Dosage of Lithiumchloride in details
Immediate-release capsules are usually given t.i.d. or q.i.d. Doses of controlled-release tablets are usually given b.i.d. (approximately 12-hour intervals). When initiating therapy with immediate-release or controlled-release Lithiumchloride, dosage must be individualized according to serum levels and clinical response.
When switching a patient from immediate-release capsules to Lithiumchloride (Lithiumchloride carbonate) CR Controlled-Release Tablets, give the same total daily dose when possible. Most patients on maintenance therapy are stabilized on 900 mg daily, e.g., Lithiumchloride (Lithiumchloride carbonate) CR 450 mg b.i.d. When the previous dosage of immediate-release Lithiumchloride is not a multiple of 450 mg, e.g., 1,500 mg, initiate Lithiumchloride (Lithiumchloride carbonate) CR at the multiple of 450 mg nearest to, but below, the original daily dose, i.e., 1,350 mg. When the 2 doses are unequal, give the larger dose in the evening. In the above example, with a total daily dose of 1,350 mg, generally 450 mg of Lithiumchloride (Lithiumchloride carbonate) CR should be given in the morning and 900 mg of Lithiumchloride (Lithiumchloride carbonate) CR in the evening. If desired, the total daily dose of 1,350 mg can be given in 3 equal 450-mg doses of Lithiumchloride (Lithiumchloride carbonate) CR. These patients should be monitored at 1- to 2-week intervals, and dosage adjusted if necessary, until stable and satisfactory serum levels and clinical state are achieved.
When patients require closer titration than that available with doses of Lithiumchloride (Lithiumchloride carbonate) CR in increments of 450 mg, immediate-release capsules should be used.
Acute Mania: Optimal patient response to Lithiumchloride (Lithiumchloride carbonate) can usually be established and maintained with 1,800 mg per day in divided doses. Such doses will normally produce the desired serum Lithiumchloride level ranging between 1.0 and 1.5 mEq/L.
Dosage must be individualized according to serum levels and clinical response. Regular monitoring of the patient's clinical state and serum Lithiumchloride levels is necessary. Serum levels should be determined twice per week during the acute phase, and until the serum level and clinical condition of the patient have been stabilized.
Long-Term Control: The desirable serum Lithiumchloride levels are 0.6 to 1.2 mEq/L. Dosage will vary from one individual to another, but usually 900 mg to 1,200 mg per day in divided doses will maintain this level. Serum Lithiumchloride levels in uncomplicated cases receiving maintenance therapy during remission should be monitored at least every two months.
Patients unusually sensitive to Lithiumchloride may exhibit toxic signs at serum levels below 1.0 mEq/L.
N.B.: Blood samples for serum Lithiumchloride determinations should be drawn immediately prior to the next dose when Lithiumchloride concentrations are relatively stable (i.e., 8 to 12 hours after the previous dose). Total reliance must not be placed on serum levels alone. Accurate patient evaluation requires both clinical and laboratory analysis.
Elderly patients often respond to reduced dosage, and may exhibit signs of toxicity at serum levels ordinarily tolerated by younger patients.
How supplied
Lithiumchloride (Lithiumchloride carbonate) Capsules 300 mg are gray and yellow capsules imprinted with "Lithiumchloride (Lithiumchloride carbonate) " and "SB" on one side of each half of the capsule, in bottles of 100 (NDC 0007-4007-20).
Lithiumchloride (Lithiumchloride carbonate) CR Tablets 450 mg are round, yellow, biconvex, controlled-release tablets, debossed with "SKF" and "J10" on one side and scored on the other side, in bottles of 100 (NDC 0007-4010-20).
STORAGE CONDITIONS: Store at 25°C (77°F), excursions permitted to 15-30°C (59-86°F).
Manufactured by: Cardinal Health., Winchester, KY 40391 for GlaxoSmithKline., Research Triangle Park, NC 27709. September 2003
FDA rev date: 03/11/2004
What other drugs will affect Lithiumchloride?
Many drugs can interact with Lithiumchloride. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:
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carbamazepine;
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a diuretic or "water pill";
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fluoxetine (Prozac);
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metronidazole;
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potassium iodide thyroid medication;
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heart or blood pressure medication - benazepril, candesartan, captopril, diltiazem, enalapril, lisinopril, losartan, olmesartan, telmisartan, valsartan, verapamil, and others; or
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NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete and many other drugs can interact with Lithiumchloride. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Lithiumchloride interactions
Caution should be used when Lithiumchloride and diuretics are used concomitantly because diuretic-induced sodium loss may reduce the renal clearance of Lithiumchloride and increase serum Lithiumchloride levels with risk of Lithiumchloride toxicity. Patients receiving such combined therapy should have serum Lithiumchloride levels monitored closely and the Lithiumchloride dosage adjusted if necessary.
Lithiumchloride levels should be closely monitored when patients initiate or discontinue NSAID use. In some cases, Lithiumchloride toxicity has resulted from interactions between an NSAID and Lithiumchloride. Indomethacin and piroxicam have been reported to increase significantly steady-state plasma Lithiumchloride 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 Lithiumchloride plasma levels increased approximately 17% in subjects receiving Lithiumchloride 450 mg b.i.d. with celecoxib 200 mg b.i.d. as compared to subjects receiving Lithiumchloride alone.
Concurrent use of metronidazole with Lithiumchloride may provoke Lithiumchloride toxicity due to reduced renal clearance. Patients receiving such combined therapy should be monitored closely.
There is evidence that angiotensin-converting enzyme inhibitors, such as enalapril and captopril, and angiotension II receptor antagonists, such as losartan, may substantially increase steady-state plasma Lithiumchloride levels, sometimes resulting in Lithiumchloride toxicity. When such combinations are used, Lithiumchloride dosage may need to be decreased, and plasma Lithiumchloride levels should be measured more often.
Concurrent use of calcium channel blocking agents with Lithiumchloride may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus. Caution is recommended.
The concomitant administration of Lithiumchloride with selective serotonin reuptake inhibitors should be undertaken with caution as this combination has been reported to result in symptoms such as diarrhea, confusion, tremor, dizziness, and agitation.
The following drugs can lower serum Lithiumchloride concentrations by increasing urinary Lithiumchloride excretion: acetazolamide, urea, xanthine preparations, and alkalinizing agents such as sodium bicarbonate.
The following have also been shown to interact with Lithiumchloride: methyldopa, phenytoin, and carbamazepine.
Reviews
The results of a survey conducted on ndrugs.com for Lithiumchloride are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Lithiumchloride. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported frequency of use
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Information checked by Dr. Sachin Kumar, MD Pharmacology
