Lithium

What is the most important information I should know about lithium?
•
Call your doctor if you experience nausea, vomiting, diarrhea, slurred speech, extreme drowsiness, or weakness. These symptoms may be early signs of lithium toxicity.
•
Do not crush, chew, or break any extended-release forms of lithium (e.g., Lithobid, Eskalith CR). They are specially formulated to release slowly in the body.
•
Lithium may cause dizziness or drowsiness. Use caution when driving or performing other hazardous activities until you know how this medication affects you. If you experience dizziness or drowsiness, avoid these activities.
What is lithium?
•
Lithium is a naturally occurring substance. As a medication, lithium reduces chemicals in the body that cause excitation or mania.
•
Lithium is used to treat manic episodes of manic-depressive illness. Lithium helps to prevent and control symptoms of mania such as hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger.
•
Lithium may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking lithium?
•
Before taking lithium, tell your doctor if you
·
have kidney disease;
·
have heart disease; or
·
have thyroid problems.
•
You may not be able to take lithium, or you may require a dosage adjustment or special monitoring if you have any of the conditions listed above.
•
Lithium is in the FDA pregnancy category D. This means that lithium is known to be harmful to an unborn baby. Do not take lithium without first talking to your doctor if you are pregnant or are planning a pregnancy.
•
Lithium passes into breast milk and may affect a nursing infant. Do not take lithium without first talking to your doctor if you are breast-feeding a baby.
•
Lithium may have greater effects in people over 65 years of age. Your doctor may prescribe a lower dose or recommend special monitoring if you are over 65 years of age.
How should I take lithium?
•
Take lithium exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
•
Take each dose with a full glass of water.
•
Do not crush, chew, or break any extended-release or controlled-release forms of lithium (e.g., Lithobid, Eskalith CR). They are specially formulated to release slowly in the body.
•
Measure the liquid form of lithium with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
•
Maintain adequate fluid intake by drinking 8 to 12 glasses of water or other fluid every day while taking lithium. Vigorous exercise, prolonged exposure to heat or sun, excessive sweating, diarrhea, or vomiting may cause dehydration and side effects from lithium. Call your doctor if you lose a significant amount of body fluid as a result of sweating, diarrhea, or vomiting.
•
Your doctor may want you to have regularly scheduled blood tests during treatment with lithium to monitor the amount of medication in your body.
•
Do not stop taking lithium without first talking to your doctor, even if you begin to feel better. Treatment with lithium may be necessary even if you are feeling well.
•
Store lithium at room temperature away from moisture and heat.
What happens if I miss a dose?
•
Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose.
What happens if I overdose?
•
Seek emergency medical attention.
•
Symptoms of a lithium overdose include diarrhea, nausea, vomiting, drowsiness, weakness, decreased coordination, giddiness, blurred vision, ringing in the ears, and seizures.
What should I avoid while taking lithium?
•
Lithium may cause dizziness or drowsiness. Use caution when driving or performing other hazardous activities until you know how this medication affects you. If you experience dizziness or drowsiness, avoid these activities.
•
Maintain adequate fluid intake by drinking 8 to 12 glasses of water or other fluid every day while taking lithium. Vigorous exercise, prolonged exposure to heat or sun, excessive sweating, fever, diarrhea, or vomiting may cause dehydration and side effects from lithium. Call your doctor if you lose a significant amount of body fluid as a result of sweating, diarrhea, or vomiting.
•
Do not change the amount of salt that you consume in your diet. Consuming more or less salt could change the amount of lithium in your blood.
What are the possible side effects of lithium?
•
If you experience any of the following serious side effects, stop taking lithium and seek emergency medical attention or contact your doctor immediately:
·
an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
·
blurred vision or eye pain;
·
nausea, vomiting, or diarrhea;
·
slurred speech;
·
extreme drowsiness, weakness, or confusion;
·
involuntary movements; or
·
ringing in your ears.
•
Other, less serious side effects may be more likely to occur. Continue to take lithium and talk to your doctor if you experience
·
fine hand tremor;
·
mild increase in thirst or urination;
·
a rash;
·
headache or mild dizziness; or
·
swollen feet or hands.
•
Side effects other than those listed here may also occur. Talk to your doctor about any side effects that you experience.
What other drugs will affect lithium?
•
Before taking lithium, tell your doctor if you are taking any other medications, especially any of the following:
·
haloperidol (Haldol);
·
a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Oruvail, Orudis KT), naproxen (Aleve, Anaprox, Naprosyn, others), indomethacin (Indocin), oxaprozin (Daypro), piroxicam (Feldene), nabumetone (Relafen), and others;
·
a diuretic (water pill) such as hydrochlorothiazide (HCTZ, HydroDiuril, others), furosemide (Lasix), triamterene (Dyazide, Dyrenium, Maxzide), chlorothiazide (Diuril), metolazone (Mykrox, Zaroxolyn), indapamide (Lozol), bumetanide (Bumex), spironolactone (Aldactone), and amiloride (Midamor);
·
an angiotensin-converting-enzyme inhibitor (ACE inhibitor) such as benazepril (Lotensin), lisinopril (Zestril, Prinivil), fosinopril (Monopril), captopril (Capoten), enalapril (Vasotec), moexipril (Univasc), quinapril (Accupril), and ramipril (Altace);
·
the calcium channel blockers diltiazem (Cardizem, Dilacor XR) or verapamil (Calan, Isoptin, Verelan);
·
a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), paroxetine (Paxil), or citalopram (Celexa);
·
carbamazepine (Tegretol);
·
metronidazole (Flagyl);
·
theophylline (Theo-Dur, Theo-Bid, Theolair, Elixophyllin, Slo-Phyllin, others); or
·
acetazolamide (Diamox).
•
You may require special monitoring or a dosage adjustment if you are taking any of the medicines listed above.
•
Drugs other than those listed here may also interact with lithium. Tell your doctor and pharmacist about all other medicines that you take, including over-the-counter preparations. Do not take any medications without the approval of your doctor.
Where can I get more information?
•
Your pharmacist has more information about lithium written for health professionals that you may read.