lithium, Lithobid (cont.)

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Medical and Pharmacy Editor:

Caffeine appears to reduce serum lithium concentrations, and side effects of lithium have increased in frequency when caffeine is consumed.

Both diltiazem (Cardizem-CD, Tiazac, Dilacor-XR) and verapamil (Calan-SR, Isoptin-SR, Verelan, Covera-HS) have been reported to have variable effects on lithium levels in blood. In some patients there may be decreased lithium blood levels and in others lithium toxicity.

Methyldopa (Aldomet) may increase the likelihood of lithium toxicity.

Various reactions have resulted when lithium is administered with phenothiazines, (for example, chlorpromazine [Thorazine], thioridazine [Mellaril], trifluoperazine [Stelazine] or with haloperidol [Haldol]). Such reactions have included delirium, seizures, encephalopathy, high fever or certain neurologic reactions that affect movement of muscles, called extrapyramidal symptoms.

Lithium can cause goiter or hypothyroidism. The use of lithium with potassium iodide can increase the likelihood of this adverse reaction.

The use of the beta blocker, propranolol (Inderal), with lithium can lead to a slow heart rate and dizziness. Other beta blockers, (for example, metoprolol [Lopressor], atenolol [Tenormin]) also may interact with lithium and be associated with a slow heart rate.

PREGNANCY: Lithium crosses the placenta and has been associated with toxicity in the fetus. Children born to women taking lithium during pregnancy have an increased risk of goiter and cardiac anomalies. If possible, lithium should be withheld during the first trimester. Women of childbearing age who may require lithium should be counseled about becoming pregnant.

Medically Reviewed by a Doctor on 3/28/2013


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