What Is Lithium Carbonate Used For

What is Lithium Carbonate and how is it used?

Lithium Carbonate is a prescription medicine used to treat the symptoms of Bipolar Disorder. Lithium Carbonate may be used solitary or with other medications.

Lithium Carbonate belongs to a course of drugs chosen Bipolar Disorder Agents.

It is not known if Lithium Carbonate is safe and constructive in children younger than vii years of age.

What are the possible side effects of Lithium Carbonate?

Lithium Carbonate may cause serious side effects including:

lightheadedness,
shortness of breath,
fever,
increased thirst or urination,
hallucinations,
memory problems,
lack of coordination,
loss of bowel or bladder control, and
convulsions (seizure)

Get medical help right away, if you lot have whatever of the symptoms listed above.

The nigh common side effects of Lithium Carbonate include:

hand tremor,
increased dilute urination,
mild thirst,
nausea,
diarrhea,
vomiting,
drowsiness,
muscular weakness, and
lack of coordination

Tell the doctor if you lot have any side upshot that bothers you lot or that does not go away.

These are not all the possible side effects of Lithium Carbonate. For more information, enquire your doctor or chemist.

Call your doctor for medical advice well-nigh side furnishings. You may report side effects to FDA at 1-800-FDA-1088.

WARNING

Lithium toxicity is closely related to serum lithium levels, and tin can occur at doses shut to therapeutic levels. Facilities for prompt and accurate serum lithium determinations should be available earlier initiating therapy (see DOSAGE AND ADMINISTRATION).

Clarification

Lithium Carbonate Extended-Release Tablets USP contain lithium carbonate, a white odorless element of group i pulverization with molecular formula Li₂ CO₃ and molecular weight 73.89. Lithium is an element of the alkali-metal group with diminutive number three, atomic weight 6.94, and an emission line at 671 nm on the flame photometer.

Each peach-colored, motion picture-coated, extended-release tablet contains 300 mg of lithium carbonate. This slowly dissolving film-coated tablet is designed to requite lower serum lithium peak concentrations than obtained with conventional oral lithium dosage forms. Inactive ingredients consist of calcium stearate, carnauba wax, cellulose compounds, FD&C Blue No. 2 Aluminum Lake, FD&C Ruddy No. 40 Aluminum Lake, FD&C Xanthous No. half dozen Aluminum Lake, povidone, propylene glycol, sodium chloride, sodium lauryl sulfate, sodium starch glycolate, sorbitol, and titanium dioxide. Production meets USP Drug Release Test 1.

3 pharmacies near 11430 have coupons for Lithium Carbonate (Brand Names:Lithium Carbonate Tablets for 300MG)

INDICATIONS

Lithium Carbonate Extended-Release Tablets USP is indicated in the treatment of manic episodes of Bipolar Disorder. Bipolar Disorder, Manic (DSM-Iv) is equivalent to Manic Depressive disease, Manic, in the older DSM-Two terminology. Lithium Carbonate Extended-Release Tablets USP is besides indicated equally a maintenance handling for individuals with a diagnosis of Bipolar Disorder. Maintenance therapy reduces the frequency of manic episodes and diminishes the intensity of those episodes which may occur.

Typical symptoms of mania include pressure of oral communication, motor hyperactivity, reduced need for sleep, flight of ideas, grandiosity, elation, poor judgment, aggressiveness, and maybe hostility. When given to a patient experiencing a manic episode, lithium may produce a normalization of symptomatology within 1 to 3 weeks.

QUESTION

Another term that has been previously used for bipolar disorder is ___________________. Come across Answer

DOSAGE AND ADMINISTRATION

Astute Mania

Optimal patient response can usually exist established with 1800 mg/day in the following dosages:

ACUTE MANIA

	Morning	Afternoon	Nighttime
Lithium Carbonate Extended-Release Tablets^one	3 tabs (900 mg)		3 tabs (900 mg)
¹Can likewise be administered on 600 mg TID recommended dosing interval.

Such doses will normally produce an effective serum lithium concentration ranging between 1.0 and i.5 mEq/50. Dosage must be individualized according to serum concentrations and clinical response. Regular monitoring of the patient's clinical state and of serum lithium concentrations is necessary. Serum concentrations should exist adamant twice per week during the acute phase, and until the serum concentrations and clinical condition of the patient accept been stabilized.

Long-Term Control

Desirable serum lithium concentrations are 0.6 to 1.2 mEq/L which can usually be accomplished with 900 to 1200 mg/day. Dosage will vary from one individual to some other, just generally the following dosages will maintain this concentration:

LONG-TERM Control

	Morning time	Afternoon	Nighttime
Lithium Carbonate Extended-Release Tablets¹	2 tabs (600 mg)		2 tabs (600 mg)
¹Can be administered on TID recommended dosing interval up to 1200 mg/twenty-four hour period.

Serum lithium concentrations in simple cases receiving maintenance therapy during remission should be monitored at least every two months. Patients abnormally sensitive to lithium may exhibit toxic signs at serum concentrations of 1.0 to 1.five mEq/L. Geriatric patients often respond to reduced dosage, and may exhibit signs of toxicity at serum concentrations ordinarily tolerated by other patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Important Considerations

Blood samples for serum lithium determinations should be fatigued immediately prior to the next dose when lithium concentrations are relatively stable (i.east., 8 to 12 hours after previous dose). Total reliance must not be placed on serum concentrations alone. Accurate patient evaluation requires both clinical and laboratory analysis.
Lithium carbonate extended-release tablets must be swallowed whole and never chewed or crushed.

HOW SUPPLIED

Lithium Carbonate Extended-Release Tablets USP 300 mg, peach-colored imprinted "LITHOBID 300" NDC 62559-340-01 (Bottle of 100)

Storage Conditions

Shop between 59° to 86°F (xv° to 30°C). Protect from moisture. Dispense in tight, child-resistant container (USP).

Manufactured By: ANI Pharmaceuticals , Inc., Baudette, MN 56623. Revised: Jun 2016

Side Effects & Drug Interactions

SIDE EFFECTS

The occurrence and severity of adverse reactions are by and large direct related to serum lithium concentrations and to individual patient sensitivity to lithium. They mostly occur more oftentimes and with greater severity at higher concentrations.

Adverse reactions may be encountered at serum lithium concentrations below 1.5 mEq/L. Mild to moderate agin reactions may occur at concentrations from 1.5 to 2.5 mEq/L, and moderate to astringent reactions may exist seen at concentrations from ii.0 mEq/50 and above.

Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the astute manic phase and may persist throughout handling. Transient and balmy nausea and general discomfort may also appear during the first few days of lithium administration.

These side effects usually subside with connected treatment or with a temporary reduction or cessation of dosage. If persistent, a cessation of lithium therapy may be required. Diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination may be early signs of lithium intoxication, and can occur at lithium concentrations below 2.0 mEq/L. At college concentrations, giddiness, ataxia, blurred vision, tinnitus, and a large output of dilute urine may exist seen. Serum lithium concentrations above three.0 mEq/Fifty may produce a complex clinical picture involving multiple organs and organ systems. Serum lithium concentrations should not be permitted to exceed 2.0 mEq/50 during the acute treatment phase.

The following reactions have been reported and appear to be related to serum lithium concentrations, including concentrations inside the therapeutic range:

Primal Nervous System: tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreoathetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, coma spells, epileptiform seizures, slurred oral communication, dizziness, vertigo, downbeat nystagmus, incontinence of urine or carrion, somnolence, psychomotor retardation, restlessness, confusion, stupor, blackout, tongue movements, tics, tinnitus, hallucinations, poor retention, slowed intellectual functioning, startled response, worsening of organic brain syndromes. Cases of Pseudotumor cerebri (increased intracranial pressure and papilledema) have been reported with lithium utilise. If undetected, this condition may upshot in enlargement of the bullheaded spot, constriction of visual fields and eventual blindness due to optic atrophy. Lithium should be discontinued, if clinically possible, if this syndrome occurs.

Cardiovascular: cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction with severe bradycardia (which may result in syncope), Unmasking of Brugada Syndrome (Meet WARNINGS and PATIENT INFORMATION).

Gastrointestinal: anorexia, nausea, vomiting, diarrhea, gastritis, salivary gland swelling, intestinal pain, excessive salivation, flatulence, indigestion.

Genitourinary: glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst and polydipsia.

Dermatologic: drying and thinning of hair, alopecia, anesthesia of peel, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with or without rash, cutaneous ulcers, angioedema.

Autonomic Nervous Arrangement: blurred vision, dry mouth, impotence/sexual dysfunction.

Thyroid Abnormalities: euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. ¹³¹Iodine uptake may exist elevated (see PRECAUTIONS). Paradoxically, rare cases of hyperthyroidism have been reported.

EEG Changes: diffuse slowing, widening of frequency spectrum, potentiation and disorganization of background rhythm.

EKG Changes: reversible flattening, isoelectricity or inversion of T-waves.

Miscellaneous : fatigue, lethargy, transient scotomata, exophthalmos, dehydration, weight loss, leucocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, albuminuria, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, and dental caries.

Some reports of nephrogenic diabetes insipidus, hyperparathyroidism, and hypothyroidism which persist after lithium discontinuation have been received.

A few reports have been received of the development of painful discoloration of fingers and toes and coldness of the extremities within one solar day of starting lithium treatment. The mechanism through which these symptoms (resembling Raynaud'south Syndrome) developed is not known. Recovery followed discontinuance.

DRUG INTERACTIONS

No information provided.

SLIDESHOW

What Is Bipolar Disorder? Symptoms, Manic Episodes, Testing See Slideshow

WARNINGS

Lithium Toxicity

Lithium toxicity is closely related to serum lithium concentrations and can occur at doses shut to therapeutic concentrations (come across DOSAGE AND ADMINISTRATION).

Outpatients and their families should be warned that the patient must discontinue lithium therapy and contact his doctor if such clinical signs of lithium toxicity as diarrhea, vomiting, tremor, mild ataxia, drowsiness, or muscular weakness occur.

The risk of lithium toxicity is increased in patients with pregnant renal or cardiovascular disease, severe debilitation or dehydration, or sodium depletion, and for patients receiving prescribed medications that may affect kidney function, such equally angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs), diuretics (loops and thiazides) and NSAIDs. For these patients, consider starting with lower doses and titrating slowly while frequently monitoring serum lithium concentrations and signs of lithium toxicity.

Unmasking Of Brugada Syndrome

There take been postmarketing reports of a possible association between treatment with lithium and the unmasking of Brugada Syndrome. Brugada Syndrome is a disorder characterized by abnormal electrocardiographic (ECG) findings and a risk of sudden death. Lithium should mostly be avoided in patients with Brugada Syndrome or those suspected of having Brugada Syndrome. Consultation with a cardiologist is recommended if: (1) handling with lithium is under consideration for patients suspected of having Brugada Syndrome or patients who accept risk factors for Brugada Syndrome, e.g., unexplained syncope, a family unit history of Brugada Syndrome, or a family history of sudden unexplained expiry earlier the age of 45 years, (two) patients who develop unexplained syncope or palpitations afterwards starting lithium therapy.

Renal Furnishings

Chronic lithium therapy may exist associated with diminution of renal concentrating ability, occasionally presenting as nephrogenic diabetes insipidus, with polyuria and polydipsia. Such patients should be carefully managed to avert dehydration with resulting lithium retention and toxicity. This status is usually reversible when lithium is discontinued.

Post marketing cases consistent with nephrotic syndrome have been reported with the utilize of lithium. Biopsy findings in patients with nephrotic syndrome include minimal modify disease and focal segmental glomerulosclerosis. Discontinuation of lithium in patients with nephrotic syndrome has resulted in remission of nephrotic syndrome.

Morphologic changes with glomerular and interstitial fibrosis and nephron atrophy have been reported in patients on chronic lithium therapy. Morphologic changes take as well been seen in manic-depressive patients never exposed to lithium. The human relationship between renal function and morphologic changes and their association with lithium therapy accept not been established.

Kidney function should exist assessed prior to and during lithium therapy. Routine urinalysis and other tests may exist used to evaluate tubular role (e.g., urine specific gravity or osmolality following a period of water deprivation, or 24-60 minutes urine book) and glomerular role (eastward.g., serum creatinine, creatinine clearance, or proteinuria). During lithium therapy, progressive or sudden changes in renal function, fifty-fifty within the normal range, indicate the need for re-evaluation of treatment.

Encephalopathic Syndrome

An encephalopathic syndrome (characterized past weakness, lethargy, fever, tremulousness and confusion, extrapyramidal symptoms, leukocytosis, elevated serum enzymes, BUN, and FBS) has occurred in a few patients treated with lithium plus a neuroleptic, most notably haloperidol. In some instances, the syndrome was followed by irreversible brain damage. Because of possible causal relationship betwixt these events and the concomitant administration of lithium and neuroleptic drugs, patients receiving such combined therapy or patients with organic brain syndrome or other CNS impairment should exist monitored closely for early evidence of neurologic toxicity and treatment discontinued promptly if such signs appear. This encephalopathic syndrome may be similar to or the same equally Neuroleptic Cancerous Syndrome (NMS).

Concomitant Use With Neuromuscular Blocking Agents

Lithium may prolong the effects of neuromuscular blocking agents. Therefore, neuromuscular blocking agents should be given with caution to patients receiving lithium.

Usage In Pregnancy

Adverse furnishings on nidation in rats, embryo viability in mice, and metabolism in vitro of rat testis and human spermatozoa have been attributed to lithium, as accept teratogenicity in submammalian species and fissure palate in mice.

In humans, lithium may cause fetal harm when administered to a pregnant woman. Data from lithium birth registries advise an increase in cardiac and other anomalies, specially Ebstein's anomaly. If this drug is used in women of childbearing potential, or during pregnancy, or if a patient becomes pregnant while taking this drug, the patient should be apprised by their dr. of the potential hazard to the fetus.

Usage In Nursing Mothers

Lithium is excreted in homo milk. Nursing should not be undertaken during lithium therapy except in rare and unusual circumstances where, in the view of the physician, the potential benefits to the mother outweigh possible take chances to the infant or neonate. Signs and symptoms of lithium toxicity such every bit hypertonia, hypothermia, cyanosis, and ECG changes have been reported in some infants and neonates.

Pediatric Use

Condom and effectiveness in pediatric patients under 12 years of age have not been adamant; its use in these patients is non recommended.

There has been a report of transient syndrome of astute dystonia and hyperreflexia occurring in a xv kg pediatric patient who ingested 300 mg of lithium carbonate.

PRECAUTIONS

The power to tolerate lithium is greater during the astute manic phase and decreases when manic symptoms subside (see DOSAGE AND ADMINISTRATION).

The distribution space of lithium approximates that of total body h2o. Lithium is primarily excreted in urine with insignificant excretion in feces. Renal excretion of lithium is proportional to its plasma concentration. The elimination half-life of lithium is approximately 24 hours. Lithium decreases sodium reabsorption by the renal tubules which could lead to sodium depletion. Therefore, information technology 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 lithium 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 lithium intake reduced or suspended until the status is resolved.

In improver to sweating and diarrhea, concomitant infection with elevated temperatures may too necessitate a temporary reduction or cessation of medication.

Previously existing thyroid disorders do not necessarily constitute a contraindication to lithium treatment. Where hypothyroidism preexists, careful monitoring of thyroid function during lithium stabilization and maintenance allows for correction of changing thyroid parameters and/or aligning of lithium doses, if any. If hypothyroidism occurs during lithium stabilization and maintenance, supplemental thyroid treatment may exist used.

Diuretic-, ACE-, and ARB-induced sodium loss may increment serum lithium concentrations. Start with lower doses of lithium or reduce dosage, while frequently monitoring serum lithium concentrations and signs of lithium toxicity. See WARNINGS for additional caution information.

Concomitant assistants of carbamazepine and lithium may increase the run a risk of neurotoxic side furnishings.

The following drugs can lower serum lithium concentrations by increasing urinary lithium excretion: acetazolamide, urea, xanthine preparations, and alkalinizing agents such equally sodium bicarbonate.

Concomitant extended use of iodide preparations, peculiarly potassium iodide, with lithium may produce hypothyroidism.

Concurrent use of calcium aqueduct blocking agents with lithium may increase the risk of neurotoxicity in the course of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus.

Concurrent use of metronidazole with lithium may provoke lithium toxicity due to reduced renal clearance. Patients receiving such combined therapy should be monitored closely.

Concurrent use of fluoxetine with lithium has resulted in both increased and decreased serum lithium concentrations. Patients receiving such combined therapy should exist monitored closely.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Lithium levels should be closely monitored when patients initiate or discontinue NSAID utilize. In some cases, lithium toxicity has resulted from interactions between an NSAID and lithium. Indomethacin and piroxicam take been reported to increment significantly steady-country plasma lithium concentrations. At that place is likewise evidence that other nonsteroidal anti-inflammatory agents, including the selective cyclooxygenase-2 (COX-2) inhibitors, have the same consequence. In a study conducted in healthy subjects, mean steady-country lithium plasma levels increased approximately 17% in subjects receiving lithium 450 mg BID with celecoxib 200 mg BID as compared to subjects receiving lithium lonely.

Lithium may impair mental and/or physical abilities. Patients should be cautioned well-nigh activities requiring alertness (e.one thousand., operating vehicles or mechanism).

Usage In Pregnancy

Pregnancy Category D. (come across WARNINGS).

Usage In Nursing Mothers

Because of the potential for serious adverse reactions in nursing infants and neonates from lithium, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother (run into WARNINGS).

Pediatric Employ

Safety and effectiveness in pediatric patients below the age of 12 take not been established (see WARNINGS).

Geriatric Use

Clinical studies of lithium carbonate extended-release tablets did non include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, normally starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac role, and of concomitant disease or other therapy.

This drug is known to be substantially excreted past the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal office, care should be taken in dose selection, and it may be useful to monitor renal function.

Overdosage & Contraindications

OVERDOSE

The toxic concentrations for lithium ( ≥ 1.5 mEq/L) are close to the therapeutic concentrations (0.6 to 1.2 mEq/L). Information technology is therefore of import that patients and their families exist cautioned to watch for early on toxic symptoms and to discontinue the drug and inform the physician should they occur. (Toxic symptoms are listed in detail under ADVERSE REACTIONS.)

Handling

No specific antitoxin for lithium poisoning is known. Treatment is supportive. Early on symptoms of lithium toxicity can unremarkably be treated by reduction or cessation of dosage of the drug and resumption of the handling at a lower dose subsequently 24 to 48 hours. In severe cases of lithium poisoning, the first and foremost goal of treatment consists of elimination of this ion from the patient.

Handling is essentially the same every bit that used in barbiturate poisoning: 1) gastric lavage, ii) correction of fluid and electrolyte imbalance and, three) regulation of kidney operation. Urea, mannitol, and aminophylline all produce significant increases in lithium excretion. Hemodialysis is an constructive and rapid means of removing the ion from the severely toxic patient. Nevertheless, patient recovery may be slow.

Infection prophylaxis, regular chest X-rays, and preservation of acceptable respiration are essential.

CONTRAINDICATIONS

No information provided.

CLINICAL PHARMACOLOGY

Actions

Preclinical studies have shown that lithium alters sodium transport in nervus and muscle cells and furnishings a shift toward intraneuronal metabolism of catecholamines, just the specific biochemical mechanism of lithium action in mania is unknown.

PATIENT INFORMATION

A condition known equally Brugada Syndrome may pre-exist and exist unmasked by lithium therapy. Brugada Syndrome is a center disorder characterized by abnormal electrocardiographic (ECG) findings and risk of sudden decease. Patients should exist advised to seek immediate emergency aid if they feel fainting, light-headedness, aberrant heart beats, or shortness of jiff because they may have a potentially life-threatening eye disorder known equally Brugada Syndrome.

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