Lithium Oral Solution

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  • Mood disorders
PAGE CONTENTS
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  • Generic Name & Formulations
  • Indications
  • Dosage and Administration
  • Contraindications
  • Boxed Warnings
  • Warnings/Precautions
  • Pharmacokinetics
  • Interactions
  • Adverse Reactions
  • Clinical Trials
  • Note
  • Patient Counseling

    • Lithium Oral Solution Generic Name & Formulations

    Legal Class

    Rx

    General Description

    Lithium ion 8mEq/5mL (equivalent to 300mg lithium carbonate); contains alcohol.

    Pharmacological Class

    Lithium salt.

    See Also

    How Supplied

    Contact supplier.

    Manufacturer

    Various generic manufacturers

    Lithium Oral Solution Indications

    Indications

    Monotherapy for bipolar I disorder.

    Lithium Oral Solution 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 Oral Solution Contraindications

    Not Applicable

    Lithium Oral Solution Boxed Warnings

    Boxed Warning

    Lithium toxicity.

    Lithium Oral Solution 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 Oral Solution Pharmacokinetics

    See Literature

    Lithium Oral Solution 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 Oral Solution 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 Oral Solution Clinical Trials

    See Literature

    Lithium Oral Solution Note

    Not Applicable

    Lithium Oral Solution Patient Counseling

    See Literature

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