Lithium + level-lowering drugs
- Renal handling drives nearly all changes
- SGLT2 inhibitors ↓ lithium first
- can markedly increase Li clearance
- Osmotic diuretics also lower lithium
- Acetazolamide/alkalinization can lower Li
- Caffeine/theophylline may lower levels
- Recheck after starting OR stopping one
Interaction at a glance
- Recheck after starting OR stopping one
Magnitude / time course
- SGLT2 inhibitors ↓ lithium first
- can markedly increase Li clearance
Monitoring
- Osmotic diuretics also lower lithium
- Acetazolamide/alkalinization can lower Li
- Caffeine/theophylline may lower levels
- Recheck after starting OR stopping one
Mechanism
- Renal handling drives nearly all changes
Self-check
- What mechanism drives most lithium level changes from level-lowering drugs?
Changes in renal lithium handling.
Drugs in this interaction (19)
All interaction examples · Open the interactive console ↗
