Hypothyroidism and Hyperthyroidism: Monitor thyroid function regularly ( 5.7).Monitor routinely for changes to cognitive function ( 5.5). Encephalopathic Syndrome: Increased risk in patients treated with lithium and an antipsychotic.Monitor kidney function during treatment with lithium ( 5.4). Lithium-Induced Chronic Kidney Disease: Associated with structural changes in patients on chronic lithium therapy.Monitor for and treat hyponatremia and lithium toxicity, which may necessitate a temporary reduction or cessation of lithium and infusion of serum sodium ( 5.3). Educate patients on maintaining a normal diet with salt and staying hydrated. Dehydration from protracted sweating, diarrhea, or elevated temperatures from infection increases risk of hyponatremia and lithium toxicity. Hyponatremia: Symptoms are more severe with faster-onset hyponatremia.Discontinue lithium or treat with amiloride as a therapeutic agent ( 5.2). Monitor for lithium toxicity and metabolic acidosis. Lithium-Induced Polyuria: May develop during initiation of treatment.Severe Renal Impairment (CLerMild to Moderate Renal Impairment (CLer 30 to 89 mL/min): Start with dosages less than those for patients with normal renal function, titrate slowly with frequent monitoring ( 2.5).Pre-treatment Screening: Evaluate renal function, vital signs, electrolytes, thyroid function, concurrent medications, and pregnancy status ( 2.1).Maintenance Treatment for Bipolar I Disorder (patients 7 years and older): Titrate to serum lithium concentrations 0.8 to 1 mEq/L ( 2.2).Acute Manic or Mixed Episodes (patients 7 years and older): Titrate to serum lithium concentrations 0.8 to 1.2 mEq/L ( 2.2).Obtain serum lithium concentration assay after 3 days, drawn 12 hours after the last oral dose and regularly until patient is stabilized.
Oral Solution: 8mEq (5mL), twice daily.Tablets or Capsules: 300 mg twice daily, or.Recommended starting dosage for pediatric patients 20 to 30 kg ( 2.2):.Oral Solution: 8mEq lithium (5 mL) three times daily.Tablets or Capsules: 300 mg, three times daily, or.Recommended starting dosage for adults and pediatric patients over 30 kg ( 2.2):.
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