When combined with lithium, NSAIDs can increase lithium levels in the blood resulting in an increased risk for serious adverse effects like confusion, tremor, slurred speech, and vomiting. Examples of non-prescription NSAIDs include: Ibuprofen (Advil® or Motrin®) Naproxen (Naprosyn®, Aleve®)
ibuprofen lithium
Nonsteroidal anti-inflammatory drugs such as ibuprofen may significantly increase the blood levels of lithium in some patients and cause lithium intoxication, which is potentially life-threatening and may require hospitalization.
Patients on lithium therapy should be advised to avoid NSAIDs. Regular use is more problematic than episodic use. NSAIDs differentially alter lithium concentrations by multiple mechanisms, and one of these is to reduce prostaglandin E2 by inhibiting cyclo-oxygenase.
Since the first observation in 1978, it has been clearly established that the non-steroidal anti-inflammatory drugs (NSAIDs) interfere with the pharmacokinetics of lithium: by reducing urinary clearance of the metal, they can raise the plasma lithium level and thus lead to intoxication.
Avoid over the counter and prescription pain medications that contain nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Aleve®, Naprosyn®) because these medications can increase the risk of toxicity from lithium.
The most commonly prescribed drugs that have the potential to interact with lithium are ACE inhibitors, angiotensin II receptor antagonists (sartans), diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs).
A six-month assessment of bipolar patients found that regular use of NSAIDs and acetaminophen, alone or in combination, does not affect outcomes in patients with bipolar disorder who are taking lithium or quetiapine.
Notes for Consumers: Caffeine may decrease the effectiveness of Lithium. It is advisable to limit your caffeine intake (including teas, coffees, colas and non-prescription or herbal medicines containing caffeine) while taking Lithium.
Although the possibility of gaining weight while taking lithium is well known, this side effect does not affect everyone who takes the medication. Approximately 25% of people gain weight from taking lithium, according to a review article published in Acta Psychiatrica Scandinavica.
Nonsteroidal anti-inflammatory drugs such as diclofenac topical may significantly increase the blood levels of lithium in some patients and cause lithium intoxication, which is potentially life-threatening and may require hospitalization.
Mild symptoms: nausea, vomiting, lethargy, tremor, and fatigue (Serum lithium concentration between 1.5-2.5 mEq/L)[33] [34]. Moderate intoxication: confusion, agitation, delirium, tachycardia, and hypertonia (serum lithium concentration between 2.5-3.5 mEq/L)[33] [34].
Lithium is used to treat mania that is part of bipolar disorder (manic-depressive illness). It is also used on a daily basis to reduce the frequency and severity of manic episodes.
Not to take over-the-counter non-steroidal anti-inflammatory drugs (e.g. ibuprofen). Patients can use paracetamol with lithium, if required for aches/pain or flu-like symptoms.
Outcome and Management. The serum aminotransferase elevations that occur on lithium therapy are usually self-limited and do not require dose modification or discontinuation of therapy. No instances of acute liver failure or chronic liver disease have been attributed to lithium.
Can I drink alcohol with lithium? People taking lithium should avoid drinking alcohol. Not only can alcohol worsen bipolar disorder symptoms, but it can also intensify side effects caused by lithium, including dizziness and drowsiness.
Alcohol can increase the nervous system side effects of lithium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment.
Combining lithium and alcohol can worsen bipolar symptoms and increase the likelihood of side effects. For this reason, doctors advise people not to consume alcohol while taking the medication.
The most serious concern in patients on long-term lithium therapy is the possibility of nephropathy in the course of interstitial nephritis. In such conditions, the main changes in laboratory results are increased creatinine concentration and decreased glomerular filtration rate (GFR).
Lithium can have toxic effects on the central nervous system (CNS) that can be both acute and chronic. The syndrome of irreversible lithium-effectuated neurotoxicity (SILENT) was suggested in the 1980s to describe lithium intoxication-induced persistent neurological sequelae.
The most concerning side effects of long term lithium use are hypothyroidism and kidney problems. According to a 2015 review article , these side effects are most likely to affect women below the age of 60 years. They are also more common among people with higher-than-average concentrations of lithium in the blood.
Lithium, methotrexate, amiodarone, and phenobarbital are high-risk medications. High-risk medications have a heightened risk of causing significant patient harm when they are used in error, where the consequences of any errors are clearly more devastating to patients.
Tell your doctor right away if you have any serious side effects, including: diarrhea, vomiting, unsteady walk, confusion, trouble speaking, blurred vision, severe hand trembling (coarse tremor), vision changes (such as growing blind spot, vision loss), joint swelling/pain, muscle weakness, pain/discoloration of finger ...
Lithium can also be used to treat schizophrenia and some types of depression. If you have a mental illness, your doctor will work with you to decide if a medicine is right for you. Lithium is just one option. You might also know lithium as a chemical element with the symbol 'Li'.