Lithium + level-raising drugs

Interaction at a glance

• ↓ renal Li clearance → toxicity
• Check level after starts/stops/illness

Mechanism

• Biggest classics: thiazides; ACEi/ARBs
• many NSAIDs also raise lithium
• Baxdrostat: hyponatremia concern

Clinical consequence

• ↓ renal Li clearance → toxicity
• Loops: inconsistent level effect, real risk
• GLP-1 drugs: early toxicity case reports

Monitoring

• Check level after starts/stops/illness

Mechanism / modifiers

• Dehydration/low Na magnify every effect

Self-check

• What should be monitored with Lithium + level-raising drugs?
  level after starts/stops/illness.
• What is the main clinical risk of Lithium + level-raising drugs?
  ↓ renal Li clearance → toxicity.

Drugs in this interaction (69)

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