Antacids, drugs containing aminophylline, caffeine, calcium, sodium, theophylline: Increased lithium excretion. Monitor serum lithium levels; monitor child for lack of drug effectiveness.
Carbamazepine, methyldopa, phenytoin, tetracyclines: Increased lithium toxicity. Monitor serum lithium levels.
Chlorpromazine: Decreased effects of chlorpromazine. Monitor child.
Electroconvulsive therapy (ECT): Acute neurotoxicity with delirium in children receiving concurrent therapy. Reduce or withdraw lithium dosage before ECT
Fluoxetine: Increased serum lithium levels. Watch for toxicity.
Haloperidol: Possible severe encephalopathy. Use together cautiously.
Indomethacin, phenylbutazone, piroxicam, other NSAIDs: Decreased renal excretion of lithium. Monitor levels closely; may need 30% reduction in lithium dosage.
Neuromuscular blockers: May potentiate effects of these drugs. Monitor child closely.
Sympathomimetics (such as norepinephrine): Lithium may interfere with pressor effects of these drugs. Monitor child.
Thiazide diuretics: Decreased renal excretion; enhanced lithium toxicity. Monitor levels closely; diuretic dosage may need to be reduced by 30%.
Dietary sodium: Altered renal elimination of lithium. Monitor child closely. |