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[Interaction between non-steroidal anti-inflammatory agents and lithium salts]
J M Danion1, M Schmidt, M Welsch
1Clinique Psychiatrique, CHRU, Hôpital Civil, Strasbourg.
L'Encephale
|July 1, 1987
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) can increase lithium levels, potentially causing toxicity by reducing lithium
Area of Science:
- Pharmacology
- Nephrology
Context:
- Lithium is a mood stabilizer used to treat bipolar disorder.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation.
Purpose:
- To summarize the established interaction between NSAIDs and lithium pharmacokinetics.
- To highlight the risk of lithium toxicity due to NSAID use.
Summary:
- NSAIDs reduce the urinary clearance of lithium, leading to elevated plasma lithium concentrations.
- This interaction has been observed with several NSAIDs, including phenylbutazone, diclofenac, indomethacin, ketoprofen, mefenamic acid, niflumic acid, and piroxicam.
- Aspirin does not exhibit this interaction, suggesting prostaglandin synthesis inhibition is not the sole mechanism.
Impact:
- Clinicians should be aware of this drug interaction to prevent lithium intoxication.
- Patients on lithium treatment must be informed about the risks associated with NSAID co-administration.
- This information is crucial given the widespread use of NSAIDs.