Lithium drug application. Lithium carbonate (Lithium carbonate)

Lithium carbonate

Chemical properties

Salt formed alkali metal lithium and carbonic acid . The substance is a colorless powder or odorless crystals. The agent is poorly soluble in water (especially in hot water), practically insoluble in alcohols. His molecular mass = 73.9 grams per mole. The melting point is about 618 degrees Celsius.

Lithium carbonate is used in the production of plastics, pyrotechnics, porcelain, glass-ceramics , in the desulfurization of steel, in the glass industry.

For medical purposes, lithium salts began to be used even by ancient physicians. They used alkaline mineral water rich in lithium compounds for the treatment of patients with agitation and other mental disorders accompanied by euphoria.

By 1949, Australian scientist John Cade is injecting ToLithium carbonate to treat, and various mania . Then, due to the high toxicity of such compounds, a ban on their use was introduced until 1970. Nowadays Lithium carbonate is actively used in medicine as normotimic and an antipsychotic.

pharmachologic effect

Sedative, antipsychotic, normothymic.

Pharmacodynamics and pharmacokinetics

The substance acts as an antagonist sodium ions in nerve and muscle cells. Thus, muscle weakness develops, it is difficult to carry out nerve impulse . Lithium has an impact on transport, and other monoamines , in some areas of the brain, sensitivity to increases.

Salts also inhibit enzyme activity. , kinase 3 glycogen synthase , protein kinase C . Substance stimulates shift intraneuronal metabolism of catecholamines .

After penetration into the stomach, the agent is rapidly and completely absorbed. It reaches its maximum concentration within 6-12 hours. The half-life is from one day to 2.5 days (after a year of daily intake). The cure overcomes blood-brain barrier passes into breast milk.

Lithium salts are excreted through the kidneys, depending on the level of sodium and potassium, lithium is either reabsorbed in the renal tubules or maintains its equilibrium concentration in the blood.

Indications for use

The tool is used:

• for treatment manic and hypomanic states of various origins;
• as prophylactic or as a medicine for affective psychosis ;
• with chronic;
• for treatment, Meniere's syndrome , sexual deviations;
• with some forms of drug dependence.

Contraindications

Lithium carbonate should not be prescribed:

• with hypersensitivity to the substance;
• after major operations;
• patients with severe cardiovascular diseases;
• for and ;
• breastfeeding women;
• if the patient, including a history;
• with renal failure;
• persons with severe dehydration and imbalance electrolytes ;
• pregnant women.

Side effects

After taking the medicine, you may experience:

• , nausea , dry mucous oral cavity, vomit, ;
• , decreased muscle tone, ;
• leukocytosis , cardiac arrhythmia, slowing hematopoiesis ;
• kidney failure, polyuria ;
• thirst, weight gain, myasthenia gravis , ;
• and allergic rashes.

Lithium Carbonate, instructions for use (Method and dosage)

The dosage is determined by the attending physician, depending on the initial concentration of lithium in the blood plasma.

Lithium carbonate preparations are taken orally.

The average daily dosage for an adult is about 900-2400 mg, divided into 3-4 doses.

The dosage should be selected in such a way that the equilibrium concentration of the agent in the blood is from 0.6 to 1.2 mmol per liter.

As a rule, when taking 1 gram of a substance per day, the optimal equilibrium concentration is reached within 10-14 days.

If during the course of treatment pronounced improvements in the patient's condition occur, then it is highly recommended not to interrupt therapy in order to avoid relapse.

For children, the optimal concentration of lithium \u003d 0.5-1 mmol per liter.

Overdose

With an overdose of the drug develop: hyperreflexia , speech disorders, epileptic seizures and tonic convulsions , oliguria , loss of consciousness, collapse . Treatment is according to the symptoms.

Interaction

The combination of a drug with thiazide diuretics , methyldopa , or may lead to rapid growth plasma concentration of lithium in the blood and the development of toxic effects.

ACE inhibitors , non-steroidal anti-inflammatory drugs increase the concentration of lithium in the blood, increase the risk of adverse reactions.

The combined intake of the substance leads to an increase in the level of lithium in the blood.

Derivatives enhance the excretion of lithium from the body with urine, this can lead to a decrease in the effectiveness of the drug.

When combined with this compound, the toxic effect of the drug is enhanced.

It is better not to combine with the drug, drug interaction unpredictable.

With the combined use of the drug, isolated cases of amplification were described hyperkinetic symptoms in patients who are sick chorea of ​​Huntington ., violations in the work of the cerebellum.

Terms of sale

Need a prescription.

Storage conditions

Tablets are stored in a dark, dry place, away from children.

Best before date

special instructions

Some phenothiazines may mask the symptoms of lithium toxicity.

After a month of continuous medication, it is recommended to monitor the concentration of lithium in the blood plasma weekly. Then these indicators can be checked once a month, then once every 2-3 months.

During therapy, you should not drive a car or perform potentially dangerous species activities.

Elderly

The elderly and debilitated patients need dosage adjustment.

With alcohol

During treatment, you can not take alcohol.

Preparations containing (Analogues)

The substance is part of the drugs: Kontemnol, Lithium Carbonate, Lyosan-SR, Lithium Carbonate Coated Tablets .

The most effective psychotropic drug in this group is lithium. Although lithium does have some antidepressant properties, it is not a true antidepressant in the strict sense of the word. The effectiveness of lithium in the treatment of patients with bipolar disorders (see Chapter 360) and other mood disorders has revolutionized psychiatric practice. After the use of lithium was approved by the FDA in 1969, intensive scientific research began in the field of theory, pharmacology and clinical use of this drug.

Mechanism of action of lithium. While some clarity has been achieved regarding the clinical use of lithium, the questions of its mechanisms of action remain largely unknown. Lithium affects the concentration of monoaminergic neurotransmitters in the brain at the level of synapses, and it is believed that this is part of the mechanism of action. In addition, lithium has a strong effect on biological membranes, and this seems to be also included in its mechanism of action on the CNS. Lithium is in some way a unique drug, as it simultaneously alleviates the emotional excitement inherent in manic states, and at the same time controls the state of depression in bipolar disorders. However, the central mechanisms through which the clinical effect of lithium on polar mood swings is mediated remain unclear.

Indications for the use of lithium. Lithium is most effective in manic-hypomanic episodes and in preventing recurrent episodes of mania and depression in bipolar disorder. Although some experts classify lithium as a mild antidepressant (especially in cases of depression that occurs on the background of bipolar disorders), it still cannot be considered the drug of choice for depression as such. However, in the prevention of recurrent unipolar depressive disorders lithium may be quite effective. It has been successfully used in combination with neuroleptics in schizoaffective schizophrenia. There may be a subpopulation of schizophrenic patients who respond well to lithium, although many reporters tend to think that such patients should rather be considered as atypical bipolar patients. Finally, there are reports that the use of lithium may be useful in alcoholism. This, of course, is an interesting, but not yet scientifically established fact.

Clinical use of lithium. Lithium is a fairly safe drug with an excellent risk/benefit ratio. The only true contraindication for its use is a significant violation of the functional state of the kidneys. Before prescribing lithium to a patient, the physician should have the following information: clinical analysis blood and urine, Zimnitsky's concentration test, data from a study in the blood of total thyroxine (T 4), serum creatinine and electrolytes, and in patients over 40 years old - ECG data.

Lithium reaches its peak serum concentration 1-3 hours after oral administration, the biological half-life of the drug is 24 hours, although this figure varies depending on the age of the patient. In elderly patients, it sometimes exceeds 30 hours (which leads to the use of lower doses), while in adolescents it is less than 20 hours (which, on the contrary, requires the use of higher doses). The content of lithium in the blood serum must be monitored. The most informative for this is a study conducted 10 hours after the last dose. The therapeutic effect in acute manic states is achieved when the concentration of lithium in the blood is 0.8-1.5 meq / l. The need to increase the concentration of lithium in the blood more than 1.5 meq / l is rare. Lithium is administered orally in doses of 600 to 3000 mg 4 times a day. It has been empirically found that each additional 300 mg lithium tablet increases its blood concentration by 0.2 mEq/L. Lithium should be taken until the patient becomes stable. Taking the drug 2-3 times a day allows you to maintain a stable therapeutic concentration in the blood during the day. Full therapeutic effect lithium occurs 7-10 days after the start of therapy, therefore, in early stages In the treatment of manic patients, it may be necessary to additionally use antipsychotic drugs. During acute manic episodes, patients usually tolerate relatively high doses of lithium, but as soon as the manic state can be stopped, the dose of lithium is immediately reduced so as not to cause intoxication. In the case of treatment of an uncomplicated acute manic-hypomanic state, lithium intake is continued for 6-8 months after the symptoms of the disease disappear. Cancel the drug gradually, within 3-4 weeks. Due to various complications long-term treatment physicians are usually quite reserved about this regimen of lithium intake, unless, of course, there are very clear indications for it.

Maintenance therapy is indicated in patients with a history of at least three episodes of diagnosed manic and/or depressive states, two of which must occur within a two-year period, and the subsequent episode of exacerbation of the disease - in the next two of the year. Thus, the doctor must be convinced that exacerbations of the manic-depressive state in the patient occur frequently, proceed quite seriously and significantly disrupt the patient's normal life. At present, they adhere to the tactics of maintaining the minimum concentration of lithium in the blood, which allows avoiding relapses of the disease. Previously, such a concentration in maintenance therapy was considered equal to 0.4-1 meq/l, but recently it has been shown that the frequency of relapses increases significantly only when the concentration of lithium in the blood falls below 0.4 meq/l.

The rate of elimination of lithium from the body in each patient is stable, so that the patient can receive the same maintenance dose of the drug for a long time without a great risk of changing its concentration in the blood. Patients on maintenance therapy should be examined by a doctor every 3-6 months, at the same time they determine the content of lithium, sodium, potassium, T4, TSH and creatinine in the blood, and also examine the concentration function of the kidneys. It should be remembered that the concentration of lithium in the blood is dependent on changes in the content of sodium, therefore, monitoring of patients receiving thiazide diuretics or on a diet low in sodium chloride should be carried out more often.

Side effects when using lithium and its interaction with other drugs. Side effects when taking lithium are varied (Table 364-4). Many of them are very harmless, they appear at the initial stages of treatment and gradually disappear, while others, on the contrary, progress as the treatment continues. As a rule, a rapid increase in the concentration of lithium in the blood portends the occurrence of certain side effects, especially from the gastrointestinal tract.

Table 364-4 Side effects of lithium

Today lithium in medicines occurs quite frequently. What is it connected with? Studies have shown that drugs based on lithium salts help to effectively cope with mental disorders. There is a huge variety of such medicines at the moment. This allows you to make an informed choice and, with the help of consultations from competent specialists, select the appropriate drug that will have a positive effect on the patient's condition. How do lithium preparations work? How safe are they? To whom would it be appropriate to appoint them? What kind of medicines belong to the considered group of medicines? We will consider this information in more detail in this article.

Lithium salts

Drugs containing such substances are currently considered the best remedy to stop a variety of manic and hypomanic phenomena in the mental state of the patient. Equally effective as a preventative

Lithium preparations act somewhat longer than many effective antipsychotics. Especially those that are prescribed for injection. But it is precisely such salts (lithium preparations) that experts consider the most preferable for correcting the condition with the so-called pure mania.

This kind of medicines have only one significant disadvantage. Some of them (in particular, lithium carbonate - the most common agent in this group) are not available as a solution for injection.

The use of lithium in psychiatry

For the first time, such funds in this field of medicine were used about forty years ago. Lithium preparations in psychiatry are used to significantly alleviate the symptoms of manic-depressive state (is a mental disorder characterized by abrupt transitions from absolute despair to uncontrollable elation; in medicine it is also known as bipolar disorder). Although, of course, the substance in question will not be able to cure the disease to the fullest, it will help smooth out its extreme manifestations.

It is also important to note that each lithium-containing drug effectively normalizes mood, corrects the emotional state in depression.

Side effects

Provided that lithium preparations are taken long time and with an increased content of the substance in question in the blood, unpleasant side effects. Among them is the feeling constant fatigue, weakness, temporary tremor of the hands, dizziness, dysuric phenomena, a decrease in the volume of accommodation, dyspeptic phenomena. These side effects additional treatment do not require and pass on their own within a certain time.

More complex conditions require immediate medical attention and conservative treatment. When they appear, you should immediately seek advice from your doctor.

Overdose

The main manifestation when the permissible dose of drugs of the group under consideration is exceeded is lithium poisoning. How to recognize it? At acute poisoning at the first stage, a variety of symptoms of disorders of the functioning of the gastrointestinal tract appear, such as nausea, vomiting, diarrhea and, as a result, dehydration. Later, various neurological disorders and malfunctions of cardio-vascular system. At the first suspicion of poisoning with lithium preparations, you should immediately contact a specialist who will help to correctly diagnose the situation and prescribe effective treatment.

Application during pregnancy

Is it possible for a pregnant woman to use products containing lithium? A drug based on the substance in question can become dangerous for a developing fetus. For example, such medications provoke the development of heart defects in a child. If, nevertheless, preparations containing lithium are indicated for use by a pregnant woman, then it is important to constantly be under the supervision of the attending physician, who will be able to monitor the concentration of this substance in plasma. If this is not done, then the infant may be diagnosed with hypotension or goiter.

"Quilonum"

The main component of the drug is This drug is available in the form of capsules or tablets, which are coated with a specialized shell.

Quilonum tablets are lithium preparations, the action of which is aimed at stopping manic states of various origins, schizoaffective psychoses, migraines, sexual disorders, alcoholism, manic-depressive psychosis, as well as a variety of drug addictions.

There are some conditions that prevent patients from taking the medication in question. Among them: infections, renal failure, hypersensitivity to any components of the drug, leukemia, psoriasis, breastfeeding period, urinary retention, thyrotoxicosis, diabetes, epilepsy, intraventricular blockade, parkinsonism, childbearing period, rehabilitation after surgery.

With prolonged use of the drug, certain adverse reactions may occur, for example, hand tremors, nausea, loss of appetite, muscle weakness, diarrhea, dizziness, convulsions, hypothyroidism, weakness, myasthenia gravis, impaired coordination, drowsiness, increased thirst.

"Contemnol"

Prolonged action drug. Produced in glass bottles.

The drug is well absorbed in the gastrointestinal tract, and its maximum concentration in the blood is reached after nine hours.

The drug must be taken for at least six months as prescribed by a doctor. It is recommended to take in the following cases: sexual deviations, Meniere's syndrome, migraine, quarterly binges, drug addiction, seasonal aggressiveness of psychopaths.

You should not use the product if you suffer from water and electrolyte imbalance or diseases of the kidneys and the cardiovascular system.

It is forbidden to take the medication in question during pregnancy.

"Lithium carbonate"

The drug can be purchased in the form of tablets in a specialized shell.

Use it rationally for functional mental disorders, epilepsy, emotional disorders, chronic alcoholism, depressive states. Sometimes experts prescribe this medication for preventive purposes. It is also appropriate to take with psychoses, which are accompanied by fear, anxiety, anger, with chronic alcoholism in individuals who are characterized by a hysterical personality, excessive sensitivity and sharp mood swings. Effectively helps to avoid relapse in psychotraumatic conditions.

Take from nine tenths of a gram to two grams, depending on the doctor's recommendations. If the condition is not very serious, the dose is usually reduced to six tenths of a gram.

Do not take the drug if you suffer from disorders thyroid gland, cardiovascular diseases, disorders in the functioning of the kidneys.

The medication in question can be combined with any other antidepressants and antipsychotics.

"Litosan-SR"

The main active ingredient is lithium carbonate.

The drug is forbidden to take with a disease of the cardiovascular system, infections, diseases of the central nervous system, pregnancy, individual intolerance to individual components of the drug, urinary retention, water and electrolyte imbalance, psoriasis, thyrotoxicosis, diabetes mellitus, renal failure, during breastfeeding.

It is important to monitor the concentration of lithium in the blood weekly at the beginning of therapy. Later, this can be done once a month, and then once every two to three months. Blood for analysis must be taken early in the morning twelve hours after the last evening dose of the drug.

The drug affects the ability to think adequately and respond quickly, so it is not recommended to drive a car, engage in activities that may pose a threat to health and life, requiring a high reaction rate.

"Sedalite"

The drug is an anti-manic drug with an antidepressant effect. Available in the form of capsules or coated tablets.

The main indications for the use of this medication are psychoses, as well as manic states. It is also appropriate to take it for Meniere's syndrome, migraine, sexual disorders, drug addictions.

Possible side effects: weakness, thirst, acne, nausea, diarrhea, myasthenia gravis, vomiting, leukocytosis, hand tremor, disorders heart rate, arrhythmia, weight gain, alopecia, drowsiness, pyoderma, dysarthria, loss of appetite, polyuria, convulsions, confusion.

Outcome

It is possible to alleviate the condition of patients who suffer from a variety of mental illnesses, accompanied by serious emotional disorders, thanks to a number of medicines made using lithium salts. Such medicines, judging by the reviews of experts and real buyers, are incredibly effective and help to stop conditions of varying severity. Treatment with drugs of the group under consideration should be prescribed by a competent attending physician who will be able to correctly formulate a therapy regimen and later, if necessary, adjust it. You should not make a decision on the use of lithium preparations on your own. In this case, mistakes can be made that will negatively affect the patient's condition or provoke lithium poisoning, which sometimes leads to death. It is important to pay sufficient attention to the study of contraindications, possible side effects. This will help to avoid unpleasant surprises or be prepared for any negative reactions from the patient's body. Constant monitoring of the attending physician will guarantee the successful course of the prescribed therapy.

Never forget to take care of yourself. Make an effort to choose the highest quality drug. Pay sufficient attention to the physical and mental well-being of your loved ones. Be always healthy!

lithium salt- dissociating lithium compounds, which are used as psychotropic drugs with an anti-manic spectrum of action.

In the USSR, lithium carbonate and lithium oxybutyrate are approved for medical use. The effect of lithium salts on the central nervous system characterized mainly by their ability to stop acute manic excitement and prevent attacks of affective disorders. Unlike many other psychotropic drugs, L.s. even with prolonged use, they do not affect memory and intelligence. Lithium oxybutyrate also has sedative and antihypoxic properties, due to the presence in its molecule of the residue of the g-hydroxybutyric acid molecule. In therapeutic doses HP have a positive inotropic and negative chronotropic effect on the heart and, therefore, increase the strength and slow down the rhythm of heart contractions, as well as prevent the development of arrhythmias, increase the volumetric rate of coronary blood flow, increase the content of glycogen and RNA in the conduction system of the heart and cardiomyocytes. Excreted in the urine, lithium ions increase the solubility of uric acid and its salts in it. In addition, L.s. stimulate leukopoiesis.

Mechanisms of psychotropic action HP. little studied. It is only known that lithium ions are antagonists of sodium ions in the processes of transport of the latter through the cell membranes of nerve and muscle cells. Under the influence of HP there are also changes in the bioenergetic, carbohydrate, lipid and protein metabolism and metabolism of certain neurotransmitters (norepinephrine, serotonin, enkephalins) and the sensitivity of the corresponding receptors on the membranes of neurons to them.

After the introduction of HP. lithium ions in the body are unevenly distributed in the tissues, as well as in the structures of the brain. They are found in the highest concentrations in the kidneys and further (in order of decreasing content) in the blood, liver, diencephalon, midbrain and cerebral cortex. When using lithium oxybutyrate, lithium ions are absorbed into the blood faster and penetrate into the central nervous system than when using its other salts. The excretion of lithium ions from the body occurs through the kidneys. About 50% of the administered dose is excreted in the urine per day. Renal excretion in the blood, as well as on the content of sodium and potassium in the body. With a low sodium content in the urine, lithium ions are reabsorbed in the renal tubules, which leads to an increase in the lithium content in the blood. Increasing the excretion of lithium ions in the urine and reducing their concentration in the blood contributes to the introduction of sodium into the body.

How psychotropic drugs HP used mainly in manic and hypomanic states,

Therapeutic efficacy HP depends on the level of lithium ion concentration in the blood, which should not be lower than 0.6, but not higher than 1.2-1.6 meq/l, because when these concentrations are exceeded, signs of lithium intoxication develop.

Side effect HP manifested by impaired renal function, as well as water-salt metabolism with the development of a similar syndrome, dyspeptic disorders and diarrhea. As a result of the inhibitory effect of lithium ions on the function of the thyroid gland, with prolonged use of its salts, diffuse a and a temporary increase in body weight may develop.

Methods of application, doses, formulations and storage conditions of the main lithium preparations are given below.

Lithium carbonate (Lithii carbonas) is administered orally on the first day at a daily dose of 0.6-0.9 G. With good tolerance, starting from the 2nd day of treatment, it is increased by 0,

Pharmacotherapeutic group N05AN01 - Antipsychotics.

Main pharmachologic effect: blocks the transport of sodium into neurons, in turn, inhibits the depolarization-dependent (i.e. calcium-dependent) release of norepinephrine and dopamine (without affecting the release of serotonin); the mechanism of action of lithium has not been fully established; lithium inhibits the reuptake of these catecholamines, in patients with bipolar or unipolar affective disorders, lithium contributes to the disappearance of the symptoms of mania and prevents their development, and also prevents the phase of depression or reduces its symptoms in both types of affective disorders, stabilizing the mood of the patient, in healthy people lithium does not cause psychotropic action. Lithium salts inhibit ADH (vasopressin) and the effect of thyroid-stimulating hormone (TSH) on thyroid gland, which may lead to certain side effects; in the kidneys and thyroid gland, lithium salts inhibit ADH and thyroid-stimulating hormone on adenylate cyclase.

INDICATIONS: treatment of the manic phase of bipolar affective disorder WHO (recommendation for the use of drugs in the Basic Formulary of the World Health Organization "" I, 2008 release), BNF (recommendation for the use of drugs in the British National Formulary, 60th edition), prevention of recurrence of episodes of bipolar affective disorder WHO ( recommendation for the use of drugs in the Basic Formulary of the World Health Organization "" I, 2008 release), BNF (recommendation for the use of drugs in the British National Formulary, 60 edition) as well as to reduce the intensity and frequency of subsequent episodes of BNF mania (recommendation for the use of drugs in British National Formulary, 60 edition) in patients with a history of manic episodes, prevention of the phase of depression WHO (recommendation for the use of drugs in the Basic Formulary of the World Health Organization "" I, 2008 issue), BNF (recommendation for the use of drugs in the British National Formulary, 60 issue) in patients with unipolar affective disorder.

Dosage and administration: due to the narrow therapeutic range of lithium concentrations, doses must be individualized based on serum lithium concentrations and clinical effect, the total daily dose, as a rule, is 0.5 - 1.25 g of lithium carbonate (in several doses) WHO (recommendation for the use of drugs in the Basic Formulary of the World Health Organization "" I, 2008 release), treatment should be started with a low daily dose, and then gradually increase it; during the initial period of treatment, the concentration of lithium in serum should be monitored at least once a week; the optimal concentration of lithium is from 0.5 to 0.8 mmol / l BNF (recommendation for the use of drugs in the British National Formulary, issue 60), after reaching the desired concentration, control analyzes can be performed less frequently - once a month BNF or once every two months, during remission, the concentration of lithium in serum can be determined every 2-3 months of BNF, in severe manic disorders, the recommended dose is 1.5 BNF-2.0 g / day, while the concentration of lithium in serum should be in the range of 0.6-1 .2 mmol /l, after relief severe symptoms the dose of lithium carbonate should be reduced immediately; The daily dose of lithium carbonate should be taken in at least three doses, if one dose was missed, the next dose should not be doubled.

Side effects when using drugs: pseudotumor of the brain, tremor (large-scale tremor and fibrillation), ataxia, athetosis, increased tendon reflexes, extrapyramidal symptoms, urinary and fecal incontinence, convulsions, drowsiness, disorientation, memory impairment, coma, visual disturbances, speech disorders, arrhythmia headache, hypotension, syncope, bradycardia, sinus node dysfunction, vascular insufficiency, peripheral edema, nausea, vomiting, diarrhea, abdominal pain, anorexia, edema salivary glands glucosuria, decreased creatinine clearance, albuminuria, oliguria, symptoms of DM (diabetes mellitus) (polyuria, polydipsia) hair loss, acne, psoriasis, itching, rash, covering with ulcers, hyperkeratosis, folliculitis; dry mouth, impotence; Graves' disease, hypothyroidism, hyperthyroidism, weight loss, hyperglycemia, hypercalcemia, allergic vasculitis, anemia, leukopenia, leukocytosis, edema, taste disorder, caries side effects caused by lithium are more pronounced in elderly patients than in young patients, despite the same concentration of lithium in serum.

Contraindications to the use of drugs: hypersensitivity to active substance or auxiliary ingredients, severe renal failure, recent MI (myocardial infarction), organic brain pathology, leukemia, pregnancy (due to embryotoxic effects in the first trimester) and breast-feeding(lithium is excreted in milk) the drug is contraindicated in children.

Forms of drug release: caps. (Capsules) 300 mg tab. (Pills) prolonged action 400 mg

Visamodia with other drugs

Diuretics, especially thiazides and amiloride, a low-sodium diet, and increased sodium loss (due to excessive sweating) delay lithium excretion and increase the risk of lithium accumulation. NSAIDs (non-steroidal anti-inflammatory drugs) (indomethacin, ibuprofen), tetracyclines, methyldopa and ACE inhibitors(ACE) - inhibition of the excretion of lithium in the urine. With haloperidol - leads to encephalopathy, with leukocytosis, increased level and plasma enzyme activity, elevated blood urea and nitrogen levels, and morning hyperglycemia. A similar interaction is possible with other antipsychotics. Strengthens and prolongs the action of muscle relaxants, regardless of their mechanism of action - as non-depolarizing (pancuronium) and depolarizing (succinylcholine) drugs. Lithium enhances the inhibitory effect of high doses of iodide on the thyroid gland. Suppresses the action of amphetamines. Fluoxetine, methyldopa and metronidazole - an increase in the concentration of lithium in the blood - the risk of side and toxic effects of lithium. Chlorpromazine and other phenothiazine derivatives - exacerbation of extrapyramidal symptoms, potentiation of the neurotoxic effect of lithium. With tricyclic antidepressants - provokes manic or manic-depressive states. Xanthines (aminophylline, caffeine, theophylline) and others with an alkaline reaction (sodium carbonate) and urea - accelerate the excretion of lithium, reducing its concentration in serum. May increase the concentration of glucose, parathyroid hormone and calcium in plasma.

Features of use in women during pregnancy and lactation

Pregnancy Contraindicated.
Lactation: Contraindicated.

Features of use in case of insufficiency of internal organs

Dysfunction of the cerebrospinal system: Contraindicated in CHF, cardiac arrhythmias and conduction disorders.
Violation of the function of the stove: No special recommendations
Impaired kidney function Contraindicated in violation of the excretory function.
Impaired function respiratory system: No special recommendations

Features of use in children and the elderly

children under 12 Contraindicated.
Persons of elderly and senile age: A proportional dose reduction is necessary.

Application measures

Information for the doctor: Use with caution in patients with Parkinson's disease, hypothyroidism, dysfunction of the sinus node and AV (atrioventricular) conduction, epilepsy, psoriasis, congenital muscle weakness, DM (diabetes mellitus) and schizophrenia. Since lithium blocks the reabsorption of sodium in the renal tubules, ensure adequate intake of sodium and water during treatment. Diarrhea or excessive sweating infectious diseases) may require dose reduction or temporary discontinuation of treatment.
Information for the patient: During the treatment of severe exacerbations of the disease, driving and operating other mechanisms is contraindicated.