Lithium-citrate

The usual starting dose for treatment of mania is 600 mg to 1,800 mg daily divided into 3 equal doses. The dose may be started at a lower level depending on the circumstances of the person taking the medication. The dose of lithium is usually aimed at keeping a certain level of lithium in the bloodstream. This is why lab tests are needed to monitor the levels. Once the best dose is reached, the medication may usually be taken in a single daily dose. This dose may be lower than the total of the initial 3 daily divided doses.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Lithium-Citrate (Lithium-citrate) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Lithium-Citrate (Lithium-citrate) at room temperature, protect it from light and moisture, and keep it out of the reach of children. Do not freeze Lithium-Citrate (Lithium-citrate).

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

July 13, 2015

Lithium citrate is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using Lithium-Citrate (Lithium-citrate), speak with your doctor or pharmacist for information about your treatment options.

Lithium should not be taken by anyone who:

• is allergic to lithium or to any of the ingredients of the medication
• is severely debilitated
• is severely dehydrated
• has brain damage
• has low blood levels of sodium or have conditions that require a low intake of sodium
• has significant kidney or heart disease

There may be an interaction between lithium citrate and any of the following:

• ACE inhibitors (e.g., Enalapril, Ramipril)
• Acetazolamide
• angiotensin II receptor blockers (e.g., Losartan, Telmisartan)
• calcium channel blockers (e.g., Diltiazem, Verapamil)
• Carbamazepine
• Celecoxib
• diuretics (e.g., Hydrochlorothiazide)
• Diazepam
• Haloperidol
• iodide salts (e.g., iodine, potassium iodide)
• MAO inhibitors (e.g., Phenelzine)
• methyldopa
• Metronidazole

• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Naproxen, Ibuprofen)
• phenothiazines (e.g., Chlorpromazine)
• Phenytoin
• Propranolol
• selective serotonin reuptake inhibitors (SSRIs; e.g., Fluoxetine, Fluvoxamine, Sertraline)
• sodium bicarbonate
• sodium chloride
• tetracyclines (e.g., doxycycline, Tetracycline)
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Nortriptyline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Lithium-Citrate (Lithium-citrate). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

HEALTH CANADA ADVISORY

February 5, 2014

Health Canada has issued new restrictions concerning the use of lithium. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Lithium-Citrate (Lithium-citrate).

Drowsiness/reduced alertness: Lithium may reduce mental or physical abilities. Avoid activities that require alertness, such as operating vehicles or machinery, until you know how the medication affects you.

Fluid intake and diet: The level of lithium in the blood is directly affected by the intake of fluid and salt, so it is important to maintain a normal diet, including adequate salt and fluid intake (2,500 mL to 3,000 mL). You should try to avoid making large changes to your diet that would affect your salt and fluid intake. Talk to your doctor about the appropriate amounts of fluid and salt to take.

Heart disease: People with heart disease should discuss with their doctor how Lithium-Citrate (Lithium-citrate) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Lithium-Citrate (Lithium-citrate), and whether any special monitoring is needed. People with severe heart disease should not take lithium citrate (see "Who should NOT take Lithium-Citrate (Lithium-citrate)?")

Kidney Disease: People with kidney disease should discuss with their doctor how Lithium-Citrate (Lithium-citrate) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Lithium-Citrate (Lithium-citrate), and whether any special monitoring is needed. Long-term lithium treatment is frequently associated with a decrease in kidney function as well as symptoms of thirst, excess urination, and weight gain. If you experience any of these symptoms, contact your doctor.

Lab tests: Side effects resulting from lithium are closely related to the level of lithium in the blood. The side effects can occur at doses that are close to the normal dose required for your body to respond. You will probably need to have regular blood tests while taking Lithium-Citrate (Lithium-citrate), so your doctor can monitor the blood levels of lithium.

Stopping the medication: Do not stop taking Lithium-Citrate (Lithium-citrate) suddenly without checking with your doctor first. Stopping the medication suddenly may cause a manic episode or other withdrawal symptoms.

Thyroid disease: People with thyroid disease should discuss with their doctor how Lithium-Citrate (Lithium-citrate) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Lithium-Citrate (Lithium-citrate), and whether any special monitoring is needed. Long-term lithium treatment is sometimes associated with the development of growths in the thyroid gland. Contact your doctor if you develop a swelling in the neck.

Pregnancy: Lithium-Citrate (Lithium-citrate) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Lithium-Citrate (Lithium-citrate), contact your doctor immediately.

Breast-feeding: Lithium-Citrate (Lithium-citrate) passes into breast milk. If you are a breast-feeding mother and are taking lithium citrate, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Lithium-Citrate (Lithium-citrate) have not been established for children under 12 years of age.

Seniors: Seniors appear to be more likely to experience side effects when taking lithium, even if the blood levels are appropriate. Lower doses may be necessary to avoid these effects.

Lithium citrate belongs to the class of medications called antimanics. Lithium is used to treat the manic episodes of bipolar disorder. It is also used to prevent or to reduce the frequency of manic episodes for people with bipolar disorder. It works by affecting the balance of chemicals that occur naturally in the brain.

Lithium starts to work within 5 to 7 days but it may take up to 3 weeks before it controls the symptoms of mania (e.g., reduced need for sleep, poor judgment, hyperactivity, feelings of grandiosity, aggressiveness, and sometimes hostility).

Your doctor may have suggested Lithium-Citrate (Lithium-citrate) for conditions other than those listed in these drug information articles. As well, some forms of Lithium-Citrate (Lithium-citrate) may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking Lithium-Citrate (Lithium-citrate), speak to your doctor. Do not stop taking Lithium-Citrate (Lithium-citrate) without consulting your doctor.

Do not give Lithium-Citrate (Lithium-citrate) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Lithium-Citrate (Lithium-citrate) if their doctor has not prescribed it.