Lithium Carbonate Tablets

— THERAPEUTIC CATEGORIES —
  • Mood disorders

Lithium Carbonate Tablets Generic Name & Formulations

General Description

Lithium carbonate 300mg; scored tabs.

Pharmacological Class

Lithium salt.

How Supplied

Contact supplier.

Lithium Carbonate Tablets Indications

Indications

Monotherapy for bipolar I disorder.

Lithium Carbonate Tablets Dosage and Administration

Adults and Children

<7yrs: not established. Individualize. ≥7yrs (>30kg): Initially 300mg 3 times daily; titrate by 300mg every 3 days. Usual acute goal: 600mg 2–3 times daily. Usual maintenance goal: 300–600mg 2–3 times daily. (20–30kg): Initially 300mg twice daily; titrate by 300mg weekly. Usual acute goal: usually 600–1500mg in divided doses daily. Usual maintenance goal: 600–1200mg in divided doses daily. Mild to moderate renal impairment: use lower initial dose; titrate slowly and monitor.

Lithium Carbonate Tablets Contraindications

Not Applicable

Lithium Carbonate Tablets Boxed Warnings

Boxed Warning

Lithium toxicity.

Lithium Carbonate Tablets Warnings/Precautions

Warnings/Precautions

Risk of lithium toxicity (esp. recent febrile illness, acute ingestion, volume depletion/dehydration, impaired renal function, cardiovascular disease, changes in electrolytes). Maintain adequate fluid and salt intake, esp. with sweating, diarrhea, infection, or fever. Monitor serum lithium levels frequently (toxic and therapeutic levels are close); draw blood for serum tests 12hrs after previous dose. Monitor serum lithium, electrolytes, and renal function prior to and during treatment. Monitor thyroid function prior to initiation, at 3 months, and every 6–12 months during treatment. Monitor serum calcium levels regularly. Discontinue if diarrhea, vomiting, tremor, ataxia, drowsiness or weakness occur. Avoid in Brugada Syndrome. Severe renal impairment (CrCl <30mL/min): not recommended. Elderly. Neonates. Pregnancy: monitor; discontinue or reduce dose 2–3 days prior to delivery. Nursing mothers: not recommended.

Lithium Carbonate Tablets Pharmacokinetics

See Literature

Lithium Carbonate Tablets Interactions

Interactions

Lithium toxicity potentiated by diuretics, ACE inhibitors, angiotensin II receptor blockers, indomethacin, ibuprofen, naproxen (possibly other NSAIDs, including COX-2 inhibitors), metronidazole, calcium channel blockers: monitor and adjust lithium dose, if needed. Discontinue if signs of neurologic toxicity occur with antipsychotics (eg, haloperidol, risperidone, thioridazine). Xanthines, acetazolamide, urea, alkalinizing agents may reduce serum lithium levels. May potentiate adverse reactions of methyldopa, phenytoin, carbamazepine. May be antagonized by SGLT2 inhibitors; monitor for frequently. Prolongs effects of neuromuscular blockers (eg, succinylcholine, pancuronium). Hypothyroidism with chronic iodide administration. Serotonin syndrome with concomitant SSRIs, SNRIs, MAOIs; discontinue if occurs.

Lithium Carbonate Tablets Adverse Reactions

Adverse Reactions

Fine hand tremor, polyuria, thirst/polydipsia, nausea, vomiting, general discomfort, thyroid abnormalities, dizziness, rash/dermatitis, ataxia/gait disturbance, decreased appetite, blurry vision; extrapyramidal symptoms, renal toxicity, seizures, lethargy, metallic taste, dry mouth, encephalopathic syndrome, pseudotumor cerebri (discontinue if occurs).

Lithium Carbonate Tablets Clinical Trials

See Literature

Lithium Carbonate Tablets Note

Not Applicable

Lithium Carbonate Tablets Patient Counseling

See Literature