Candesartan and Lithium: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Candesartan
Lithium
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of lithium toxicity
Interaction Deep Dive
Coadministration of lithium and this drug as this may increase the risk of lithium toxicity. If concomitant use is required, reduce initial lithium dose, titrate slowly, and monitor lithium levels and for signs of lithium toxicity1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) A 77-year-old woman stabilized on lithium 625 mg daily for manic-depressive psychosis had a lithium plasma level of 0.63 mmol/L (therapeutic range: 0.5 to 0.8 mmol/L). Because of persistent hypertension not controlled by nifedipine, losartan 50 mg daily was added to her therapy. At this time, her CrCl was 60 mL/min. Five weeks following the addition of losartan, the patient was hospitalized with ataxia, dysarthria, and confusion which had been present for 10 days. Her lithium level on admission was 2 mmol/L and CrCl was 53 mL/min. Lithium and losartan were both discontinued, and 2 days later her lithium level had decreased to 0.55 mmol/L. Lithium therapy was reinstituted, along with nicardipine 100 mg daily, without the reappearance of lithium toxicity 2.
Common questions
Can I take Candesartan and Lithium together?
Increased risk of lithium toxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Candesartan and Lithium interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Candesartan or Lithium need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: LITHOBID(R) oral extended release tablets, lithium carbonate oral extended release tablets. ANI Pharmaceuticals, Inc. (per FDA), Baudette, MN, 2016. DailyMed
- Blanche P, Raynaud E, Kerob D, et al: Lithium intoxication in an elderly patient after combined treatment with losartan (letter). Eur J Clin Pharmacol 1997; 52:501. PubMed
Keep reading about Candesartan
Keep reading about Lithium
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist