How do NSAIDs cause lithium toxicity?

Since the first observation in 1978, it has been clearly established that the non-steroidal anti-inflammatory drugs (NSAIDs) interfere with the pharmacokinetics of lithium: by reducing urinary clearance of the metal, they can raise the plasma lithium level and thus lead to intoxication.

Is ibuprofen contraindicated with lithium?

Taking lithium along with NSAIDs might increase the risk of lithium side effects. Avoid taking lithium supplements and NSAIDs at the same time. Some NSAIDs include ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene), aspirin, and others.

What drugs are contraindicated with lithium?

The most commonly prescribed drugs that have the potential to interact with lithium are ACE inhibitors, angiotensin II receptor antagonists (sartans), diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs).

Does ibuprofen increase lithium levels?

Ibuprofen increased the serum lithium level and decreased the lithium clearance with marked interindividual variations. These findings indicate that lithium dosage may need to be reduced in some patients following initiation of ibuprofen therapy.

What drugs increase lithium toxicity?

Drugs that alter renal function can increase the risk for chronic lithium toxicity (2, 17, 18). Among these, ACE inhibitors, NSAID, and thiazide diuretics increase the reabsorption of lithium and result in increased serum lithium concentrations (Table 4).

Is aspirin OK with lithium?

A clinically important drug interaction with the risk of lithium intoxication can occur between lithium salts and indomethacin. However, aspirin did not affect steady state plasma levels of lithium ion and thus may be preferable for antirheumatic treatment of patients undergoing long-term therapy with lithium salts.

Can you take meloxicam with lithium?

Taking lithium with meloxicam can cause amounts of lithium in your blood to increase to dangerous levels. Symptoms of lithium toxicity may include tremors, excessive thirst, or confusion. If you take these drugs together, your doctor may monitor your lithium levels.

Does aspirin interact with lithium?

What medications cause lithium toxicity?

nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin, Advil) or naproxen (Aleve) indomethacin. selective cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib (Celebrex) acetaminophen (Tylenol)

Does aspirin increase lithium levels?

What affects lithium absorption?

Sodium restriction enhances the renal tubular reabsorption of lithium (20), thus leading to potentially toxic serum levels of lithium. Serum potassium concentrations can have variable effects on serum lithium levels. For example, acute hyperkalemia increases lithium reabsorption in dogs (21).

How do you manage lithium toxicity?

Supportive therapy is the mainstay of treatment of lithium toxicity. Airway protection is crucial due to emesis and risk of aspiration. Seizures can be controlled with benzodiazepines, phenobarbital, or propofol.