Lithobid Side Effects

Generic Name: lithium

Please note - some side effects for Lithobid may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Lithobid - for the Consumer

Lithobid Controlled-Release and Extended-Release Tablets

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 when using Lithobid Controlled-Release and Extended-Release Tablets:

Mild hand tremor; mild thirst; temporary, mild nausea and general discomfort at the beginning of treatment.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; confusion; diarrhea; drowsiness; excessive weight gain; fainting; giddiness; inability to control the bladder or bowels; increased thirst; increased or decreased urination; involuntary twitching or muscle movements; loss of consciousness; loss of coordination; muscle weakness; persistent headache; persistent or severe nausea; ringing in the ears; seizures; slow or irregular heartbeat; slurred speech; swelling of the ankles or wrists; unsteadiness; vision changes; vomiting.

Side Effects by Body System

Nervous system

The hand tremor associated with lithium therapy is usually a fine rapid intentional tremor. Coarsening of the tremor or occurrence of tremor in a new part of the body may suggest lithium toxicity.

A wide variety of other nervous system effects have been reported and include ataxia, dysarthria, hyperreflexia, other movement disorders, EEG changes, blackouts, stupor, coma, central incontinence, sleep disturbances, dizziness, vertigo, pseudotumor cerebri, seizures, and worsening of organic brain syndrome.

One study (n=34) has concluded that chronic maintenance treatment with lithium affects the peripheral nerves even if the impairment rarely leads to discontinuation of therapy. This study suggests that monitoring of electroneuronographic results could be useful for the early detection of neurotoxicity of lithium.

Nervous system side effects most commonly have included nervous system effects include tremor, lethargy, lassitude, and muscle weakness. Headache, decreased concentration and confusion also have been reported less frequently. Most of these effects resolve during continuing therapy.

Gastrointestinal

Taking lithium with meals or dividing doses may ameliorate some of the gastrointestinal effects of lithium.

Gastrointestinal side effects including nausea, vomiting, diarrhea, anorexia, abdominal pain, and dry mouth have been reported frequently.

Renal

Renal side effects including nephrogenic diabetes insipidus have been reported in as many as 50% of patients started on lithium. As a consequence, many patients experience polydipsia and polyuria. Rarely, some patients may show serum electrolyte abnormalities and clinical evidence of dehydration.

The nephrogenic diabetes insipidus associated with lithium therapy is generally reversible after discontinuation of lithium but may take up to a year or more to resolve.

Some investigators have suggested that indomethacin may be useful in the treatment of lithium-induced nephrogenic diabetes insipidus. The mechanism of action of indomethacin's favorable effects may be related to its antiprostaglandin activity or to the prevention of sodium loss in the ascending loop of Henle. Other investigators have recommended amiloride as a useful drug in the medical management of lithium-induced nephrogenic diabetes insipidus.

Moderate reversible increases in blood urea nitrogen and serum creatinine as well as proteinuria have been observed in patients with lithium toxicity. Rarely the decreases in glomerular filtration have been persistent. A variety of renal effects have been reported and include glomerular sclerosis, interstitial fibrosis, chronic interstitial nephritis, nephrotic syndrome, renal tubular acidosis and tubular atrophy.

Endocrine

Endocrine side effects including clinically evident hypothyroidism (1% to 4%) have been reported. Therefore some clinicians recommend baseline thyroid function tests and yearly thyroid function tests while patients are on lithium. Goiter occurs in approximately 5% of patients. Myxedema coma and hyperglycemia have also been reported.

Lithium exerts multiple effects on the thyroid gland. Most importantly it inhibits the release of thyroxine and triiodothyronine and can lead to enhanced thyrotropin activity resulting in goiter.

Cardiovascular

The EKG manifestations of lithium are similar to those seen in hypokalemia and include reversible flattening and inversion of the T wave.

In addition to the effects noted above, interstitial myocarditis has been reported in one patient who experienced lithium overdose.

Cases of sinus node dysfunction have also been reported (often in association with concomitant carbamazepine therapy).

Cardiovascular side effects including a variety of arrhythmias, hypotension, peripheral circulatory collapse and EKG changes have been reported.

Dermatologic

Dermatologic side effects including alopecia have been reported fairly commonly. Folliculitis, maculopapular rash, acneform eruptions, exacerbations of psoriasis, and lower extremity ulcers have also been reported. One case of mycosis fungoides has been reported.

Lithium-induced alopecia has generally been reported to occur within the first six months of treatment. Although the scalp is the most common site for lithium-associated hair loss, rare reports of body hair loss also exist. The alopecia appears to be reversible upon discontinuation of therapy.

Excessive lithium concentration has been determined not to be a contributing factor to hair loss. An increase in the telogen shedding rate has been determined to be the most likely mechanism for lithium-associated hair loss.

Hematologic

Hematologic side effects including reversible leukocytosis (with leukocyte counts in the range of 8,000 to 15,000 cells/mm3) have been reported to occur in most patients on lithium. Erythrocytosis and thrombocytosis have been reported to occur much more rarely.

General

General side effects including weight gain and, less frequently, weight loss as well as edema have been reported. Metallic taste in the mouth, fever and pruritus have also been reported.

Hypersensitivity

Hypersensitivity side effects including allergic vasculitis have been reported rarely.

Metabolic

Metabolic side effects including a decrease in thyroid hormone secretion have been reported.

Genitourinary

Genitourinary side effects may include a significant decrease sperm motility as suggested by one in vitro study.

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. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. 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.