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Generic Name: lithium (LITH ee um)
Brand Names: Eskalith, Eskalith-CR, Lithobid, Lithonate, Lithotabs

What is Eskalith-CR (lithium)?

Lithium affects the flow of sodium through nerve and muscle cells in the body. Sodium affects excitation or mania.

Lithium is used to treat the manic episodes of manic depression. Manic symptoms include hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger. Lithium also helps to prevent or lessen the intensity of manic episodes.

Lithium may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Eskalith-CR (lithium)?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

What should I discuss with my healthcare provider before taking Eskalith-CR (lithium)?

Before taking lithium, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;

• kidney disease;

• underactive thyroid;

• a severe or debilitating medical condition; or

• if you are dehydrated or have low levels of sodium in your blood (hyponatremia).

If you have any of these conditions, you may need to receive lithium in a hospital, or you may need a dosage adjustment or special tests during treatment.

Older adults may be more sensitive to the effects of this medication.

How should I take Eskalith-CR (lithium)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Measure the liquid form of lithium with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Taking lithium can make it easier for you to become dehydrated, especially if you have any vomiting or diarrhea, if you are outdoors in the sun, or if you exercise vigorously or sweat more than usual. Dehydration can increase some of the side effects of lithium.

To be sure this medication is not causing harmful effects, your kidney function will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lithium.

Store lithium at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

What should I avoid while taking Eskalith-CR (lithium)?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not change the amount of salt that you consume in your diet. Changing your intake of salt could alter the amount of lithium in your blood.

Eskalith-CR (lithium) side effects

• extreme thirst, urinating more or less than usual;

• weakness, fever, feeling restless or confused, eye pain and vision problems;

• restless muscle movements in your eyes, tongue, jaw, or neck;

• pain, cold feeling, or discoloration in your fingers or toes;

• feeling light-headed, fainting, slow heart rate;

• hallucinations, seizure (blackout or convulsions);

• fever with muscle stiffness, sweating, fast or uneven heartbeats; or

• early signs of lithium toxicity, such as nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.

Continue to take lithium and talk to your doctor if you have any of these less serious side effects:

• mild tremor of the hands;

• weakness, lack of coordination;

• mild nausea, vomiting, loss of appetite, stomach pain or upset;

• thinning or drying of the hair; or

• itching skin.

Side effects other than those listed here may also occur. Talk to your doctor about any side effects that you experience.

What other drugs will affect Eskalith-CR (lithium)?

Before taking lithium, tell your doctor if you are taking any other medications, especially any of the following:

• acetazolamide (Diamox);

• aminophylline (Truphylline) or theophylline (Elixophyllin, Respbid, Theo-Bid, Theo-Dur, Uniphyl);

• sodium bicarbonate (Alka-Seltzter, Bicitra, Polycitra, or baking soda home remedy antacid);

• carbamazepine (Carbatrol, Tegretol);

• fluoxetine (Prozac);

• metronidazole (Flagyl);

• sodium potassium iodide thyroid medication (Pima);

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);

• a calcium channel blocker such as diltiazem (Tiazac, Cartia, Cardizem) or verapamil (Calan, Covera, Isoptin, Verelan);

• a diuretic (water pill) such as amiloride (Midamor, Moduretic), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others;

• medicines to treat psychiatric disorders, such as haloperidol (Haldol), aripiprazole (Abilify), chlorpromazine (Thorazine), clozapine (Clzaril, Fazaclo), olanzapine (Zyprexa), quetiapine (Seroquel), pimozide (Orap), risperidone (Risperdal), or ziprasidone (Geodon); or

• celecoxib (Celebrex) or an NSAID (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

If you are using any of these drugs, you may not be able to use lithium or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect lithium. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about lithium written for health professionals that you may read.

What does my medication look like?

Lithium is available with a prescription generically and under the brand names Lithobid, Lithonate, Lithotabs, and Eskalith. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.