Skip to main content

Drug Interactions between eprosartan and lithium

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Major

lithium eprosartan

Applies to: lithium and eprosartan

MONITOR CLOSELY: Concomitant use of angiotensin II receptor antagonists may increase the serum concentrations of lithium. The exact mechanism of interaction is unknown, but thought to be related to the natriuresis induced by angiotensin II receptor antagonists secondary to the inhibition of aldosterone secretion. Increased steady-state lithium concentrations and lithium toxicity have been reported in association with the interaction, sometimes with a delayed onset of up to several weeks after coadministration.

MANAGEMENT: Given the narrow therapeutic index of lithium, caution is advised during coadministration with angiotensin II receptor antagonists, particularly in the elderly or patients with other risk factors (e.g., sodium restriction, renal impairment, congestive heart failure, dehydration, concomitant use of diuretics or NSAIDs). Pharmacologic response and serum lithium levels should be monitored more closely whenever an angiotensin II receptor antagonist is added to or withdrawn from therapy, and the lithium dosage adjusted as necessary. Empiric reductions of both drugs may be appropriate during initial therapy. Renal function should also be monitored regularly. Patients should be advised to seek medical attention if they experience potential signs and symptoms of lithium toxicity such as drowsiness, dizziness, confusion, muscle weakness, vomiting, diarrhea, polydipsia, polyuria, tinnitus, tremor, ataxia, and blurred vision.

References

  1. (2002) "Product Information. Eskalith (lithium)." SmithKline Beecham
  2. (2001) "Product Information. Cozaar (losartan)." Merck & Co., Inc
  3. Blanche P, Raynaud E, Kerob D, Galezowski N (1997) "Lithium intoxication in an elderly patient after combined treatment with losartan." Eur J Clin Pharmacol, 52, p. 501
  4. (2001) "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals
  5. (2001) "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim
  6. Leung M, Remick RA (2000) "Potential drug interaction between lithium and valsartan." J Clin Psychopharmacol, 20, p. 392-3
  7. (2002) "Product Information. Benicar (olmesartan)." Sankyo Pharma
  8. (2003) "Product Information. Benicar HCT (hydrochlorothiazide-olmesartan)." Sankyo Pharma
  9. Spinewine A, Schoevaerdts D, Mwenge GB, Swine C, Dive A (2005) "Drug-induced lithium intoxication: a case report." J Am Geriatr Soc, 53, p. 360-1
  10. Su YP, Chang CJ, Hwang TJ (2007) "Lithium intoxication after valsartan treatment." Psychiatry Clin Neurosci, 61, p. 204
View all 10 references

Switch to consumer interaction data

Drug and food interactions

Moderate

lithium food

Applies to: lithium

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

Switch to consumer interaction data

Moderate

eprosartan food

Applies to: eprosartan

GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.

MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.

References

  1. (2001) "Product Information. Cozaar (losartan)." Merck & Co., Inc
  2. (2001) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals

Switch to consumer interaction data

Moderate

lithium food

Applies to: lithium

MONITOR: One study has suggested that caffeine withdrawal may significantly increase blood lithium levels. The mechanism may be involve reversal of a caffeine-induced increase in renal lithium excretion.

MANAGEMENT: When caffeine is eliminated from the diet of lithium-treated patients, caution should be exercised. When caffeine consumption is decreased, close observation for evidence of lithium toxicity and worsening of the psychiatric disorder is recommended. Patients should be advised to notify their physician if they experience symptoms of possible lithium toxicity such as drowsiness, dizziness, weakness, ataxia, tremor, vomiting, diarrhea, thirst, blurry vision, tinnitus, or increased urination.

References

  1. Mester R, Toren P, Mizrachi I, Wolmer L, Karni N, Weizman A (1995) "Caffeine withdrawal increases lithium blood levels." Biol Psychiatry, 37, p. 348-50

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer