DIURETICS AND LITHIUM - THIAZIDES
The thiazide and related diuretics can cause a rapid rise in lithium levels, which may lead to lithium toxicity. This interaction has been seen with bendroflumethiazide, chlorothiazide, chlortalidone, hydrochlorothiazide and indapamide, and potentially occurs with hydroflumethiazide. Other thiazides and related diuretics are expected to behave similarly.
Lithium levels should be closely monitored if a thiazide is started or stopped. One UK manufacturer recommends an initial lithium dose reduction, but this does not seem to be in line with most other recommendations. Patients taking lithium should be aware of the symptoms of lithium toxicity and told to report them immediately should they occur.
Lithium levels should be closely monitored if a thiazide is started or stopped. One UK manufacturer recommends an initial lithium dose reduction, but this does not seem to be in line with most other recommendations. Patients taking lithium should be aware of the symptoms of lithium toxicity and told to report them immediately should they occur.