Before taking lithium

Before taking lithium make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have heart problems.
• If you have kidney problems.
• If you suffer from psoriasis (a skin problem).
• If you have Addison's disease (a disorder of the adrenal glands).
• If you suffer from myasthenia gravis (a muscle weakening disease).
• If you suffer from thyroid problems.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to take lithium

• A specialist will start your lithium treatment and take blood samples to make sure they have prescribed the correct dose. Once you have begun treatment, you need to have regular blood tests (sometimes called 'a lithium level', a 'serum lithium level' or a 'plasma lithium level'). When your lithium level has stabilised, this type of test will be needed less often. This test is important because it tells the doctor how much lithium is in the bloodstream, checking that your dosage is at the correct level. Blood tests are needed more often in the early stages of treatment or if your dosage has changed.
• Do not crush or chew lithium tablets because this could cause you to absorb too much from them.
• Important: your pharmacist should supply you with the same brand of lithium each time you receive a new prescription. If the medicine you have been given looks different to usual, speak to your pharmacist before taking any of them. This is because different brands give different blood levels of lithium.
• Try to get into the habit of taking lithium at the same times each day to avoid missing any doses.

Getting the most from your treatment

• When you first begin treatment with lithium you will be given an information booklet about lithium treatment, a lithium alert card for you to carry with you at all times and to show to any healthcare professional who is treating you, and a booklet for keeping a record of your blood tests. These are all to help make sure you continue to receive the correct dose of lithium. Your doctor and pharmacist will want to check the record of your blood levels before they prescribe or dispense your prescriptions.
• Lots of medicines can cause your level of lithium to rise too high so always check with your pharmacist or doctor before taking any medicines; including painkillers such as ibuprofen, available to buy in shops and pharmacies.
• It may take several weeks before you feel the full benefits of this treatment, although lots of people do notice a difference earlier.
• You should drink plenty of fluids while you are being treated with lithium.
• Keep to your usual salt intake and avoid any changes from your regular diet, e.g. crash dieting programmes. This is because it can change your lithium level. Speak with your doctor before making any changes to your diet.
• If you have an infection or illness that causes heavy sweating, being sick or diarrhoea, consult your doctor, as this can affect the levels of lithium in your blood.
• Do not stop taking lithium without speaking to your doctor first. Stopping suddenly can cause problems.

Can lithium cause problems

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

How to store lithium

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Camcolit® 250, Norgine Limited, electronic Medicines Compendium. Dated February 2009, accessed December 2009.
• Manufacturer's PIL, Camcolit® 400, Norgine Limited, electronic Medicines Compendium. Dated February 2009, accessed December 2009.
• Manufacturer's PIL, Li-Liquid® 5.4 mmol/5 ml Oral Syrup, Rosemont Pharmaceuticals Limited, electronic Medicines Compendium. Dated February 2009, accessed December 2009.
• Manufacturer's PIL, Liskonum® Tablets, GlaxoSmithKline UK, electronic Medicines Compendium. Dated April 2009, accessed December 2009.
• Manufacturer's PIL, Priadel® Tablets, sanofi-aventis, electronic Medicines Compendium. Dated August 2007, accessed December 2009.
• British National Formulary; 58th Edition (September 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF).