Lithosun SR
Generic Name
Lithium Carbonate
Manufacturer
Sun Pharmaceutical Industries Ltd.
Country
India
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lithosun sr 400 mg tablet | ৳ 5.60 | ৳ 56.00 |
Description
Overview of the medicine
Lithosun SR 400 mg Tablet contains Lithium Carbonate, a mood-stabilizing agent primarily used to treat and prevent episodes of bipolar disorder (manic-depressive illness). It helps to reduce the severity and frequency of manic episodes and can also be used as an adjunct in treating depression.
Uses & Indications
Dosage
Adults
Initial: 300 mg SR twice daily or 400 mg SR once daily. Gradually increase to achieve a target serum level of 0.6-1.2 mEq/L (acute mania) or 0.6-1.0 mEq/L (maintenance). Typical maintenance dose: 600-1200 mg/day in divided doses.
Elderly
Lower initial doses and slower titration are recommended due to decreased renal function and increased sensitivity. Target serum levels typically 0.4-0.8 mEq/L.
Renal_impairment
Requires significant dose reduction and careful monitoring of serum lithium levels. Contraindicated in severe renal impairment.
How to Take
Oral administration. Tablets should be swallowed whole with food or milk to minimize gastrointestinal irritation. Do not crush, chew, or break sustained-release tablets. Maintain adequate fluid and salt intake.
Mechanism of Action
The exact mechanism of action of lithium is not fully understood, but it is believed to involve multiple neurotransmitter systems. It affects the transport of sodium ions across nerve cell membranes, influences the synthesis and release of neurotransmitters (like norepinephrine, serotonin, and dopamine), and modulates intracellular signaling pathways (e.g., inositol phosphate system, GSK-3beta inhibition). These actions contribute to its mood-stabilizing effects.
Pharmacokinetics
Onset
Clinical effects may take 1-3 weeks to become fully apparent, though some effects can be seen within days.
Excretion
Primarily excreted renally (95%) via glomerular filtration, with 80% reabsorbed in the proximal tubules. Clearance is directly proportional to creatinine clearance.
Half life
Approximately 18-36 hours, but varies with age and renal function (longer in elderly and renal impairment).
Absorption
Well absorbed orally, peak plasma concentrations typically achieved in 2-4 hours for conventional release, and 6-12 hours for sustained-release formulations like SR-400 mg. Bioavailability is nearly 100%.
Metabolism
Not metabolized by the liver. Excreted almost entirely unchanged by the kidneys.
Side Effects
Contraindications
- Severe renal impairment
- Severe cardiovascular disease
- Dehydration
- Sodium depletion
- Brain damage
- Brugada syndrome or family history of Brugada syndrome
- Pregnancy (especially first trimester) and breastfeeding (relative contraindication)
Drug Interactions
Caffeine
May decrease serum lithium levels.
Metronidazole
May increase serum lithium levels.
Thiazide Diuretics
Can increase serum lithium levels significantly by reducing renal clearance. Examples: hydrochlorothiazide.
Neuroleptics/Antipsychotics
Increased risk of neurotoxicity (e.g., EPS, encephalopathy), especially with haloperidol or chlorpromazine.
Serotonergic drugs (SSRIs, SNRIs, triptans)
Increased risk of serotonin syndrome, though less common than with other serotonergic agents.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Can increase serum lithium levels by reducing renal clearance, increasing the risk of toxicity. Examples: ibuprofen, naproxen.
ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)
Can increase serum lithium levels. Examples: lisinopril, valsartan.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include nausea, vomiting, diarrhea, tremors, muscle weakness, drowsiness, ataxia, slurred speech, confusion, and seizures. Severe toxicity can lead to coma, renal failure, cardiac arrhythmias, and death. Management involves immediate discontinuation of lithium, supportive care, correction of fluid and electrolyte imbalances, and in severe cases, hemodialysis.
Pregnancy & Lactation
Pregnancy: Lithium is associated with an increased risk of cardiac malformations (especially Ebstein's anomaly) if taken during the first trimester. Use in pregnancy should be carefully weighed against the risks. If used, monitor serum levels closely. Lactation: Lithium is excreted into breast milk and can reach toxic levels in infants. Breastfeeding is generally not recommended while on lithium. If necessary, close monitoring of infant for signs of toxicity is required.
Side Effects
Contraindications
- Severe renal impairment
- Severe cardiovascular disease
- Dehydration
- Sodium depletion
- Brain damage
- Brugada syndrome or family history of Brugada syndrome
- Pregnancy (especially first trimester) and breastfeeding (relative contraindication)
Drug Interactions
Caffeine
May decrease serum lithium levels.
Metronidazole
May increase serum lithium levels.
Thiazide Diuretics
Can increase serum lithium levels significantly by reducing renal clearance. Examples: hydrochlorothiazide.
Neuroleptics/Antipsychotics
Increased risk of neurotoxicity (e.g., EPS, encephalopathy), especially with haloperidol or chlorpromazine.
Serotonergic drugs (SSRIs, SNRIs, triptans)
Increased risk of serotonin syndrome, though less common than with other serotonergic agents.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Can increase serum lithium levels by reducing renal clearance, increasing the risk of toxicity. Examples: ibuprofen, naproxen.
ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)
Can increase serum lithium levels. Examples: lisinopril, valsartan.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include nausea, vomiting, diarrhea, tremors, muscle weakness, drowsiness, ataxia, slurred speech, confusion, and seizures. Severe toxicity can lead to coma, renal failure, cardiac arrhythmias, and death. Management involves immediate discontinuation of lithium, supportive care, correction of fluid and electrolyte imbalances, and in severe cases, hemodialysis.
Pregnancy & Lactation
Pregnancy: Lithium is associated with an increased risk of cardiac malformations (especially Ebstein's anomaly) if taken during the first trimester. Use in pregnancy should be carefully weighed against the risks. If used, monitor serum levels closely. Lactation: Lithium is excreted into breast milk and can reach toxic levels in infants. Breastfeeding is generally not recommended while on lithium. If necessary, close monitoring of infant for signs of toxicity is required.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established lithium's efficacy in treating and preventing bipolar disorder. Ongoing research explores its neuroprotective effects and potential use in other neurological conditions.
Lab Monitoring
- Serum lithium levels (regularly, especially during initiation and dose changes, then every 3-6 months for maintenance)
- Renal function (serum creatinine, BUN, eGFR, urinalysis, every 6-12 months)
- Thyroid function (TSH, T3, T4, every 6-12 months)
- Electrolytes (sodium, potassium, calcium)
- ECG (before treatment and periodically, especially in elderly or those with cardiac risk factors)
Doctor Notes
- Emphasize the importance of consistent lithium levels and adherence to monitoring schedules.
- Educate patients on early signs of toxicity and the need for immediate medical consultation.
- Counsel on adequate hydration and stable salt intake to prevent fluctuations in lithium levels.
- Consider lower target ranges for elderly or renally impaired patients.
Patient Guidelines
- Take medicine exactly as prescribed by your doctor.
- Do not stop taking lithium suddenly, as this can lead to relapse.
- Drink plenty of fluids (8-12 glasses of water per day) and maintain a normal salt intake.
- Be aware of symptoms of lithium toxicity (e.g., severe nausea, vomiting, diarrhea, coarse tremor, slurred speech) and seek immediate medical attention if they occur.
- Avoid activities that can lead to dehydration (e.g., excessive exercise, saunas, hot weather without adequate fluid intake).
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. Contact your doctor for advice if you miss several doses.
Driving Precautions
Lithium can cause drowsiness, dizziness, and impaired coordination, especially during the initial stages of treatment or if serum levels are high. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy and balanced diet.
- Regular exercise, but ensure adequate hydration.
- Avoid excessive alcohol consumption.
- Manage stress effectively.
- Regular sleep schedule.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.