Lithium Carbonate

💊 What is Lithium Carbonate used for?

• •The label says lithium carbonate is used alone (monotherapy) to treat bipolar I disorder in people 7 years of age and older. It is used for two purposes: short-term treatment of manic and mixed episodes, and maintenance treatment to help keep the condition under control over time. The label says it is not known if it is safe and effective in children under 7 with bipolar I disorder.

How it works

How it is usually taken

• •The label says to take lithium carbonate exactly as your healthcare provider tells you. Your provider will do blood tests before starting treatment and during treatment, and may change the dose if needed. The label says not to change your dose on your own. The label also says that nausea and general discomfort in the first few days may get better when the medicine is taken with food. Keep your salt intake and fluid intake steady as your provider instructs, and avoid becoming overheated or dehydrated.

Comes as

• •150 mg capsules (white hard gelatin capsules)
• •300 mg capsules
• •600 mg capsules

⚠️ Lithium Carbonate side effects

🛑 Who should not take Lithium Carbonate, and who should be careful

The label says not to take it if

• 🚨You are allergic to lithium or to any of the ingredients in lithium carbonate capsules, such as gelatin.
• 🚨The label says to avoid use of lithium if you have severe kidney impairment.

Tell your doctor before taking it if

• •Tell your provider if you have kidney problems, heart problems, breathing problems, or thyroid problems.
• •Tell your provider if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to breastfeed.
• •Tell your provider about all medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.
• •Your provider will do blood tests and check kidney function, vital signs, electrolytes, and thyroid function before starting treatment.
• •The label says lithium can make you sleepy, so ask your provider before driving or doing dangerous activities.

🔀 Lithium Carbonate with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Diuretics (water pills), NSAIDs (pain relievers such as ibuprofen), renin-angiotensin system antagonists, or metronidazole may increase lithium levels in the blood. The label says these need frequent monitoring.
• •Serotonin-related medicines, including MAOIs, SSRIs, tricyclic antidepressants, triptans, tramadol, fentanyl, buspirone, tryptophan, and St John's Wort, may raise the risk of serotonin syndrome when taken with lithium.
• •Antipsychotic medicines: the label says there have been reports of nervous system side effects when lithium is taken with an antipsychotic.
• •The label says not to start or stop any medicines while taking lithium carbonate without talking to your provider first.

Alcohol and food

The label does not mention alcohol. The label says that nausea may improve when lithium is taken with food. It also says not to change how much salt you eat, because this can change the amount of lithium in your blood. Follow your provider's instructions about fluids, especially during exercise or hot weather.

🤰 Lithium Carbonate in pregnancy and breastfeeding

Pregnancy

The label says lithium may harm an unborn baby. Early reports suggested an increase in heart defects, especially Ebstein's anomaly, when lithium was used in the first trimester. Later studies suggest the increased risk for heart defects is likely small, but the data are not enough to confirm a drug-related risk. The label also describes concerns about lithium toxicity in the mother or newborn during late pregnancy and after birth. Animal studies reported harm to developing babies at levels similar to the human therapeutic range.

Breastfeeding

The label says lithium can pass into breast milk and may harm the baby. It states that you should not breastfeed during treatment with lithium carbonate. Talk with your provider about the best way to feed your baby.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store lithium carbonate at 20 to 25 degrees C (68 to 77 degrees F). Keep it in a tight, child-resistant container and protect it from moisture.

If a dose is missed

The label says not to double your dose if you miss one. It says to talk with your healthcare provider if you miss a dose.

If too much is taken

The label says that lithium toxicity levels are close to therapeutic levels. At lithium levels above 3 mEq/L, patients may progress to seizures, coma, and irreversible brain damage. There is no specific antidote for lithium poisoning. If you take too much, call the National Poison Control Center at 1-800-222-1222 or go to the nearest emergency room right away.

🗒️ Questions to ask about Lithium Carbonate

• How often will I need blood tests to check my lithium level, and what range is my provider aiming for?
• What symptoms of lithium toxicity should prompt me to call you or seek emergency care right away?
• How much fluid should I drink, and should I change my salt intake in hot weather or during exercise?
• Are any of my current medicines, including over-the-counter pain relievers or supplements, known to affect lithium levels?
• What should I do if I miss a dose?
• How will my kidney and thyroid function be checked during treatment?
• Is it safe for me to drive or operate machinery while I am getting used to this medicine?

❓ Lithium Carbonate: frequently asked questions