Ibuprofen can increase serum lithium level in lithium-treated patients

Area of Science:

• Pharmacology
• Psychiatry
• Nephrology

Background:

• Lithium is a mood stabilizer commonly prescribed for bipolar disorder.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are frequently used for pain relief.
• Potential drug interactions between lithium and NSAIDs require careful consideration, especially in elderly patients.

Purpose of the Study:

• To investigate the pharmacokinetic interaction between lithium and ibuprofen in patients with bipolar or schizoaffective disorder.
• To assess the effect of ibuprofen on serum lithium levels and lithium clearance.
• To explore potential correlations between changes in lithium levels and renal function.

Main Methods:

• A study involving nine male patients in a geropsychiatric ward.
• Patients maintained a steady-state lithium level before and during ibuprofen administration (1800 mg/day for 6 days).
• Serum lithium levels and lithium clearance were monitored throughout the study.

Main Results:

• Ibuprofen administration led to increased serum lithium levels.
• Lithium clearance was decreased during ibuprofen co-administration.
• Significant interindividual variations in lithium level changes were observed.
• No significant correlation was found between lithium level changes and creatinine clearance.

Conclusions:

• Ibuprofen can significantly alter lithium pharmacokinetics, necessitating potential lithium dosage reduction.
• The interaction highlights the importance of monitoring lithium levels when initiating ibuprofen therapy.
• Further research is needed to elucidate the role of renal prostaglandin systems in lithium excretion.