LITHIUM

Brand & Generic Names

Carbolith	Lithane
Cibalith-S	Lithizine
Duralith	Lithobid
Eskalith	Lithonate
Eskalith CR	Lithotabs

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Tranquilizer

Uses

• Normalizes mood and behavior in manic-depressive illness.
• Treats alcohol toxicity and addiction.
• Treats schizoid personality disorders.

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food. Drink 2 or 3 quarts liquid per day.
Extended-release tablets--Swallow each dose whole.
Syrup--Take at mealtime. Follow with 8 oz. water.

When to take:
At the same times each day, preferably mealtime.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
May correct chemical imbalance in brain's transmission of nerve impulses that influence mood and behavior.

Time lapse before drug works:
1 to 3 weeks. May require 3 months before depressive phase of illness improves.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Moderate overdose increases some side effects and may cause diarrhea, nausea. Large overdose may cause vomiting, muscle weakness, convulsions, stupor and coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Dizziness, diarrhea, nausea, vomiting, shakiness, tremor.
• Dry mouth, thirst, decreased sexual ability, increased urination, anorexia.

Infrequent:

• Rash, stomach pain, fainting, heartbeat irregularities, shortness of breath, ear noises.
• Swollen hands, feet; slurred speech; thyroid impairment (coldness, dry, puffy skin); muscle aches; headache; weight gain; fatigue; menstrual irregularities, acne-like eruptions.
• Drowsiness, confusion, weakness.

Rare:

• Blurred vision, eye pain.
• Jerking of arms and legs, worsening of psoriasis, hair loss.

Warnings & Precautions

Don't take if:

• You are allergic to lithium or tartrazine dye.
• You have kidney or heart disease.
• Patient is younger than 12.

Before you start, consult your doctor:

• About all medications you take.
• If you plan to become pregnant within medication period.
• If you have diabetes, low thyroid function, epilepsy or any significant medical problem.
• If you are on a low-salt diet or drink more than 4 cups of coffee per day.
• If you plan surgery within 2 months.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Don't give to children younger than 12.

Prolonged use:

• Enlarged thyroid with possible impaired function.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check lithium levels, ECG*, kidney function, thyroid, complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit).

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:

• Regular checkups, periodic blood tests, and tests of lithium levels and thyroid function recommended.
• Avoid exercise in hot weather and other activities that cause heavy sweating. This contributes to lithium poisoning.
• Some products contain tartrazine dye. Avoid, especially if allergic to aspirin.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acetazolamide	Decreased lithium effect.
Antihistamines*	Possible excessive sedation.
Bupropion	Increased risk of major seizures.
Carbamazepine	Increased lithium effect.
Desmopressin	Possible decreased desmopressin
	effect.
Diazepam	Possible hypothermia.
Diclofenac	Possible increase in effect and
	toxicity.
Didanosine	Increased risk of peripheral
	neuropathy.
Diuretics*	Increased lithium effect.
Dronabinol	Increased effects of both drugs.
	Avoid.
Haloperidol	Increased toxicity of both drugs.
Indomethacin	Increased lithium effect.
Iodide salts	Increased lithium effects on
	thyroid function.
Ketoprofen	May increase lithium in blood.
Methyldopa	Increased lithium effect.
Molindone	Brain changes.
Muscle relaxants,	Increased skeletal muscle relaxation.
Nicardipine	Possible decreased lithium effect.
Nimodipine	Possible decreased lithium effect.
Non-steroidal	Increased lithium toxicity.
Oxyphenbutazone	Increased lithium effect.
Phenothiazines*	Decreased lithium effect.
Phenylbutazone	Increased lithium effect.
Phenytoin	Increased lithium effect.
Potassium iodide	Increased potassium iodide effect.
Sodium bicarbonate	Decreased lithium effect.
Sumatriptan	Adverse effects unknown. Avoid.
Tetracyclines*	Increased lithium effect.
Theophylline	Decreased lithium effect.
Tiopronin	Increased risk of toxicity to
	kidneys.
Verapamil	Decreased lithium effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible lithium poisoning.
Caffeine drinks.	Decreased lithium effect.
Cocaine:	Possible psychosis.
Salt.	High intake could decrease lithium
	effect. Low intake could increase
	lithium effect. Don't restrict
	intake.
Marijuana:	Increased tremor and possible
	psychosis.
Tobacco:	None expected.