Generic Name: lithium (LITH ee um)
Brand Names: Eskalith, Lithobid

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. It also helps to prevent or lessen the intensity of manic episodes.

Lithium may also be used for other purposes not listed.

Important information

Do not use lithium without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Call your doctor at once if you have any early signs of lithium toxicity, such as nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. Drink extra fluids to keep from getting dehydrated while you are taking this medication. Tell your doctor if you have been sweating excessively, or if you are sick with fever, vomiting, or diarrhea.

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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.

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.

Before taking this medicine

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. Lithium can cause harm to an unborn baby. Do not use this medication 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.

See also: Pregnancy and breastfeeding warnings (in more detail)

Older adults may be more sensitive to the effects of lithium.

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

How should I take lithium?

Take lithium exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from lithium.

Do not crush, chew, or break an extended-release lithium tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the lithium pill would cause too much of the drug to be released at one time.

Measure the liquid form of lithium with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Taking this medication can make it easier for you to become dehydrated, especially if you have any vomiting or diarrhea, if you are outdoors in the sun, or if you exercise vigorously or sweat more than usual. Dehydration can increase some of the side effects of lithium.

Drink extra fluids each day to keep from getting dehydrated while you are taking lithium. Tell your doctor if you have been sweating excessively, or if you are sick with fever, vomiting, or diarrhea for more than a few hours.

To be sure this medication is not causing harmful effects, your kidney function will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lithium.

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. 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.

What happens if I overdose?

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.

What should I avoid?

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.

Lithium 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 effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect lithium?

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.

Where can I get more information?

  • Your pharmacist can provide more information about lithium.

What does my medication look like?

Lithium is available with a prescription generically and under the brand names Lithobid, Lithonate, Lithotabs, and Eskalith. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about lithium, especially if it is new to you.

  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. 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. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2014 Cerner Multum, Inc. Version: 2.15. Revision Date: 4/12/2009 4:40:30 PM.

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