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Does Metronidazole Interact with Lithium?

Metronidazole and Lithium have a major drug interaction according to U.S. FDA drug labeling data. 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. The mechanism involves elevation of serum lithium concentration. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Major
Metronidazole Class
Nitroimidazole Antimicrobial
Management
Close medical supervision required
Data Source
U.S. FDA via OpenFDA

How This Interaction Works

The interaction between Metronidazole and Lithium occurs because elevation of serum lithium concentration. Clinically, this means 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. This is classified as a major interaction, meaning it could cause serious harm if not properly managed. Your healthcare provider may need to adjust dosages, substitute one medication, or increase monitoring frequency.

What To Tell Your Doctor or Pharmacist

If you are taking Metronidazole and your doctor is considering prescribing Lithium (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask how frequently you should be monitored while these are co-prescribed
  • Ask whether any dosage adjustments are needed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Metronidazole+💊 Lithium(Lithium)

Severity & Interaction Details

⚠️
major
Use with caution — major interaction
Serious risk of clinically significant harm. Generally avoid; if used, monitor closely.
Severity scale
MinorContra
On record
Yes
Drug A class
Nitroimidazole Antimicrobial
Drug B class
—
Source
NLP:metronidazole

What this means in plain English

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.

What the FDA label says

"Elevation of serum lithium concentration"

📖 Source: NLP:metronidazole

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.