Generic Name: lithium (LITH-ee-um)
Brand Name: Eskalith

Lithium toxicity is closely related to blood lithium levels and can occur at doses close to normal blood lithium levels. Do not exceed the recommended dose. Your doctor should monitor your blood lithium levels routinely to help prevent lithium toxicity. Contact your doctor immediately if you experience symptoms of toxicity, such as nausea, diarrhea, vomiting, blurred vision, ringing in the ears, drowsiness, giddiness, muscle weakness, tremor, twitching, seizures, loss of consciousness, back and forth eye movements, loss of coordination, or increased urination.


Lithium is used for:

Treating manic episodes in patients with bipolar disorder. It is also used to reduce the frequency and decrease the severity of manic episodes in patients with bipolar disorder. It may also be used for other conditions as determined by your doctor.

Lithium is an antimanic agent. Exactly how lithium works is unknown, but it may work by altering the balance of certain chemicals in the brain.

Do NOT use lithium if:

  • you are allergic to any ingredient in lithium
  • you have moderate to severe kidney or heart problems
  • you have low blood sodium levels
  • you are severely dehydrated, ill, or weakened

Contact your doctor or health care provider right away if any of these apply to you.

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Before using lithium:

Some medical conditions may interact with lithium. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have diarrhea, vomiting, excessive sweating, dehydration, fever, infection, or illness, or you are in a weakened state
  • if you have psoriasis or kidney, heart, or thyroid problems
  • if you have or are suspected to have a certain genetic heart disease (Brugada syndrome), or you have risk factors for it (eg, unexplained fainting; family history of Brugada syndrome; family history of sudden, unexplained death before the age of 45 years)
  • if you have brain or nerve problems (eg, organic brain syndrome)
  • if you are on a low-salt (sodium) diet

Some MEDICINES MAY INTERACT with lithium. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin II receptor antagonists (eg, losartan), calcium channel blockers (eg, verapamil), carbamazepine, diuretics (eg, furosemide, hydrochlorothiazide), hydantoins (eg, phenytoin), methyldopa, metronidazole, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin, celecoxib), selective serotonin reuptake inhibitor (SSRI) antidepressants (eg, fluoxetine), or serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, venlafaxine) because the risk of toxicity of lithium may be increased
  • Butyrophenones (eg, haloperidol) or other medicines for mental or mood problems because the risk of a severe and sometimes permanent nervous system problem (encephalopathic syndrome) characterized by weakness, fever, tremor, confusion, sluggishness, or uncontrolled muscle movements may be increased
  • Iodide preparations (eg, potassium iodide) because the risk of low thyroid levels may be increased
  • Acetazolamide, urea, urinary alkalinizers (eg, sodium bicarbonate), or xanthines (eg, theophylline) because they may decrease lithium's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if lithium may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use lithium:

Use lithium as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take lithium by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Drinking extra fluids while you are taking lithium is recommended. Check with your doctor for instructions.
  • Do not change your diet, including the amount of salt in your diet, unless instructed by your doctor.
  • If you miss a dose of lithium, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use lithium.

Important safety information:

  • Lithium may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use lithium with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do NOT take more than the recommended dose without checking with your doctor.
  • It may take 1 to 3 weeks for lithium to work. Do not stop using lithium or change your dose without checking with your doctor.
  • Tell your doctor or dentist that you take lithium before you receive any medical or dental care, emergency care, or surgery.
  • Fever, infection, vomiting, diarrhea, or excessive sweating may affect the levels of lithium in your blood. If you experience any of these conditions, contact your doctor. Talk to your doctor about how to replace the salt lost through sweating during exercise.
  • Do not change the amount of salt in your diet unless instructed by your doctor. Check with your doctor before restricting your salt intake. Tell your doctor if you are on a low-salt diet.
  • A certain heart problem (Brugada syndrome) has shown up in certain people taking lithium. These people had this problem but did not know it at the time. People with Brugada syndrome have an irregular heartbeat and are at risk for sudden death. Discuss any questions or concerns with your doctor.
  • Lab tests, including blood lithium levels and kidney function tests, may be performed while you use lithium. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use lithium with caution in the ELDERLY; they may be more sensitive to its effects.
  • Lithium is not approved for use in CHILDREN younger than 12 years old. Talk with the doctor.
  • PREGNANCY and BREAST-FEEDING: Lithium may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using lithium while you are pregnant. Lithium is found in breast milk. Do not breast-feed while taking lithium.

Possible side effects of lithium:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Drying or thinning of the hair; hair loss; mild hand tremor; mild loss of appetite; mild thirst; mild tiredness; temporary, mild nausea and general discomfort at the beginning of treatment.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); back and forth eye movements; confusion; diarrhea; dizziness or light-headedness; drowsiness; dry mouth or eyes; fainting; giddiness; inability to control the bladder or bowels; increased or decreased urination; increased thirst; involuntary twitching or muscle movements; loss of consciousness; loss of coordination; muscle weakness; numbness of the skin; restlessness; ringing in the ears; seizures; severe or persistent headache or nausea; shortness of breath; slow or irregular heartbeat; sluggishness; slurred speech; swelling of the ankles or wrists; tremor; unsteadiness; vision changes (eg, blurred vision); vomiting; weight changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of lithium:

Store lithium at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, light, and moisture. Do not store in the bathroom. Keep lithium out of the reach of children and away from pets.

General information:

  • If you have any questions about lithium, please talk with your doctor, pharmacist, or other health care provider.
  • Lithium is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take lithium or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about lithium. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to lithium. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using lithium.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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