Lithium

Increased risk of Torsade de Pointes. Avoid concomitant use.

Diuretic component reduces lithium renal clearance, creating high risk of lithium toxicity. Generally should not be given together.

Lithium should generally not be given with bumetanide as diuretics reduce lithium renal clearance and add high risk of lithium toxicity.

Lithium should generally not be given with chlorothiazide diuretics, as diuretics reduce renal clearance of lithium and add high risk of lithium toxicity.

Lithium generally should not be given with chlorothiazide sodium. Diuretics reduce renal clearance of lithium and add high risk of lithium toxicity.

Furosemide reduces lithium's renal clearance and adds a high-risk of lithium toxicity. Avoid concomitant use with lithium.

Hydrochlorothiazide generally should not be given with lithium as it reduces renal clearance and greatly increases risk of lithium toxicity.

Diuretics reduce renal clearance of lithium and add high risk of lithium toxicity. Lithium generally should not be given with diuretics.

Increased risk of serotonin syndrome when co-administered with lithium.

Should generally not be given with amiloride HCl as diuretics reduce renal clearance of lithium, creating high risk of lithium toxicity.

Generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.

Increased serum lithium levels and symptoms of lithium toxicity have been reported. Frequent monitoring of serum lithium levels is recommended.

Increases in serum lithium levels and potential lithium toxicity may occur with valsartan.

Olmesartan increases serum lithium concentrations and may cause lithium toxicity.

Serotonergic drug that increases risk of serotonin syndrome when used concomitantly with amphetamine sulfate.

Concomitant use increases steady-state serum lithium concentrations.

Azilsartan reduces lithium renal clearance; chlorthalidone further reduces clearance. Combined effect increases serum lithium concentrations and risk of lithium toxicity.

Risk of lithium toxicity symptoms with concomitant use.

Renal clearance of lithium is reduced by thiazides and ACE inhibitors, increasing risk of lithium toxicity. Monitor lithium levels.

Increased lithium serum concentrations; measure serum lithium and serum creatinine concentrations during therapy.

Increases in serum lithium concentrations and toxicity have been reported during concomitant administration. Monitor serum lithium levels.

Increases in serum lithium concentrations and toxicity have been reported during concomitant administration. Monitor serum lithium levels.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration with candesartan or hydrochlorothiazide.

CAROSPIR reduces renal clearance of lithium, increasing risk of lithium toxicity. Monitor lithium levels periodically.

Celecoxib increases mean steady-state lithium plasma levels by approximately 17%. Patients on lithium should be closely monitored when celecoxib is introduced or withdrawn.

Chlorthalidone reduces lithium renal clearance, increasing the risk of lithium toxicity. Monitor serum lithium levels during concomitant use.

May prolong neuromuscular blockade action of cisatracurium besylate. Use peripheral nerve stimulator and monitor clinical signs.

Concomitant use increases risk of serotonin syndrome.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and discontinue if serotonin syndrome occurs.

Serotonergic drug that increases risk of serotonin syndrome when combined with amphetamines. Initiate with lower doses and monitor for serotonin syndrome signs.

Serotonergic drug increasing risk of serotonin syndrome with dextroamphetamine sulfate.

NSAIDs elevate plasma lithium levels and reduce renal lithium clearance by ~20%, increasing lithium toxicity risk. Careful monitoring required.

Diuretic-induced sodium loss may reduce lithium clearance and increase serum lithium concentrations.

Lithium toxicity has been reported; generally reversible. Monitor serum lithium levels frequently.

Lithium toxicity reported in patients receiving enalapril and lithium concomitantly. Monitor serum lithium levels frequently.

Lithium toxicity has been reported in patients receiving enalapril concomitantly with lithium; effects are reversible upon discontinuation.

Concomitant use may cause lithium toxicity, generally reversible. Monitor serum lithium levels frequently.

Lithium toxicity has been reported in patients receiving lithium concomitantly with enalapril. Monitor serum lithium levels frequently; toxicity is reversible upon discontinuation of both drugs.

Lithium toxicity reported with eplerenone coadministration. Serum lithium levels should be monitored frequently.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dosage increases.

Serotonergic drug that increases risk of serotonin syndrome when combined with escitalopram oxalate.

Ethacrynate sodium reduces renal clearance of lithium, increasing risk of lithium toxicity. Concurrent use generally should be avoided.

Lithium should not be given with ethacrynic acid as diuretics reduce its renal clearance and add high risk of lithium toxicity.

NSAIDs like etodolac produce elevation of plasma lithium levels and reduction in renal lithium clearance. Careful monitoring of lithium levels is advised.

Concomitant use with fluoxetine increases the risk of serotonin syndrome.

Concomitant use increases risk of serotonin syndrome; monitor for symptoms.

ACE inhibitors may increase serum lithium levels and cause lithium toxicity. Co-administer with caution and monitor serum lithium frequently. Risk increases if diuretic is also used.

Increased serum lithium levels and symptoms of lithium toxicity have been reported. Frequent monitoring of serum lithium levels is recommended.

Risk of lithium toxicity increased due to reduced renal clearance from both ACE inhibitor and thiazide components; frequent serum lithium level monitoring recommended.

Furosemide reduces lithium's renal clearance and adds high risk of lithium toxicity. Avoid concomitant use.

Lithium should not be given with furosemide because diuretics reduce lithium's renal clearance and add a high risk of lithium toxicity.

Ibuprofen produces elevation of plasma lithium levels and reduction in renal lithium clearance, increasing risk of lithium toxicity. Mean minimum lithium concentration increased 15% and renal clearance decreased 19%.

Ibuprofen elevates plasma lithium levels and reduces renal lithium clearance, increasing risk of lithium toxicity. Observe patients carefully for signs of toxicity.

Interaction with lithium noted in WARNINGS section; indapamide may affect lithium levels and clearance.

Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of irbesartan and lithium. Monitor lithium levels in patients receiving both drugs.

Increased serum lithium concentrations and risk of lithium toxicity. Monitor lithium levels.

NSAIDs elevate plasma lithium levels and reduce renal lithium clearance by approximately 20%, increasing lithium toxicity risk. Close observation for lithium toxicity is warranted.

May decrease thyroid hormone secretion; long-term therapy can result in goiter and subclinical or overt hypothyroidism in up to 20% of patients.

Concomitant use may increase lithium levels and cause symptoms of lithium toxicity.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration. Monitor serum lithium levels during concomitant use.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration. Monitor serum lithium levels during concomitant use.

Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use. Monitor lithium levels in patients receiving both drugs.

Concomitant use may increase risk of lithium toxicity, especially if hypovolemia or renal impairment develops; frequently monitor lithium concentrations and signs of toxicity.

NSAIDs elevate plasma lithium levels and reduce renal lithium clearance by approximately 20%, increasing risk of lithium toxicity. Careful monitoring is required.

NSAIDs elevate plasma lithium levels and reduce renal lithium clearance (mean 15% increase, 20% clearance decrease), increasing risk of lithium toxicity.

Increases lithium plasma levels and AUC by 21%, increasing risk of lithium toxicity.

Concomitant use requires careful monitoring for symptoms of lithium toxicity.

Serum lithium levels may increase, potentially leading to lithium toxicity.

Hydrochlorothiazide reduces renal clearance of lithium and increases risk of lithium toxicity. Monitor serum lithium concentrations.

Short-term metronidazole therapy associated with elevation of serum lithium and signs of lithium toxicity in patients on high doses. Serum lithium and creatinine levels should be monitored.

Elevation of plasma lithium concentrations and signs of lithium toxicity reported with oral metronidazole use.

Concomitant use can result in serotonin syndrome. Careful monitoring advised.

Concomitant use increases risk of serotonin syndrome. Monitor for signs and symptoms, particularly during initiation and dose increases.

ACE inhibitors can increase serum lithium levels and symptoms of lithium toxicity. These drugs should be coadministered with caution and frequent monitoring of serum lithium levels is recommended.

NSAIDs produce elevation of plasma lithium levels and reduction in renal lithium clearance by approximately 20%. Subjects should be observed carefully for signs of lithium toxicity.

NSAIDs can elevate plasma lithium levels and reduce renal lithium clearance, increasing risk of lithium toxicity. Monitor carefully.

Co-administration increases risk of Torsade de Pointes due to QT prolongation.

NSAIDs decrease renal blood flow, resulting in decreased renal clearance and increased serum lithium concentrations.

Increases in serum lithium concentrations and lithium toxicity reported during concomitant administration with olmesartan medoxomil. Monitor serum lithium levels.

Increases serum lithium concentrations and may cause lithium toxicity.

Increases serum lithium concentrations and risk of lithium toxicity.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration. Monitor serum lithium levels during concomitant use.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration. Monitor serum lithium levels during concomitant use.

Concomitant use increases risk of serotonin syndrome.

Increased serum lithium levels and symptoms of lithium toxicity reported. Frequent monitoring of serum lithium concentration recommended.

Concurrent use may potentiate hypothyroid and goitrogenic effects.

Increased serum lithium levels and lithium toxicity symptoms have been reported. Risk is increased if a diuretic is also used. Coadminister with caution and monitor serum lithium levels frequently.

Increased serum lithium levels and symptoms of lithium toxicity reported. Risk increases if diuretic also used. Requires frequent monitoring.

Increased serum lithium levels and symptoms of lithium toxicity reported with ACE inhibitors; thiazides further reduce lithium renal clearance, increasing toxicity risk.

Increased serum lithium levels and symptoms of lithium toxicity have been reported. Risk may be increased if a diuretic is also used. Frequent monitoring of serum lithium levels is recommended.

May enhance rocuronium bromide activity and neuromuscular blockade.

Increased risk of lithium toxicity with elevated serum lithium concentrations. Monitor serum lithium levels during concomitant use.

NSAIDs may elevate plasma lithium levels and reduce renal lithium clearance, increasing lithium toxicity risk. Subjects should be observed carefully for signs of lithium toxicity.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms, particularly during initiation and dosage increases.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms, particularly during treatment initiation and dosage increases.

Concomitant use may increase renal sodium and lithium clearance, resulting in decreased lithium concentrations. Avoid use; if unavoidable, monitor serum lithium concentrations more frequently.

Avoid concomitant use. If concomitant use is unavoidable, monitor serum lithium concentrations more frequently.

Spironolactone reduces renal clearance of lithium, increasing the risk of lithium toxicity. Monitor lithium levels periodically.

NSAIDs have produced elevation of plasma lithium levels and reduction in renal lithium clearance.

Naproxen increases lithium plasma levels, potentially leading to lithium toxicity.

Reversible increases in serum lithium concentrations and toxicity reported with concomitant administration. Monitor serum lithium levels during concomitant use.

Reversible increases in serum lithium concentrations and toxicity reported with telmisartan. Monitor serum lithium levels during concomitant use.

Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of thiazide diuretics or angiotensin II receptor antagonists, including telmisartan.

Increases in serum lithium concentrations and toxicity reported with telmisartan. Monitor serum lithium levels during concomitant use.

NSAIDs can elevate plasma lithium levels and reduce renal lithium clearance by approximately 20%, increasing risk of lithium toxicity. Subjects should be observed carefully for signs of toxicity.

Risk of lithium toxicity with torsemide use.

Increased serum lithium levels and symptoms of lithium toxicity reported with concomitant ACE inhibitor therapy. Risk further increased if diuretic also used.

Increased lithium neurotoxicity and serum levels reported with verapamil component. ACE inhibitor component also increases toxicity risk. Frequent monitoring recommended.

ACE inhibitors can increase serum lithium levels and cause symptoms of lithium toxicity. Risk increased if a diuretic is also used. Coadminister with caution and monitor serum lithium levels frequently.

Concomitant use increases risk of serotonin syndrome. Monitor patients for signs and symptoms during trazodone initiation.

Diuretic-induced sodium loss may reduce renal clearance of lithium and increase serum lithium levels with risk of lithium toxicity. Serum lithium levels should be monitored closely.

Diuretics reduce lithium renal clearance and add high risk of lithium toxicity. Generally should not be given together.

Diuretic-induced sodium loss may reduce renal clearance of lithium and increase serum lithium levels with risk of lithium toxicity. Serum lithium levels should be monitored closely.

Increases in serum lithium concentrations and lithium toxicity have been reported. Monitor serum lithium levels during concomitant use.

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration with valsartan and hydrochlorothiazide. Monitor lithium levels.

Potential for serotonin syndrome with serotonergic drug lithium. Careful patient observation advised.

Potential for serotonin syndrome when used with serotonergic drugs. Careful patient observation advised.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Increased sensitivity to lithium effects (neurotoxicity) reported with concomitant verapamil-lithium therapy. Serum lithium levels may increase, decrease, or remain unchanged. Careful monitoring required.

Risk of serotonin syndrome with concomitant therapy with lithium.

Risk of serotonin syndrome with concomitant lithium therapy.

Risk of serotonin syndrome with concomitant serotonergic therapy including lithium.

3% Sodium Chloride Injection may increase renal lithium clearance, resulting in decreased lithium levels. Caution is advised.

Acetazolamide increases lithium excretion, potentially decreasing lithium levels.

Acetazolamide increases lithium excretion, which may lead to decreased lithium levels.

Acetazolamide increases lithium excretion, which may decrease lithium levels.

Can lower serum lithium concentrations by increasing urinary lithium excretion.

May enhance the neuromuscular blocking action of atracurium.

Bexagliflozin may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently upon initiation and discontinuation.

Concomitant use may lead to reduction in plasma lithium concentrations due to increased urinary clearance. Lithium dose may require adjustment.

Increases risk of hypercalcemia when used concomitantly. Increase frequency of calcium concentration monitoring.

Increases risk of hypercalcemia. Increase frequency of calcium concentration monitoring.

Concomitant use may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during INVOKANA initiation and dosage changes.

Concomitant use may increase risk of adverse reactions of carbamazepine.

Concomitant use of dapagliflozin with lithium may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during dapagliflozin initiation and dosage changes.

SGLT2 inhibitor may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during initiation and dosage changes.

Concomitant use may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during initiation and dosage changes.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms and consider discontinuation if serotonin syndrome occurs.

Dextrose and Sodium Chloride Injection may increase renal sodium and lithium clearance, resulting in decreased serum lithium concentrations. Monitor serum lithium concentrations during concomitant use.

Monitor patients for signs of lithium toxicity during concomitant use.

Monitor patients for signs of lithium toxicity during concomitant use.

Concomitant use increases risk of serotonin syndrome. Monitor for symptoms during treatment initiation and dose increases.

Concomitant use may decrease serum lithium concentrations. Monitor lithium levels more frequently during initiation and dosage changes.

SGLT2 inhibitor component may decrease serum lithium concentrations. Monitor lithium levels more frequently during initiation and dosage changes.

Concomitant use with SGLT2 inhibitor may decrease lithium clearance.

SGLT2 inhibitor may decrease serum lithium concentrations, reducing therapeutic efficacy.

SGLT2 inhibitor concomitant use with lithium may decrease lithium clearance.

Concomitant use of STEGLATRO with lithium may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during initiation and dosage changes.

SGLT2 inhibitor may decrease serum lithium concentrations; more frequent monitoring required.

SGLT2 inhibitor component may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during initiation and dosage changes.

May increase or decrease the blood glucose lowering effect. Dose adjustment and increased glucose monitoring required.

May increase or decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dosage adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose-lowering effect; dosage adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dosage adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect; dosage adjustment and increased glucose monitoring may be required.

May increase or decrease the blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dosage adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

May increase or decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

May increase or decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring required.

May increase or decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.

Serotonergic drug that increases risk of serotonin syndrome. Monitor for symptoms and discontinue if serotonin syndrome occurs.

Meloxicam may increase lithium plasma levels. Monitor for increases in lithium levels.

Additive drowsiness and CNS depression reported with concurrent use.

NSAIDs decrease renal blood flow, resulting in decreased renal clearance and increased serum lithium concentrations.

Concomitant use of serotonergic drugs with paroxetine increases the risk of serotonin syndrome. Monitor for symptoms.

Caution advised due to potential for serotonin syndrome when coadministered with paroxetine.

Concomitant use may increase risk of adverse reactions of phenytoin.

Renal sodium and lithium clearance may be increased, resulting in decreased lithium concentrations. Monitor serum lithium concentrations during concomitant use.

Renal sodium and lithium clearance may be increased, resulting in decreased serum lithium concentrations. Monitor serum lithium concentrations during concomitant use.

May potentiate LEUKINE's myeloproliferative effects. Use with caution and monitor frequently for clinical and laboratory signs of excess myeloproliferation.

Renal sodium and lithium clearance may be altered during sodium chloride injection administration, potentially resulting in increased or decreased lithium concentrations.

Renal clearance of lithium may be increased during administration. Monitor serum lithium concentrations during concomitant use.

Renal clearance of lithium may be increased during administration. Monitor serum lithium concentrations during concomitant use.

Sodium Polystyrene Sulfonate may bind lithium and decrease its gastrointestinal absorption. Administer at least 3 hours before or after Sodium Polystyrene Sulfonate.

Sotagliflozin may decrease serum lithium concentrations. Monitor serum lithium concentration more frequently during initiation and dosage changes.

Lithium may cause additive bradycardic effect with thalidomide and should be used with caution.

Tinidazole may elevate serum lithium levels. Monitor serum lithium and creatinine levels after several days of simultaneous treatment to detect potential lithium intoxication.

Monitor lithium levels when used with high-dose topiramate.

Can lower serum lithium concentrations by increasing urinary lithium excretion.

Suspected of causing diabetes insipidus; may decrease pressor and antidiuretic effects of vasopressin. Hemodynamic monitoring recommended.

May cause diabetes insipidus, decreasing pressor and antidiuretic effects of vasopressin. Hemodynamic monitoring recommended; adjust vasopressin dose as needed.

Serotonergic drug that increases risk of serotonin syndrome; monitor patients for signs and symptoms during initiation.

Serotonergic drug that increases risk of serotonin syndrome when used with TRINTELLIX. Monitor for serotonin syndrome symptoms.

Can lower serum lithium concentrations by increasing urinary lithium excretion.

Pharmacokinetic interaction between lithium and paliperidone is unlikely based on available data.

Risperidone does not affect lithium exposure. Dose adjustment for lithium not recommended.

When using olanzapine in combination with lithium, refer to the Drug Interactions section of lithium package insert.