pms-Lithium Carbonate

pms-Lithium Carbonate





Concise Prescribing Info
Lithium carbonate
Manic episodes of manic-depressive illness.
Dosage/Direction for Use
Acute mania Individualized dose based on patient's blood conc & clinical response. Adjust dose to obtain serum conc between 0.8 & 1.2 mEq or mmol/L. Properly screened adult w/ good renal function Initial daily dose: 900-1,800 mg (15-20 mg/kg) divided into 3 doses. Can be started as 600-900 mg/day, reaching gradually a level of 1,200-1,800 mg in 3 divided doses. Elderly Usually 600-1,200 mg/day. Maintenance therapy Rapidly reduce dose after acute manic episode subsides to achieve serum conc between 0.6 & 1 mEq or mmol/L. Average suggested dose: 900 mg/day (approx 25 mEq), divided into 3 doses, w/ range usually between 500 & 1,200 mg/day. Once stabilized on maintenance dose & stable therapeutic blood levels are reached, dosage schedule may be changed to once daily administration. Total daily dose when administered as a single daily dose may be approx 5-30% lower than when given in divided doses.
Should be taken with food.
Should generally not be given to patients w/ significant renal or CV disease, severe debilitation or dehydration, or Na depletion, & to patients receiving diuretics.
Special Precautions
Risk of lithium toxicity. Decreased lithium tolerance when manic symptoms subside; when sweating, diarrhea, or concomitant infection w/ elevated temp occurs. Decrease in renal function w/ chronic lithium therapy. Hypercalcemia w/ or w/o hyperparathyroidism. Na depletion. Maintain patient on a normal diet, including salt, w/ adequate fluid intake, at least during the initial stabilization period. May impair mental &/or physical abilities; use caution when undertaking activities requiring alertness (eg, operating vehicles or machinery). Pregnancy & lactation. Reports of increase in cardiac & other anomalies, especially Ebstein's anomaly; nephrogenic diabetes insipidus, euthyroid goiter & hypoglycemia in infants born to women who took lithium during pregnancy. Not recommended in childn <12 yr. Elderly.
Adverse Reactions
Nausea, abdominal pain, vomiting, diarrhea, vertigo, muscle weakness, sleepiness, dazed feeling; fine tremor of the hands, fatigue, thirst, polyuria.
Drug Interactions
Risk of encephalopathy resembling malignant neuroleptic syndrome w/ haloperidol. Reduced plasma conc of chlorpromazine. Increased red cell uptake of lithium w/ phenothiazines. Increased renal lithium excretion w/ chlorpromazine. Cases of neurotoxicity w/ thioridazine. Prolonged action of neuromuscular blocking agents. Increased risk of lithium toxicity w/ methyldopa or tetracycline. Increased risk of CNS toxicity w/ carbamazepine or phenytoin. Administration of aminophylline or theophylline to patients on lithium therapy may require increased lithium doses to maintain psychotropic effect. Patients stabilized on lithium therapy receiving concomitant thiazide diuretic may require reduction of lithium dose to avoid accumulation & toxicity.
MIMS Class
ATC Classification
N05AN01 - lithium ; Belongs to the class of lithium antipsychotics.
pms-Lithium Carbonate cap 150 mg
pms-Lithium Carbonate cap 300 mg
pms-Lithium Carbonate cap 600 mg
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