Lithium (patient information)

IMPORTANT WARNING

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to lithium.

Why this medication is prescribed

Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Lithium is in a class of medications called antimanic agents. It works by decreasing abnormal activity in the brain.

How this medication should be used

Lithium comes as a tablet, capsule, extended-release (long-acting) tablet, and solution (liquid) to take by mouth. The tablets, capsules, and solution are usually taken three to four times a day.The extended-release tablets are usually taken two to three times a day. Take lithium at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lithium exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release tablet whole; do not split, chew, or crush it.

Your doctor may increase or decrease the dose of your medication during your treatment. Follow these directions carefully.

Lithium may help to control your condition but will not cure it. It may take 1-3 weeks or longer for you to feel the full benefit of lithium. Continue to take lithium even if you feel well. Do not stop taking lithium without talking to your doctor.

Other uses for this medicine

Lithium is also sometimes used to treat certain blood disorders, depression, schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), disorders of impulse control (inability to resist the urge to perform a harmful action), and certain mental illnesses in children. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions

Before taking lithium:

tell your doctor and pharmacist if you are allergic to lithium or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); aminophylline; angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik);angiotensin II receptor antagonists such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan); antacids such as sodium bicarbonate; caffeine (found in certain medications to treat drowsiness and headaches); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Covera, Isoptin, Verelan);carbamazepine (Tegretol); diuretics ('water pills'); medications for mental illness such as haloperidol (Haldol); methyldopa (Aldomet); metronidazole (Flagyl); nonsteroidal anti-inflammatory medications (NSAIDs) such as celecoxib (Celebrex), indomethacin (Indocin), and piroxicam (Feldene); potassium iodide; phenytoin (Dilantin); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); and theophylline (Theolair, Theochron). *Your doctor may have to change the doses of your medication or monitor you more carefully for side effects.
tell your doctor if you have or have ever had organic brain syndrome (any physical condition that affects the way your brain works); or thyroid, heart, or kidney disease. Also tell your doctor if you have severe diarrhea, excessive sweating, or fever. Call your doctor if you develop these symptoms during your treatment.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lithium, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lithium.
you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

Special dietary instructions

It is important to follow a proper diet, including the right amounts of fluid and salt during your treatment. Your doctor will give you specific directions about the diet that is right for you. Follow these directions carefully.

Talk to your doctor about drinking drinks that contain caffeine, such as tea, coffee, cola, or chocolate milk.

What to do if you forget a dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Side effects

Minor side effects

Lithium may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

restlessness
fine hand movements that are difficult to control
loss of appetite
stomach pain or bloating
gas
indigestion
weight gain or loss
dry mouth
excessive saliva in the mouth
tongue pain
change in the ability to taste food
swollen lips
acne
hair loss
unusual discomfort in cold temperatures
constipation
depression
joint or muscle pain
thin, brittle fingernails or hair

Severe side effects

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

tiredness
shaking of a part of your body that you cannot control
muscle weakness, stiffness, twitching, or tightness
loss of coordination
diarrhea
vomiting
excessive thirst
frequent urination
giddiness
ringing in the ears
slow, jerky movements
movements that are unusual or difficult to control
blackouts
seizures
slurred speech
fast, slow, irregular, or pounding heartbeat
chest tightness
confusion
hallucinations (seeing things or hearing voices that do not exist)
crossed eyes
painful, cold, or discolored fingers and toes
headache
pounding noises inside the head
changes in vision
paleness
itching
rash
swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs

Lithium may cause other side effects. Call your doctor if you experience any unusual symptoms while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

diarrhea
vomiting
upset stomach
drowsiness
muscle weakness
loss of coordination

Other information

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

Eskalith CR®
Eskalith®
Lithobid®