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Related Experiment Videos

Lithium interaction with sulindac and naproxen.

M Ragheb, A L Powell

    Journal of Clinical Psychopharmacology
    |June 1, 1986
    PubMed
    Summary

    Naproxen, unlike sulindac, can significantly increase serum lithium levels and decrease its clearance in patients. Lithium dosage adjustments and frequent monitoring are recommended when using naproxen concurrently.

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    Area of Science:

    • Pharmacology
    • Geriatric Psychiatry
    • Clinical Pharmacy

    Background:

    • Lithium is a common mood stabilizer.
    • Interactions between lithium and nonsteroidal anti-inflammatory drugs (NSAIDs) require careful consideration.

    Purpose of the Study:

    • To investigate the pharmacokinetic interaction between lithium and two NSAIDs: sulindac and naproxen.
    • To assess the impact of these NSAIDs on serum lithium levels and lithium clearance.

    Main Methods:

    • A study involving patients on stable lithium therapy.
    • Administration of lithium alone, followed by lithium with either sulindac (300 mg/day) or naproxen (750 mg/day) for 6 days.
    • Subsequent administration of lithium alone for 5 days.
    • Monitoring of serum lithium levels and lithium clearance.

    Main Results:

    • Sulindac did not significantly alter serum lithium levels or lithium clearance.
    • Naproxen demonstrated considerable interindividual variability in its effect on lithium.
    • Naproxen led to an increase in serum lithium levels (up to 41.9%) and a decrease in lithium clearance.
    • These effects were observed within 5 days of naproxen administration.

    Conclusions:

    • Naproxen poses a risk of increasing serum lithium levels and reducing lithium clearance.
    • Patients on lithium therapy may require reduced lithium dosages when co-administered with naproxen.
    • Close monitoring of serum lithium levels is crucial upon initiating naproxen therapy to manage potential drug interactions.

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