
Medically Reviewed by a Doctor on 3/28/2013
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