LITHIUM - Watsons Health

LITHIUM

COMMON BRAND NAME(S): Litcab [ P.I. Pharma ]

GENERIC NAME(S): LITHIUM

 

Description: Lithium alters intraneuronal metabolism of catecholamines and sodium transport in neurons and muscle cells.

Pharmacokinetics:

Absorption: Readily and completely absorbed from the GI tract (oral); serum levels increase with food. Peak plasma concentrations after 0.5-3 hr (conventional preparation), 2-12 hr (modified-release preparations).

Distribution: Throughout the body, bones, thyroid gland, portions of the brain; crosses the placenta, enters breast milk. Not protein-bound.

Metabolism: Not metabolised.

Excretion: Via urine (as unchanged drug), faeces, saliva, sweat (small amounts). Elimination half-life: 20-24 hr (normal renal function), 36 hr (elderly), 40-50 hr (renal dysfunction).

Effective for:

Bipolar disorder (manic-depressive disorder).

Likely Effective for:

Major depression.

Possibly Effective for:

Schizophrenia and related mental disorders. Lithium is usually used in combination with antipsychotic drugs when it is used for these disorders. However, sometimes lithium is given alone.

Impulsive aggressive behavior associated with attention-deficit hyperactivity disorder (ADHD).

Lithium seems to be safe for most people when taken appropriately with careful monitoring by a healthcare provider. Avoid using lithium orotate until more is known.

Lithium can cause the following:

  • Nausea
  • Diarrhea
  • Dizziness
  • muscle weakness
  • fatigue
  • dazed feeling
  • Fine tremor
  • frequent urination
  • thirst
  • Weight gain
  • swelling from excess fluid skin disorders (e.g. acne, psoriasis, and worsen rashes)

Special Precautions & Warnings:

Pregnancy and breast-feeding: Lithium can poison a developing baby (fetus) and can increase the risk of birth defects, including heart problems.

Lithium treatment is UNSAFE in women who are breast-feeding.

Heart disease: Lithium may cause irregular heart rhythms.

Kidney disease: Lithium is removed from the body by the kidneys.

Surgery: There is some concern that lithium might interfere with surgical procedures that often involve anesthesia and other drugs that affect the central nervous system. Lithium use should be stopped, with the approval of a healthcare provider, at least two weeks before a scheduled surgery.

Thyroid disease: Lithium might make thyroid problems worse.

Major Interaction Do not take this combination

  • Medications for depression (Antidepressant drugs) some of them are:
  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • sertraline (Zoloft)
  • amitriptyline (Elavil)
  • clomipramine (Anafranil)
  • imipramine (Tofranil)
  • Medications for depression (MAOIs) some of them are phenelzine (Nardil) and tranylcypromine (Parnate)

Moderate Interaction Be cautious with this combination

  • Dextromethorphan (Robitussin DM, and others)
  • Medications for high blood pressure (ACE inhibitors), some of them are:
  • captopril (Capoten)
  • enalapril (Vasotec)
  • lisinopril (Prinivil, Zestril)
  • ramipril (Altace)
  • Medications for high blood pressure (Calcium channel blockers), some of them are:
  • nifedipine (Adalat, Procardia)
  • verapamil (Calan, Isoptin, Verelan)
  • diltiazem (Cardizem)
  • isradipine (DynaCirc)
  • felodipine (Plendil)
  • amlodipine (Norvasc)
  • Medications used to prevent seizures (Anticonvulsants), some of them are:
  • phenobarbital
  • primidone (Mysoline)
  • valproic acid (Depakene)
  • gabapentin (Neurontin)
  • carbamazepine (Tegretol)
  • phenytoin (Dilantin)
  • Meperidine (Demerol)
  • Methyldopa (Aldomet)
  • Methylxanthines (aminophylline, caffeine, and theophylline)
  • Muscle relaxants, some of them are:
  • carisoprodol (Soma)
  • pipecuronium (Arduan)
  • orphenadrine (Banflex, Disipal)
  • cyclobenzaprine
  • gallamine (Flaxedil)
  • atracurium (Tracrium)
  • pancuronium (Pavulon)
  • succinylcholine (Anectine)
  • NSAIDs (Nonsteroidal anti-inflammatory drugs, some of them are:
  • ibuprofen (Advil, Motrin, Nuprin, others)
  • indomethacin (Indocin)
  • naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
  • piroxicam (Feldene)
  • aspirin
  • Phenothiazines, some of them are:
  • chlorpromazine (Thorazine)
  • fluphenazine (Prolixin)
  • trifluoperazine (Stelazine)
  • thioridazine (Mellaril)
  • Tramadol (Ultram)
  • Water pills (Loop diuretics)
  • Water pills (Thiazide diuretics), some of them are:
  • chlorothiazide (Diuril)
  • hydrochlorothiazide (HydroDIURIL, Esidrix)
  • indapamide (Lozol)
  • metolazone (Zaroxolyn)
  • chlorthalidone (Hygroton)

Minor Interaction Be watchful with this combination

  • Pentazocine (Talwin)

 

Dosing:

The following doses have been studied in scientific research:

BY MOUTH:

For acute manic episodes: 1.8 g or 20-30 mg per kg of lithium carbonate per day in 2-3 divided doses. Some healthcare providers begin therapy at 600-900 mg per day and gradually increase the dose.

For bipolar disorder and other psychiatric conditions: The usual adult dose is 900 mg to 1.2 g per day in 2-4 divided doses. 24-32 mEq of lithium citrate solution, given in 2-4 divided doses daily, has also been used. Doses usually should not exceed 2.4 g of lithium carbonate or 65 mEq lithium citrate daily. For children, 15-60 mg per kg (0.4-1.6 mEq per kg) per day in divided doses has been used.

Lithium may be given as a single daily dose, but is usually given in divided doses to lessen side effects.

Stopping lithium therapy suddenly increases the chance that symptoms of bipolar disorder will return. The dose of lithium should be reduced gradually over at least 14 days.

There is no recommended dietary allowance (RDA) for lithium. A provisional RDA of 1 mg per day for a 70 kg adult has been suggested.

Available Brands:

Litcab [ P.I. Pharma ]

 

Also marketed as:

Quilonium-R [ GlaxoSmithKline ]

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