What happens if I overdose Lithiumcarbonaat PCH?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.
Proper storage of Lithiumcarbonaat PCH controlled-release and extended-release tablets:
Store Lithiumcarbonaat PCH controlled-release and extended-release tablets at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, light, and moisture. Do not store in the bathroom. Keep Lithiumcarbonaat PCH controlled-release and extended-release tablets out of the reach of children and away from pets.
Overdose of Lithiumcarbonaat PCH in details
The toxic concentrations for Lithiumcarbonaat PCH (>1.5 mEq/L) are close to the therapeutic concentrations (0.6 to 1.2 mEq/L). It is therefore important that patients and their families be cautioned to watch for early toxic symptoms and to discontinue the drug and inform the physician should they occur. (Toxic symptoms are listed in detail under ADVERSE REACTIONS.)
Treatment
No specific antidote for Lithiumcarbonaat PCH poisoning is known. Treatment is supportive. Early symptoms of Lithiumcarbonaat PCH toxicity can usually be treated by reduction or cessation of dosage of the drug and resumption of the treatment at a lower dose after 24 to 48 hours. In severe cases of Lithiumcarbonaat PCH poisoning, the first and foremost goal of treatment consists of elimination of this ion from the patient.
Treatment is essentially the same as that used in barbiturate poisoning: 1) gastric lavage, 2) correction of fluid and electrolyte imbalance and, 3) regulation of kidney functioning. Urea, mannitol, and aminophylline all produce significant increases in Lithiumcarbonaat PCH excretion. Hemodialysis is an effective and rapid means of removing the ion from the severely toxic patient. However, patient recovery may be slow.
Infection prophylaxis, regular chest x-rays, and preservation of adequate respiration are essential.
What should I avoid while taking Lithiumcarbonaat PCH?
Lithiumcarbonaat PCH can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Do not change the amount of salt you consume in your diet. Changing your salt intake could change the amount of Lithiumcarbonaat PCH in your blood.
Lithiumcarbonaat PCH warnings
Lithiumcarbonaat PCH may cause fetal harm when administered to a pregnant woman. There have been reports of Lithiumcarbonaat PCH having adverse effects on nidations in rats, embryo viability in mice, and metabolism in vitro of rat testis and human spermatozoa have been attributed to Lithiumcarbonaat PCH, as have teratogenicity in submammalian species and cleft palates in mice. Studies in rats, rabbits and monkeys have shown no evidence of Lithiumcarbonaat PCH-induced teratology. Data from Lithiumcarbonaat PCH birth registries suggest an increase in cardiac and other anomalies, especially Ebstein's anomaly. If the patient becomes pregnant while taking Lithiumcarbonaat PCH, she should be apprised of the potential risk to the fetus. If possible, Lithiumcarbonaat PCH should be withdrawn for at least the first trimester unless it is determined that this would seriously endanger the mother.
Chronic Lithiumcarbonaat PCH therapy may be associated with diminution of renal concentrating ability, occasionally presenting as nephrogenic diabetes insipidus, with polyuria and polydipsia. Such patients should be carefully managed to avoid dehydration with resulting Lithiumcarbonaat PCH retention and toxicity. This condition is usually reversible when Lithiumcarbonaat PCH is discontinued.
Morphologic changes with glomerular and interstitial fibrosis and nephronatrophy have been reported in patients on chronic Lithiumcarbonaat PCH therapy. Morphologic changes have also been seen in bipolar patients never exposed to Lithiumcarbonaat PCH. The relationship between renal functional and morphologic changes and their association with Lithiumcarbonaat PCH therapy has not been established.
When kidney function is assessed, for baseline data prior to starting Lithiumcarbonaat PCH therapy or thereafter, routine urinalysis and other tests may be used to evaluate tubular function (e.g., urine specific gravity or osmolality following a period of water deprivation, or 24-hour urine volume) and glomerular function (e.g., serum creatinine or creatinine clearance). During Lithiumcarbonaat PCH therapy, progressive or sudden changes in renal function, even within the normal range, indicate the need for reevaluation of treatment.
Lithiumcarbonaat PCH toxicity is closely related to serum Lithiumcarbonaat PCH levels, and can occur at doses close to therapeutic levels.
What should I discuss with my healthcare provider before taking Lithiumcarbonaat PCH?
Some medical conditions may interact with Lithiumcarbonaat PCH syrup. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have diarrhea, vomiting, excessive sweating, dehydration, fever, infection, or illness, or you are in a weakened state
- if you have psoriasis or kidney, heart, or thyroid problems
- if you have or are suspected to have a certain genetic heart disease (Brugada syndrome), or you have risk factors for it (eg, unexplained fainting; family history of Brugada syndrome; family history of sudden, unexplained death before the age of 45 years)
- if you have brain or nerve problems (eg, organic brain syndrome)
- if you are on a low-salt diet
Some MEDICINES MAY INTERACT with Lithiumcarbonaat PCH syrup. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin II receptor antagonists (eg, losartan), calcium channel blockers (eg, verapamil), carbamazepine, diuretics (eg, furosemide, hydrochlorothiazide), hydantoins (eg, phenytoin), methyldopa, metronidazole, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin, celecoxib), selective serotonin reuptake inhibitor (SSRI) antidepressants (eg, fluoxetine), or serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, venlafaxine) because the risk of toxicity of Lithiumcarbonaat PCH syrup may be increased
- Butyrophenones (eg, haloperidol) or other medicines for mental or mood problems because the risk of a severe and sometimes permanent nervous system problem (encephalopathic syndrome) characterized by weakness, fever, tremor, confusion, sluggishness, or uncontrolled muscle movements may be increased
- Iodide preparations (eg, potassium iodide) because the risk of low thyroid levels may be increased
- Acetazolamide, urea, urinary alkalinizers (eg, sodium bicarbonate), or xanthines (eg, theophylline) because they may decrease Lithiumcarbonaat PCH syrup's effectiveness
This may not be a complete list of all interactions that may occur. Ask your health care provider if Lithiumcarbonaat PCH syrup may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Lithiumcarbonaat PCH precautions
The ability to tolerate Lithiumcarbonaat PCH is greater during the acute manic phase and decreases when manic symptoms subside.
The distribution space of Lithiumcarbonaat PCH approximates that of total body water. Lithiumcarbonaat PCH is primarily excreted in urine with insignificant excretion in feces. Renal excretion of Lithiumcarbonaat PCH is proportional to its plasma concentration. The elimination half-life of Lithiumcarbonaat PCH is approximately 24 hours. Lithiumcarbonaat PCH decreases sodium reabsorption by the renal tubules which could lead to sodium depletion. Therefore, it is essential for the patient to maintain a normal diet, including salt, and an adequate fluid intake (2500 to 3500 mL) at least during the initial stabilization period. Decreased tolerance to Lithiumcarbonaat PCH has been reported to ensue from protracted sweating or diarrhea and, if such occur, supplemental fluid and salt should be administered under careful medical supervision and Lithiumcarbonaat PCH intake reduced or suspended until the condition is resolved.
In addition to sweating and diarrhea, concomitant infection with elevated temperatures may also necessitate a temporary reduction or cessation of medication.
Previously existing thyroid disorders do not necessarily constitute a contraindication to Lithiumcarbonaat PCH treatment. Where hypothyroidism preexists, careful monitoring of thyroid function during Lithiumcarbonaat PCH stabilization and maintenance allows for correction of changing thyroid parameters and/or adjustment of Lithiumcarbonaat PCH doses, if any. If hypothyroidism occurs during Lithiumcarbonaat PCH stabilization and maintenance, supplemental thyroid treatment may be used.
Diuretic-, ACE-, and ARB-induced sodium loss may increase serum Lithiumcarbonaat PCH concentrations. Start with lower doses of Lithiumcarbonaat PCH or reduce dosage, while frequently monitoring serum Lithiumcarbonaat PCH concentrations and signs of Lithiumcarbonaat PCH toxicity. See WARNINGS for additional caution information.
Concomitant administration of carbamazepine and Lithiumcarbonaat PCH may increase the risk of neurotoxic side effects.
The following drugs can lower serum Lithiumcarbonaat PCH concentrations by increasing urinary Lithiumcarbonaat PCH excretion: acetazolamide, urea, xanthine preparations, and alkalinizing agents such as sodium bicarbonate.
Concomitant extended use of iodide preparations, especially potassium iodide, with Lithiumcarbonaat PCH may produce hypothyroidism.
Concurrent use of calcium channel blocking agents with Lithiumcarbonaat PCH may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus.
Concurrent use of metronidazole with Lithiumcarbonaat PCH may provoke Lithiumcarbonaat PCH toxicity due to reduced renal clearance. Patients receiving such combined therapy should be monitored closely.
Concurrent use of fluoxetine with Lithiumcarbonaat PCH has resulted in both increased and decreased serum Lithiumcarbonaat PCH concentrations. Patients receiving such combined therapy should be monitored closely.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Lithiumcarbonaat PCH levels should be closely monitored when patients initiate or discontinue NSAID use. In some cases, Lithiumcarbonaat PCH toxicity has resulted from interactions between a NSAID and Lithiumcarbonaat PCH. Indomethacin and piroxicam have been reported to increase significantly steady-state plasma Lithiumcarbonaat PCH concentrations. There is also evidence that other nonsteroidal anti-inflammatory agents, including the selective cyclooxygenase-2 (COX-2) inhibitors, have the same effect. In a study conducted in healthy subjects, mean steady-state Lithiumcarbonaat PCH plasma levels increased approximately 17% in subjects receiving Lithiumcarbonaat PCH 450 mg BID with celecoxib 200 mg BID as compared to subjects receiving Lithiumcarbonaat PCH alone.
Lithiumcarbonaat PCH may impair mental and/or physical abilities. Patients should be cautioned about activities requiring alertness (e.g., operating vehicles or machinery).
What happens if I miss a dose of Lithiumcarbonaat PCH?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
