Lithium Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Mania

Usual dose: 1800 mg/day.
Extended release: 900 mg in the morning and nighttime or 600 mg in the morning, afternoon, and nighttime.
Regular release: 600 mg in the morning, afternoon, and nighttime.
Maintenance dose: 900 to 1200 mg/day.
Extended release: 450 mg in the morning and nighttime or 600 mg in the morning and nighttime.
Regular release: 300 mg in the morning, afternoon, and nighttime or 300 mg 4 times a day.

Usual Adult Dose for Bipolar Disorder

Usual dose: 1800 mg/day.
Extended release: 900 mg in the morning and nighttime or 600 mg in the morning, afternoon, and nighttime.
Regular release: 600 mg in the morning, afternoon, and nighttime.
Maintenance dose: 900 to 1200 mg/day.
Extended release: 450 mg in the morning and nighttime or 600 mg in the morning and nighttime.
Regular release: 300 mg in the morning, afternoon, and nighttime or 300 mg 4 times a day.

Usual Pediatric Dose for Mania

6 to 12 years:
15 to 60 mg/kg/day in 3 to 4 divided doses.

Usual Pediatric Dose for Bipolar Disorder

6 to 12 years:
15 to 60 mg/kg/day in 3 to 4 divided doses.

Renal Dose Adjustments

CrCl less than 10 mL/min: The dosage should be 25% to 50% of the normal dose.

CrCl 10 to 50 mL/min: The dosage should be 50% to 75% of the normal dose.

Liver Dose Adjustments

Data not available

Dose Adjustments

Serum levels should be determined twice a week during the acute phase, and until the serum levels and clinical condition of the patient have been stabilized. Desirable serum lithium levels are 0.6 to 1.2 mEq/L which can usually be achieved with 900 to 1200 mg/day. Serum lithium levels in uncomplicated cases receiving maintenance therapy during remission should be monitored at least every 2 months. Elderly patients often respond to reduced dosage, and may exhibit signs of toxicity at serum levels ordinarily tolerated by other patients.

Precautions

Patients abnormally sensitive to lithium may exhibit toxic signs at serum levels of 1 to 1.5 mEq/L.

Dialysis

Lithium is dialyzable at 50% to 100%.

It has been suggested that in patients undergoing hemodialysis, lithium administration should occur immediately post- dialysis.

Other Comments

Initial doses will normally produce an effective serum lithium concentration ranging between 1.0 and 1.5 mEq/L.

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