What is lithium?

Lithium affects the flow of sodium through nerve and muscle cells in the body. Sodium affects excitation or mania.

Lithium is used to treat the manic episodes of manic depression. Manic symptoms include hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger. Lithium also helps to prevent or lessen the intensity of manic episodes.

Lithium may also be used for other purposes not listed in this medication guide.

Precautions

Do not use this medication if you are allergic to lithium.

Before taking lithium, tell your doctor if you are allergic to any drugs, or if you have:

  • heart disease;
  • kidney disease;
  • underactive thyroid;
  • a severe or debilitating medical condition; or
  • if you are dehydrated or have low levels of sodium in your blood (hyponatremia).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take lithium.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use lithium without your doctor’s consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Lithium can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medication.

Do not give lithium to a child younger than 12 years old.

Lithium can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not change the amount of salt that you consume in your diet. Changing your intake of salt could alter the amount of lithium in your blood.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking lithium and call your doctor at once if you have any of these serious side effects:

  • extreme thirst, urinating more or less than usual;
  • weakness, fever, feeling restless or confused, eye pain and vision problems;
  • restless muscle movements in your eyes, tongue, jaw, or neck;
  • pain, cold feeling, or discoloration in your fingers or toes;
  • feeling light-headed, fainting, slow heart rate;
  • hallucinations, seizure (blackout or convulsions);
  • fever with muscle stiffness, sweating, fast or uneven heartbeats; or
  • early signs of lithium toxicity, such as nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.

Less serious side effects may include:

  • mild tremor of the hands;
  • weakness, lack of coordination;
  • mild nausea, vomiting, loss of appetite, stomach pain or upset;
  • thinning or drying of the hair; or
  • itching skin.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before taking lithium, tell your doctor if you are taking any other medications, especially any of the following:

  • acetazolamide (Diamox);
  • aminophylline (Truphylline) or theophylline (Elixophyllin, Respbid, Theo-Bid, Theo-Dur, Uniphyl);
  • sodium bicarbonate (Alka-Seltzer, Bicitra, Polycitra, or baking soda home remedy antacid);
  • carbamazepine (Carbatrol, Tegretol);
  • fluoxetine (Prozac);
  • metronidazole (Flagyl);
  • potassium iodide thyroid medication (Pima);
  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);
  • a calcium channel blocker such as diltiazem (Tiazac, Cartia, Cardizem) or verapamil (Calan, Covera, Isoptin, Verelan);
  • a diuretic (water pill) such as amiloride (Midamor, Moduretic), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Vasoretic, Zestoretic), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others;
  • medicines to treat psychiatric disorders, such as haloperidol (Haldol), aripiprazole (Abilify), chlorpromazine (Thorazine), clozapine (Clozaril, Fazaclo), olanzapine (Zyprexa), quetiapine (Seroquel), pimozide (Orap), risperidone (Risperdal), or ziprasidone (Geodon); or
  • celecoxib (Celebrex) or an NSAID (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

This list is not complete and there may be other drugs that can interact with lithium. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

Eskalith, Eskalith-CR, Lithobid, Lithonate, Lithotabs, and lithium

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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