Generic Name and Formulations:
Lithium carbonate 300mg; caps.
Mania in bipolar disorder.
Acute mania: 1800mg/day in 2–3 divided doses. Usual maintenance: 900–1200mg daily in 2–3 divided doses.
Renal or cardiovascular disease, diuretics, dehydration, sodium depletion, ACE inhibitors, angiotensin II receptor blockers, or severely debilitated: not recommended (hospitalize, use low doses, monitor serum lithium levels daily). Seizure disorders. Maintain adequate fluid and salt intake, esp. with fever, sweating, or infection. Monitor serum lithium levels frequently (toxic and therapeutic levels are close); draw blood for serum tests 8–12 hrs after previous dose. Monitor thyroid, renal function. Discontinue if diarrhea, vomiting, tremor, ataxia, drowsiness or weakness occur. Elderly. Pregnancy (Cat.D), nursing mothers: not recommended.
Lithium toxicity potentiated by diuretics, ACE inhibitors, angiotensin II receptor blockers, carbamazepine, indomethacin, piroxicam (possibly other NSAIDs, including COX-2 inhibitors), metronidazole, calcium channel blockers. Discontinue if signs of neurologic toxicity occur with neuroleptics (eg, haloperidol). Xanthines, acetazolamide, urea, alkalinizing agents may reduce serum lithium levels. Fluoxetine has variable effects on serum lithium levels. Prolongs effects of neuromuscular blockers. Hypothyroidism with chronic iodide administration. Serotonin syndrome with SSRIs.
Polyuria, polydipsia, drowsiness, tremor, hypothyroidism, extrapyramidal symptoms, nausea, renal toxicity, seizures, arrhythmias, hypotension, lethargy, metallic taste, dry mouth, blurred vision, pseudotumor cerebri.
Caps, CR tabs—100
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