Drug Interaction Report

Indapamide and Lithium Carbonate: Interaction Details

A pharmacist-reviewed analysis of the Indapamide and Lithium Carbonate interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Indapamide

No brand names on record
+

Lithium Carbonate

Lithobid
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 102 documented Indapamide interactions, 54 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
delayed
Evidence
probable
Severity
Major

What happens

Increased lithium exposure and an increased risk of lithium toxicity (weakness, tremor, excessive thirst, confusion)

Interaction Deep Dive

Coadministration of indapamide with lithium is not recommended as it may add a high risk of lithium toxicity4. Concurrent use of lithium and diuretics, such as indapamide may result in elevated lithium exposure 51 due to reabsorption of sodium and lithium ions at the proximal renal tubule 23. Although cotherapy is useful in cases of lithium polyuria 6 or lithium-induced nephrogenic diabetes insipidus 7.

Why it happens (mechanism)

Reduced lithium renal clearance

Literature reports

1 report — tap to read

a) In a case report, the concomitant use of lithium (1500 mg daily) and indapamide (5 mg daily) resulted in increased lithium levels (3.93 mEq/L) and symptoms of lithium toxicity (confusion, nystagmus, cardiac ectopy) 8.

Common questions

Can I take Indapamide and Lithium Carbonate together?

Increased lithium exposure and an increased risk of lithium toxicity (weakness, tremor, excessive thirst, confusion) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Indapamide and Lithium Carbonate 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 "probable". Good supporting evidence, though not definitively proven.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Indapamide or Lithium Carbonate 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 (8)

  1. Petersen V, Hvidt S, Thomsen K, et al: Effect of prolonged thiazide treatment on renal lithium clearance. Br Med J 1974; 3:143-145. PubMed
  2. Singer I & Rotenberg P: Mechanisms of lithium action. N Engl J Med 1973; 289:254. DOI
  3. Davis JM & Fann WE: Lithium. Ann Rev Pharmacol 1971; 11:285.
  4. Product Information: WIDAPLIK(TM) oral tablets, telmisartan amlodipine indapamide oral tablets. George Medicines Pty Limited (per FDA), Pithampur, Pradesh, India, 2025. DailyMed
  5. Product Information: Lithium Carbonate. Roxane Laboratories Inc. Columbus, OH, 2002. DailyMed
  6. MacNeil S, Hanson-Nortey E, Paschalis C, et al: Diuretics during lithium therapy (letter). Lancet 1975; 1:1295-1296. DOI
  7. Himmelhoch JM, Forrest J, Neil JF, et al: Thiazide-lithium synergy in refractory mood swings. Am J Psychiatry 1977; 134:149-152. PubMed
  8. Hanna ME, Lobao CB, & Stewart JT: Severe lithium toxicity associated with indapamide therapy (letter). J Clin Psychopharmacol 1990; 10:379-380. DOI
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Indapamide

Keep reading about Indapamide

All Indapamide interactions (102)
Also serious with: Glipizide Nateglinide Aspirin Rectal Miglitol
Lithium Carbonate

Keep reading about Lithium Carbonate

All Lithium Carbonate interactions (317) Lithium Carbonate drug information
Also serious with: Phenelzine Tranylcypromine Zuclopenthixol Feprazone
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Indapamide + Activated Charcoal American Hellebore American Mistletoe Arsenic Cesium Dolomite Ephedra Grapefruit + 207 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.