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Lithium Intoxication in the Elderly: A Possible Interaction between Azilsartan, Fluvoxamine, and Lithium
1Dr. Nagamine is with the Sunlight Brain Research Center in Yamaguchi, Japan.
Abstract:
Lithium intoxication might be lethal particularly in elderly persons who have multiple drugs. We present an aged bipolar patient with lithium intoxication probably caused by the interaction between fluvoxamine and azilsartan. Fluvoxamine inhibits many cytochrome P450 enzyme (CYP) including CYP2C9, which metabolizes azilsartan. Thus, azilsartan could cause more negative effects for sodium reabsorption at renal tubules when co-administered with fluvoxamine, resulted in a decrease in lithium excretion.
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