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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 bipolar disorder (manic depression). Manic symptoms include hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger.
Lithium also helps to prevent or lessen the intensity of manic episodes.
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.
Lithium toxicity can cause death. Lithium is a medicine with a narrow range of safety and toxicity can occur if you take only slightly more than a recommended dose.
Stop using lithium and call your doctor right away if you have symptoms of lithium toxicity: muscle weakness, twitching, drowsiness, feeling light-headed, mood changes, blurred vision, ringing in your ears, irregular heartbeats, confusion, slurred speech, clumsiness. trouble breathing, or seizures.
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.
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.
You should not use lithium if you are allergic to it.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
breathing problems;
heart disease;
kidney disease;
a thyroid disorder;
an abnormal electrocardiograph or ECG (sometimes called an EKG);
fainting spells; or
a family member who died before age 45.
Some medicines can interact with lithium and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
It is not known whether lithium will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breast-feed while using this medicine.
Lithium is not approved for use by anyone younger than 7 years old.
Take lithium exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Never use lithium in larger amounts, or for longer than prescribed. Overdose can occur if you take only slightly more than a recommended dose.
Swallow the tablet whole and do not crush, chew, or break it.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
Call your doctor if you are sick with a fever and vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking lithium, which may affect your dose needs. Do not change your dose or medication schedule without your doctor's advice.
Drink extra fluids each day to prevent dehydration.
It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not begin to improve after 1 week of treatment.
You may need frequent blood tests.
If you need surgery, tell the surgeon ahead of time that you are using this medicine.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
Usual Adult Dose for Mania:
Acute Control:
-Usual dose: 1800 mg/day
-Extended release formulations: 900 mg orally in the morning and at nighttime
-Regular release formulations: 600 mg orally 3 times a day, in the morning, afternoon, and nighttime
Long-term Control:
-Maintenance dose: 900 to 1200 mg/day
-Extended release formulations: 600 mg orally in the morning and at nighttime
-Regular release formulations: 300 mg orally 3 to 4 times a day
Uses:
-Treatment of manic episodes of bipolar disorder
-Maintenance treatment for individuals with bipolar disorder
Usual Adult Dose for Bipolar Disorder:
Acute Control:
-Usual dose: 1800 mg/day
-Extended release formulations: 900 mg orally in the morning and at nighttime
-Regular release formulations: 600 mg orally 3 times a day, in the morning, afternoon, and nighttime
Long-term Control:
-Maintenance dose: 900 to 1200 mg/day
-Extended release formulations: 600 mg orally in the morning and at nighttime
-Regular release formulations: 300 mg orally 3 to 4 times a day
Uses:
-Treatment of manic episodes of bipolar disorder
-Maintenance treatment for individuals with bipolar disorder
Usual Pediatric Dose for Mania:
12 years and older:
Acute Control:
-Usual dose: 1800 mg/day
-Extended release formulations: 900 mg orally in the morning and at nighttime
-Regular release formulations: 600 mg orally 3 times a day, in the morning, afternoon, and nighttime
Long-term Control:
-Maintenance dose: 900 to 1200 mg/day
-Extended release formulations: 600 mg orally in the morning and at nighttime
-Regular release formulations: 300 mg orally 3 to 4 times a day
Uses:
-Treatment of manic episodes of bipolar disorder
-Maintenance treatment for individuals with bipolar disorder
Usual Pediatric Dose for Bipolar Disorder:
12 years and older:
Acute Control:
-Usual dose: 1800 mg/day
-Extended release formulations: 900 mg orally in the morning and at nighttime
-Regular release formulations: 600 mg orally 3 times a day, in the morning, afternoon, and nighttime
Long-term Control:
-Maintenance dose: 900 to 1200 mg/day
-Extended release formulations: 600 mg orally in the morning and at nighttime
-Regular release formulations: 300 mg orally 3 to 4 times a day
Uses:
-Treatment of manic episodes of bipolar disorder
-Maintenance treatment for individuals with bipolar disorder
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Stop taking lithium and seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Early signs of toxicity include: vomiting, diarrhea, drowsiness, muscle weakness, or loss of coordination.
Avoid driving or hazardous activity until you know how lithium will affect you. Your reactions could be impaired.
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink.
Do not change the amount of salt you consume in your diet. Changing your salt intake could change the amount of lithium in your blood.
Get emergency medical help if you have signs of an allergic reaction to lithium: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Too much lithium in your body can cause death. Lithium toxicity can occur if you take only slightly more than a recommended dose.
Stop using this medicine and call your doctor right away if you have symptoms of lithium toxicity: muscle weakness, twitching, drowsiness, feeling light-headed, mood changes, blurred vision, ringing in your ears, irregular heartbeats, confusion, slurred speech, clumsiness, trouble breathing, or seizures.
Call your doctor at once if you have:
a light-headed feeling, like you might pass out;
shortness of breath;
fever, increased thirst or urination;
weakness, dizziness or spinning sensation;
memory problems, hallucinations;
problems with balance or muscle movement;
loss of bowel or bladder control;
a seizure (blackout or convulsions);
dehydration symptoms - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or
increased pressure inside the skull -severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common lithium side effects may include:
dizziness, drowsiness;
tremors in your hands;
trouble walking;
dry mouth, increased thirst or urination;
nausea, vomiting, loss of appetite, stomach pain;
cold feeling or discoloration in your fingers or toes;
rash; or
blurred vision.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your doctor about all your current medicines. Many drugs can affect lithium, especially:
buspirone;
fentanyl;
St. John's wort;
tramadol;
a "triptan" migraine headache medicine;
tryptophan;
an antidepressant or antipsychotic medication; or
a MAO inhibitor - isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
This list is not complete and many other drugs may interact with lithium. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use lithium only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Lithium Carbonate Er (www.drugs.com/lithium.html).
Applies to lithium: oral capsule, oral solution, oral tablet, oral tablet extended release
Oral route (Solution)
Lithium toxicity is closely related to serum lithium levels, and can occur at doses close to therapeutic levels. Facilities for prompt and accurate serum lithium determinations should be available before initiating therapy.
Oral route (Tablet; Tablet, Extended Release; Capsule)
Lithium toxicity is closely related to serum lithium levels, and can occur at doses close to therapeutic levels. Facilities for prompt and accurate serum lithium determinations should be available before initiating therapy.
Along with its needed effects, lithium may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking lithium:
Less common
Rare
Incidence not known
Get emergency help immediately if any of the following symptoms of overdose occur while taking lithium:
Symptoms of overdose
Some side effects of lithium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Applies to lithium: compounding powder, oral capsule, oral syrup, oral tablet, oral tablet extended release
Frequency not reported: Abnormal reflex convulsions, acute dystonia, ataxia, benign intracranial hypertension, blackout spells, choreoathetotic movements, cerebellar syndrome, clonic movements of whole limbs, coarse tremor of the extremities and lower jaw, cogwheel rigidity, coma, convulsions, diffuse slowing of EEG, dizziness, downbeat nystagmus, drowsiness, dysarthria, dysgeusia/taste distortion, encephalopathy, encephalopathic syndrome, epileptiform seizures, extrapyramidal syndrome, fine hand tremor, giddiness, headache, hyperactive deep tendon reflexes, hypertonicity, impaired consciousness, lack of coordination, lethargy, metallic/salty taste, myoclonus, nystagmus, peripheral sensorimotor neuropathy, poor memory, potentiation and disorganization of EEG background rhythm, pseudotumor cerebri (increased intracranial pressure and papilledema), psychomotor retardation, seizures, serotonin syndrome, slowed intellectual functioning, slurred speech/speech disorder, somnolence, startle response, stupor, tendency to sleep, tongue movements, transient electroencephalogram (EEG), tremor, vertigo, widening of EEG frequency spectrum
Drowsiness and lack of coordination may be early signs of lithium toxicity, and may occur at lithium levels below 2 mEq/L.
Ataxia and giddiness occurred at levels above 2 mEq/L.
Fine hand tremor may occur during initial therapy for the acute manic phase, and may persist during therapy.
The development of transient EEG changes, headache, dysgeusia/taste distortion, and metallic taste were unrelated to dosage.
Peripheral neuropathy may occur in patients on long-term treatment, but is usually reversible after discontinuation of therapy.
The development of transient ECG changes, chest tightness, and edematous swelling of ankles/wrists were unrelated to dosage.
Painful discoloration of the fingers/toes and coldness of extremities (resembling Raynaud's syndrome) occurred within one day of initiation; the patient recovered after discontinuation. The exact mechanism for this side effect is unknown.
Frequency not reported: Atrioventricular block, bradycardia, cardiac arrhythmia, cardiomyopathy, chest tightness, conduction disturbance, ECG changes, edema, hypotension, inversion of T-waves, isoelectricity of ECG, peripheral circulatory collapse, peripheral edema/edematous swelling of ankles or wrists, peripheral vasculopathy, QT prolongation, Raynaud's phenomena/syndrome, reversible flattening of ECG, sinus node dysfunction with severe bradycardia and/or sinoatrial block (may result in syncope), transient ECG changes, unmasking of Brugada syndrome, ventricular tachyarrhythmia
Frequency not reported: Abdominal pain/discomfort, constipation, dental caries, diarrhea, dry mouth, excessive salivation, flatulence, gastritis, incontinence of feces, indigestion, nausea/transient and mild nausea, salivary gland swelling, swollen lips, vomiting
Diarrhea and vomiting may be early signs of lithium toxicity, and may occur at lithium levels below 2 mEq/L.
Transient and mild nausea may occur within the first few days of therapy.
The development of metallic/salty taste, dental caries, and swollen lips were unrelated to dosage.
Frequency not reported: Acne/acneform eruptions, alopecia, anesthesia of skin, chronic folliculitis/folliculitis, cutaneous ulcers, drying and thinning of hair, generalized pruritus with/without rash, papular skin disorders, pruritus, psoriasis onset/exacerbation, urticaria, xerosis cutis
The development of generalized pruritus with/without rash and cutaneous ulcers were unrelated to dosage.
Frequency not reported: Diffuse nontoxic goiter with/without hypothyroidism, euthyroid goiter, hyperparathyroidism, hyperthyroidism, hypothyroidism (including myxedema), iodine 131 uptake increased, lower T3 and T4 levels, thyrotoxicosis
Hyperthyroidism has been rarely reported, and may persist after discontinuation of treatment.
Hyperparathyroidism may persist after discontinuation of treatment.
The development of diffuse nontoxic goiter with/without hypothyroidism and hyperparathyroidism were unrelated to dosage.
Muscular weakness develops early in lithium toxicity, and may occur at lithium levels below 2 mEq/L.
Muscle hyperirritability includes fasciculations, twitching, clonic movements of whole limbs.
The development of swollen/painful joints and polyarthralgia were unrelated to dosage.
Frequency not reported: Arthralgia/polyarthralgia, muscle hyperirritability, muscular weakness, myalgia, myasthenia gravis, myoclony, rhabdomyolysis, swollen/painful joints, twitching
Frequency not reported: Decreased creatinine clearance, glycosuria, histological renal changes with interstitial fibrosis, lithium-induced chronic kidney disease, microcysts, nephrogenic diabetes insipidus, nephrotic syndrome, oliguria, renal dysfunction
Diabetes insipidus may persist after discontinuation of treatment.
Histological renal changes with interstitial fibrosis occurred in patients on prolonged treatment, and was usually reversible upon discontinuation. Long-term treatment may cause permanent kidney changes and impairment of renal function; high serum concentrations and/or acute lithium toxicity may worsen these changes.
Frequency not reported: Anorexia, dehydration, excessive weight gain, hypercalcemia, hypermagnesemia, hyponatremia, polydipsia, thirst/mild thirst, transient hyperglycemia/hyperglycemia, weight loss
The development of transient hyperglycemia, hypercalcemia, and excessive weight gain were unrelated to dosage.
Tinnitus occurred at levels above 2 mEq/L.
Mild thirst may occur during initial therapy for the acute manic phase, and may persist during therapy; in some cases, thirst resembled diabetes insipidus. The development of thirst was unrelated to dosage.
General discomfort may also appear within the first few days of therapy.
The development of fever was unrelated to dosage.
Frequency not reported: Fall, fasciculations, fatigue, feeling dazed, fever, general discomfort, lithium toxicity, tinnitus
Frequency not reported: Albuminuria, impotence/sexual dysfunction, incontinence of urine, large output of dilute urine, lithium-induced polyuria/polyuria
At levels above 2 mEq/L, patients excreted a large output of dilute urine.
Polyuria may occur during initial therapy for the acute manic phase, and may persist during therapy; in some cases, polyuria resembled diabetes insipidus. The development of polyuria was unrelated to dosage.
The development of albuminuria was unrelated to dosage.
Frequency not reported: Confusion, delirium, hallucinations, restlessness, tics, worsening of organic brain syndromes
The worsening of organic brain syndromes was unrelated to dosage.
Frequency not reported: Allergic rashes, angioedema
Frequency not reported: Blindness, blurred vision, enlargement of the blind spot, exophthalmos, optic atrophy, transient scotomata/scotoma, visual field constriction
Blurred vision occurred at levels above 2 mEq/L.
Frequency not reported: Collecting duct renal carcinoma, oncocytoma
Collecting duct renal carcinoma occurred in patients on long-term therapy.
Frequency not reported: Leukocytosis
The development of leukocytosis was unrelated to dosage.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Lithium Carbonate Er (www.drugs.com/lithium.html).
July 6, 2020
July 6, 2020
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