ESKALITH CR Rx
Generic Name and Formulations:
Lithium carbonate 450mg; controlled-release tabs (contains immediate-release + ext-rel components).
Indications for ESKALITH CR:
Mania in bipolar disorder.
Swallow whole. Usually 450mg twice daily; if higher, unequal doses are used give larger dose in PM. Converting from immediate-release caps: give same daily dose; round down to nearest mulitple of 450mg.
Renal or cardiovascular disease, diuretics, dehydration, sodium depletion, ACE inhibitors, angiotensin II receptor blockers, or severely debilitated: not recommended (hospitalize, use low doses, monitor serum lithium levels daily). Seizure disorders. Maintain adequate fluid and salt intake, esp. with fever, sweating, or infection. Monitor serum lithium levels frequently (toxic and therapeutic levels are close); draw blood for serum tests 8–12 hrs after previous dose. Monitor thyroid, renal function. Discontinue if diarrhea, vomiting, tremor, ataxia, drowsiness or weakness occur. Elderly. Pregnancy (Cat.D), nursing mothers: not recommended.
Lithium toxicity potentiated by diuretics, ACE inhibitors, angiotensin II receptor blockers, carbamazepine, indomethacin, piroxicam (possibly other NSAIDs, including COX-2 inhibitors), metronidazole, calcium channel blockers. Discontinue if signs of neurologic toxicity occur with neuroleptics (eg, haloperidol). Xanthines, acetazolamide, urea, alkalinizing agents may reduce serum lithium levels. Fluoxetine has variable effects on serum lithium levels. Prolongs effects of neuromuscular blockers. Hypothyroidism with chronic iodide administration. Serotonin syndrome with SSRIs.
Polyuria, polydipsia, drowsiness, tremor, hypothyroidism, extrapyramidal symptoms, nausea, renal toxicity, seizures, arrhythmias, hypotension, lethargy, metallic taste, dry mouth, blurred vision, pseudotumor cerebri.
Caps, CR tabs—100
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