How often should lithium levels be monitored?
Once levels of lithium in the blood are steady, they will be checked regularly (typically 3 monthly), usually 12 hours after the last dose. You will also have blood tests at least every 6 months to check on kidney and thyroid function.
What should be monitored when taking lithium?
Calcium levels: A serum calcium level should be checked yearly as lithium may cause hypoparathyroidism. Kidney tests: A BUN and creatinine (kidney function tests) should be drawn at the beginning of treatment, regularly during treatment, and if any symptoms of kidney disease become evident.
Does lithium require therapeutic drug monitoring?
TDM for lithium is necessary in clinical practice, and this study further confirms the need for TDM, as lithium levels remain below or above the therapeutic range in a substantial number of cases. Regular lithium level monitoring helps in uncovering unsuspected poor compliance and for better clinical management.
Why do you have to monitor lithium levels?
Lithium levels are monitored on a regular basis because lithium has a narrow therapeutic index. This means there is relatively little space between therapeutic and toxic levels. Too little drug, and the medication will not be effective. Too much drug and symptoms of lithium toxicity may develop.
What is a safe level of lithium?
A safe blood level of lithium is 0.6 and 1.2 milliequivalents per liter (mEq/L). Lithium toxicity can happen when this level reaches 1.5 mEq/L or higher. Severe lithium toxicity happens at a level of 2.0 mEq/L and above, which can be life-threatening in rare cases.
What is the normal range of lithium level?
The reference range for therapeutic levels of lithium is 0.8-1.2 mEq/L.
Why do we monitor lithium levels?
How do you measure lithium levels?
Lithium testing requires a blood sample. Ideally, you should undergo a blood draw right before the next scheduled dose, 6-12 hours after your last dose [6]. The results are given in units of mmol/L (or sometimes mEq/L).
What drugs need plasma levels monitored?
Monitored Drugs by Category
| Drug Category | Drugs |
|---|---|
| Immunosuppressants | Cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, azathioprine |
| Anti-cancer drugs | Methotrexate, all cytotoxic agents |
| Psychiatric drugs | Lithium, valproic acid, some antidepressants (imipramine, amitriptyline, nortriptyline, doxepin, desipramine) |
Why is therapeutic drug monitoring done for lithium?
Therapeutic drug monitoring is likely to improve the safety of lithium because TDM has advantages in terms of reduced likelihood of toxicity or severe adverse effects. Lithium is widely used for the treatment of bipolar disorder.
What happens if lithium levels are too high?
In early lithium toxicity, you may have mild confusion. As the toxicity worsens, you may feel delirious or even have seizures or go into a coma. In very rare cases, lithium toxicity may cause diabetes insipidus. This condition leads to large amounts of urine in your body, regardless of how much fluid you drink.
When to check lithium level?
serum lithium levels should be checked 1 week after starting and 1 week after every dose change, and until the levels are stable. The aim should be to maintain serum lithium levels between 0.6 and 0.8 mmol per litre in people being prescribed it for the first time.
How often to check lithium level?
Check lithium levels (12 hours post-dose) at least every three months and during any intercurrent illness (can increase and cause toxicity). Therapeutic lithium levels: 0.4 to 1.0 mmol/L (may vary from laboratory to laboratory).
How do you test lithium levels?
The lithium blood test or checking lithium level in the body is done by taking a venous blood sample of the patient. The sample is taken 10-12 hours after the last Lithium dose.
What does an elevated lithium level mean?
A lithium level above 1.5 mEq/L may be indicative of lithium toxicity in patients wit chronic intoxication from long-term lithium therapy. Patients with acute intoxication have less of a correlation between lithium levels and toxic symptoms. Toxicity may be predicted in some patients when lithium levels are above 1.43 mmol/L,…