Lithium tablets or capsules

What is this medicine?

LITHIUM (LITH ee um) is used to prevent and treat the manic episodes caused by manic-depressive illness.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take after a meal or snack to avoid stomach upset. Take your doses at regular intervals. Do not take your medicine more often than directed. The amount of this medicine you take is very important. Taking more than the prescribed dose can cause serious side effects. Do not stop taking except on the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed. While this drug may be prescribed for children as young as 7 years for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in emotions or moods

• changes in vision

• fingers or toes feel numb, cool, painful

• hallucinations, loss of contact with reality

• increased thirst

• increased urination

• mild tremor (hands)

• persistent headache with or without blurred vision

• signs and symptoms of a dangerous change in heartbeat or heart rhythm like chest pain; dizziness; fast, irregular heartbeat; palpitations; feeling faint or lightheaded; falls; breathing problems

• signs and symptoms of lithium toxicity like diarrhea, vomiting, increased tremor, loss of balance or coordination, drowsiness, ringing of the ears, muscle weakness or twitching, slurred speech, confusion, seizures

• unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• decreased appetite

• mild thirst

• nausea

• stomach upset

• tiredness

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• cisapride

• dofetilide

• dronedarone

• pimozide

• thioridazine

This medicine may also interact with the following medications:

• buspirone

• caffeine

• calcium iodide

• carbamazepine

• certain medicines for depression, anxiety, or psychotic disturbances

• certain medicines for high blood pressure

• certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan

• diuretics

• fentanyl

• linezolid

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• medicines that relax muscles for surgery

• metronidazole

• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen

• other medicines that prolong the QT interval (cause an abnormal heart rhythm)

• phenytoin

• potassium iodide, KI

• sodium bicarbonate

• sodium chloride

• St. John's Wort

• theophylline

• tramadol

• tryptophan

• urea

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• active infection

• breathing problems

• Brugada Syndrome

• dehydration (diarrhea or sweating)

• diet low in salt

• heart disease

• high levels of calcium in the blood

• history of irregular heartbeat

• kidney disease

• low level of potassium or sodium in the blood

• parathyroid disease

• problems urinating

• thyroid disease

• an unusual or allergic reaction to lithium, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It can take several weeks of treatment before you start to get better.

The amount of salt (sodium) in your body influences the effects of this medicine, and this medicine can increase salt loss from the body. Eat a normal diet that includes salt. Do not change to salt substitutes. Avoid changes involving diet, or medications that include large amounts of sodium like sodium bicarbonate. Ask your doctor or health care professional for advice if you are not sure.

Drink plenty of fluids while you are taking this medicine. Avoid drinks that contain caffeine, such as coffee, tea and colas. You will need extra fluids if you have diarrhea or sweat a lot. This will help prevent toxic effects from this medicine. Be careful not to get overheated during exercise, saunas, hot baths, and hot weather. Consult your doctor or health care professional if you have a high fever or persistent diarrhea.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.