Lithium

Lithobid, Eskalith

Mood stabilizer • Alkali metal salt

Premium

NTIQT RiskCNS DepressantNephrotoxic

Half-life

18-36 hours

Protein Binding

Metabolized By

N/A

External

Drugs.com

Boxed warning

Lithium toxicity (therapeutic range 0.6-1.2 mEq/L; toxic >1.5)

Clinical alerts

Boxed warning

1 boxed warning

Narrow therapeutic index

Small dose changes can cause toxicity or loss of effect

QT prolongation

Avoid combining with other QT-prolonging agents; check electrolytes

Nephrotoxic

Monitor renal function; avoid other nephrotoxins where possible

CNS depressant

Additive sedation with other CNS depressants and alcohol

Mechanism of action

Modulates neurotransmitter release, intracellular signaling cascades, and gene expression

Recorded indications

From the drug index — may include conditions studied rather than approved indications

·Bipolar disorder — acute manic episodes
·Bipolar disorder — maintenance (relapse prevention)
·Augmentation in treatment-resistant depression
·Cluster headache prophylaxis

Dosing

Typical adult starting point — always confirm against local guidelines

Typical dose: [object Object] mg every 8 h; Oral

Monitoring

Therapeutic range: 0.6–1.2 mmol/L; Trough
Steady state: ~5-7 days
Re-check: Weekly until stable; then every 3-6 months

12 h post-dose (standard trough)

Interactions

2 curated · 2 major or contraindicated · select a row for management

Interacting drug	Severity	Effect
ibuprofen	major	Lithium toxicity — neurotoxicity, cardiac arrhythmias, renal damage.
lisinopril	major	Elevated lithium levels and toxicity risk

Common adverse effects

Tremor
Polyuria
Polydipsia
Thyroid dysfunction
Weight gain

Food, alcohol & herbal

Food

Maintain consistent sodium intake (changes affect lithium levels)
Stay hydrated

Alcohol · moderate

Dehydration from alcohol may increase lithium toxicity

Herbal

Caffeine (moderate) — Caffeine increases lithium excretion, reducing levels

Pharmacokinetics

Published parameters · PMID:15663006

Half-life: 18-36 hours
Protein binding: 0%
Clearance: 1.5 L/h; adult psychiatric patients
Volume of distribution: 45 L
Bioavailability: 100%
Renally eliminated: 95%; Dose review in renal impairment
Model: 1-compartment

Pregnancy & lactation

Pregnancy category: D
Lactation: avoid

Sources

Assembled from: drug index, curated drug database, curated interaction pairs, published PK literature, TDM population profiles.

Not a substitute for clinical judgement

Lithium

Lithobid, Eskalith

Mood stabilizer • Alkali metal salt

Premium

NTIQT RiskCNS DepressantNephrotoxic

Half-life

18-36 hours

Protein Binding

Metabolized By

N/A

External

Drugs.com

Boxed warning

Lithium toxicity (therapeutic range 0.6-1.2 mEq/L; toxic >1.5)

Clinical alerts

Boxed warning

1 boxed warning

Narrow therapeutic index

Small dose changes can cause toxicity or loss of effect

QT prolongation

Avoid combining with other QT-prolonging agents; check electrolytes

Nephrotoxic

Monitor renal function; avoid other nephrotoxins where possible

CNS depressant

Additive sedation with other CNS depressants and alcohol

Mechanism of action

Modulates neurotransmitter release, intracellular signaling cascades, and gene expression

Recorded indications

From the drug index — may include conditions studied rather than approved indications

·Bipolar disorder — acute manic episodes
·Bipolar disorder — maintenance (relapse prevention)
·Augmentation in treatment-resistant depression
·Cluster headache prophylaxis

Dosing

Typical adult starting point — always confirm against local guidelines

Typical dose: [object Object] mg every 8 h; Oral

Monitoring

Therapeutic range: 0.6–1.2 mmol/L; Trough
Steady state: ~5-7 days
Re-check: Weekly until stable; then every 3-6 months

12 h post-dose (standard trough)

Interactions

2 curated · 2 major or contraindicated · select a row for management

Interacting drug	Severity	Effect
ibuprofen	major	Lithium toxicity — neurotoxicity, cardiac arrhythmias, renal damage.
lisinopril	major	Elevated lithium levels and toxicity risk

Common adverse effects

Tremor
Polyuria
Polydipsia
Thyroid dysfunction
Weight gain

Food, alcohol & herbal

Food

Maintain consistent sodium intake (changes affect lithium levels)
Stay hydrated

Alcohol · moderate

Dehydration from alcohol may increase lithium toxicity

Herbal

Caffeine (moderate) — Caffeine increases lithium excretion, reducing levels

Pharmacokinetics

Published parameters · PMID:15663006

Half-life: 18-36 hours
Protein binding: 0%
Clearance: 1.5 L/h; adult psychiatric patients
Volume of distribution: 45 L
Bioavailability: 100%
Renally eliminated: 95%; Dose review in renal impairment
Model: 1-compartment

Pregnancy & lactation

Pregnancy category: D
Lactation: avoid

Sources

Assembled from: drug index, curated drug database, curated interaction pairs, published PK literature, TDM population profiles.

Not a substitute for clinical judgement

Lithium Drug Profile | PharmaGraphX