Litiam-ER
Generic Name
Lithium Carbonate Extended Release 400 mg tablet
Manufacturer
Reputable Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| litiam er 400 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Lithium Carbonate is a mood stabilizer primarily used to treat and prevent episodes of bipolar disorder (manic-depressive illness). The extended-release formulation allows for less frequent dosing.
Uses & Indications
Dosage
Adults
Initial dose typically 400-1200 mg daily, administered in 1-3 divided doses. Dosage is adjusted to achieve serum lithium levels of 0.6-1.2 mEq/L.
Elderly
Lower starting doses are recommended, with careful monitoring of serum lithium levels due to increased sensitivity and potential for renal impairment.
Renal_impairment
Dosage must be significantly reduced based on kidney function and serum lithium levels should be closely monitored to avoid toxicity.
How to Take
Take the tablet orally with plenty of water, preferably after food. Do not crush, chew, or break the extended-release tablet.
Mechanism of Action
The exact mechanism of action of lithium is not fully understood, but it is believed to affect neurotransmitter systems (like serotonin, norepinephrine, dopamine) and intracellular signaling pathways in the brain. It helps stabilize neuronal activity.
Pharmacokinetics
Onset
Therapeutic effects may take 1-2 weeks to manifest.
Excretion
Primarily excreted unchanged by the kidneys via urine.
Half life
18-36 hours (dependent on renal function).
Absorption
Completely absorbed from the gastrointestinal tract. Extended-release formulations are absorbed slowly.
Metabolism
Not metabolized in the human body.
Side Effects
Contraindications
- Severe renal or cardiovascular disease.
- Severe dehydration or sodium depletion.
- Brugada Syndrome (or family history).
- First trimester of pregnancy and lactation.
- Hypersensitivity to lithium.
Drug Interactions
Neuroleptics
Increased risk of neuroleptic malignant syndrome (rarely, when used concurrently).
Calcium Channel Blockers (e.g., Verapamil)
May increase the risk of lithium toxicity.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of serotonin syndrome.
Thiazide Diuretics, NSAIDs (e.g., Ibuprofen), ACE Inhibitors
Can increase serum lithium levels, leading to increased risk of toxicity.
Storage
Store below 30°C, in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, diarrhea, hand tremors, muscle weakness, drowsiness, ataxia (lack of coordination), confusion, seizures, and coma. Management involves discontinuing lithium, gastric lavage, bowel decontamination, and enhancing renal excretion with diuresis and adequate hydration. Hemodialysis is effective in severe cases.
Pregnancy & Lactation
Pregnancy: Use in the first trimester is associated with an increased risk of congenital abnormalities (especially Ebstein's anomaly). Use during pregnancy should be carefully considered and discussed with a doctor. Lactation: Lithium is excreted into breast milk. It is generally not recommended for breastfeeding mothers.
Side Effects
Contraindications
- Severe renal or cardiovascular disease.
- Severe dehydration or sodium depletion.
- Brugada Syndrome (or family history).
- First trimester of pregnancy and lactation.
- Hypersensitivity to lithium.
Drug Interactions
Neuroleptics
Increased risk of neuroleptic malignant syndrome (rarely, when used concurrently).
Calcium Channel Blockers (e.g., Verapamil)
May increase the risk of lithium toxicity.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of serotonin syndrome.
Thiazide Diuretics, NSAIDs (e.g., Ibuprofen), ACE Inhibitors
Can increase serum lithium levels, leading to increased risk of toxicity.
Storage
Store below 30°C, in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, diarrhea, hand tremors, muscle weakness, drowsiness, ataxia (lack of coordination), confusion, seizures, and coma. Management involves discontinuing lithium, gastric lavage, bowel decontamination, and enhancing renal excretion with diuresis and adequate hydration. Hemodialysis is effective in severe cases.
Pregnancy & Lactation
Pregnancy: Use in the first trimester is associated with an increased risk of congenital abnormalities (especially Ebstein's anomaly). Use during pregnancy should be carefully considered and discussed with a doctor. Lactation: Lithium is excreted into breast milk. It is generally not recommended for breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic Available
WHO Essential Medicine
YesClinical Trials
Lithium continues to be studied for its efficacy and safety in various populations and novel applications beyond its established indications.
Lab Monitoring
- Therapeutic serum lithium levels (initially weekly, then every 1-3 months).
- Renal function tests (creatinine, BUN, GFR).
- Thyroid function tests (TSH, T3, T4).
- Electrolyte levels.
- ECG (especially in elderly patients or those with cardiac risk factors).
Doctor Notes
- Emphasize the narrow therapeutic index and the critical need for regular serum lithium level monitoring.
- Educate patients on the importance of consistent fluid and sodium intake.
- Monitor renal and thyroid function tests regularly, especially in long-term therapy.
- Be vigilant for signs of lithium toxicity and counsel patients on when to seek immediate medical attention.
Patient Guidelines
- Take the medicine regularly as prescribed by your doctor.
- Undergo regular blood tests to ensure lithium levels are within the therapeutic range.
- Maintain adequate fluid intake and consistent sodium consumption.
- Inform your doctor if you experience sudden dietary changes or excessive sweating (e.g., intense exercise, illness).
- Do not take any other medications without consulting your doctor during lithium therapy.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Driving Precautions
Lithium may cause drowsiness, dizziness, or muscle weakness. Avoid driving or operating heavy machinery until you know how this medicine affects you.
Lifestyle Advice
- Drink adequate amounts of water or other fluids (8-10 glasses daily).
- Maintain a consistent amount of sodium in your diet. Avoid sudden changes in sodium intake.
- Avoid excessive physical activity or extreme heat to prevent dehydration.
- Maintain a healthy diet and regular exercise to manage potential weight gain.
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