What is the most important information I should know about lithium?
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
What is lithium?
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 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.
Lithium may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking lithium?
You should not use lithium if you are allergic to it.
To make sure lithium is safe for you, tell your doctor if you have:
- a history of abnormal electrocardiograph or ECG (sometimes called an EKG);
- a history of fainting spells;
- a family history of death before age 45;
- kidney disease;
- heart disease;
- a debilitating illness;
- a thyroid disorder;
- low levels of sodium in your blood; or
- if you are dehydrated.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Lithium can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.
Lithium is not approved for use by anyone younger than 12 years old.
How should I take lithium?
Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Taking lithium can make it easier for you to become dehydrated, especially if you have any vomiting or diarrhea, if you are outdoors in the sun, or if you exercise vigorously or sweat more than usual. Dehydration can increase some of the side effects of lithium.
Call your doctor if you have 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.
If you need surgery, tell the surgeon ahead of time that you are using lithium.
While using lithium, you may need frequent blood tests.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Stop taking lithium and seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking lithium?
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.
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. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
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.
What are the possible side effects of lithium?
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a light-headed feeling, like you might pass out;
- shortness of breath;
- pounding heartbeats or fluttering in your chest;
- increased urination;
- weakness, dizziness or spinning sensation;
- confusion, memory problems, hallucinations;
- fever;
- muscle stiffness, slurred speech;
- uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
- loss of bowel or bladder control;
- a seizure (blackout or convulsions);
-
early signs of lithium toxicity --vomiting, diarrhea, tremors, loss of balance or coordination, drowsiness or muscle weakness;
-
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.
Common side effects may include:
- drowsiness;
- tremors in your hands;
- dry mouth, increased thirst or urination;
- nausea, vomiting, loss of appetite, stomach pain;
- changes in your skin or hair;
- cold feeling or discoloration in your fingers or toes;
- feeling uneasy; or
- impotence, loss of interest in sex.
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.
What other drugs will affect lithium?
Many drugs can interact with lithium. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:
- carbamazepine;
- a diuretic or "water pill";
- fluoxetine (Prozac);
- metronidazole;
- potassium iodide thyroid medication;
-
heart or blood pressure medication --benazepril, candesartan, captopril, diltiazem, enalapril, lisinopril, losartan, olmesartan, telmisartan, valsartan, verapamil, and others; or
-
NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete and many other drugs can interact with lithium. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Where can I get more information?
Your pharmacist can provide more information about lithium.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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