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Lithium

Last updated on 19/03/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions   |   Tips   |   Where To Buy  

GENERIC NAME: Lithium 

CHINESE NAME:

BRAND NAME(S) IN HONG KONG: Apo-Lithium Carbonate, Licrab, Lithiofor, PMS-Lithium Carbonate

DRUG CLASS: Antimanic agent 

USED FOR: Bipolar disorder, mania, depression 

OTHER DRUGS IN THE SAME CLASS: Carbamazepine, Haloperidol, Olanzapine, Sodium Valproate

AVAILABLE DOSAGE FORMS: 150mg, 300mg, 600mg (capsules)

What is Lithium for?

Lithium is a mood stabilizer. It can be used to treat and prevent mania, bipolar disorder, recurrent depression, and self-harming or aggressive behaviour. The exact mechanism of action of Lithium is still unknown, but it is thought to be related to the enhancement of nerve cells connecting certain brain regions that regulate mood, mind and behaviour. Lithium is effective in reducing the frequency and severity of manic episodes.

How to use it?

The doses of Lithium vary between different products and are adjusted according to the concentration of Lithium in your blood. Regular blood tests are therefore required if you are taking Lithium. Lithium can be taken once, twice or three times daily. Your doctor will adjust your Lithium dose based on your response. Lithium has a very narrow therapeutic window and hence the dose of Lithium must be controlled precisely. Symptoms of Lithium toxicity like extreme thirst, frequent urination and abnormal movement start to appear when the blood Lithium level reaches above 1.5 mmol/L (1.2 mmol/L for elderly). Remember to stay hydrated to avoid toxicity.

What are the side effects of Lithium? 

Common side effects of Lithium include metallic taste, thirst, nausea, diarrhoea, tremors, blurred vision, delirium, loss of kidney functions, hypothyroidism and ECG changes.

Who should not take Lithium?

– People allergic to Lithium or any ingredient of the formulation
– Patients with Addison’s disease or heart diseases associated with irregular heartbeats
– People who are on a low-sodium diet
– People who have family or personal history of Brugada syndrome

Pharmacist Tips:

– Drink an adequate amount of fluid to prevent Lithium toxicity.
– Lithium may affect your mental alertness. Do not drive or operate machinery until you know how Lithium affects you.
– Do not stop taking Lithium abruptly or on your own. Always discuss with your doctor or pharmacist.

Common dosing schedule:
You can take Lithium with meals to reduce stomach upset.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Lithium may interact with:
– Angiotensin-converting enzyme inhibitors, e.g. Captopril, Lisinopril
– Angiotensin II receptor blockers, e.g. Losartan, Valsartan
– Caffeine
– Non-steroidal anti-inflammatory drugs, e.g. Ibuprofen, Indomethacin
– Serotonergic agents, such as monoamine oxidase inhibitors (e.g. Phenelzine), selective serotonin reuptake inhibitors (e.g. Fluoxetine), triptans (e.g. Sumatriptan), tricyclic antidepressants, (e.g. Nortriptyline), Tramadol, St. John’s Wort

Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Lithium in Hong Kong?

In Hong Kong, Lithium is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk/

Need more information?

For detailed information about the use of Lithium in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.