Lithium Carbonate and Succinylcholine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lithium Carbonate
Succinylcholine
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
Prolongation of succinylcholine-induced neuromuscular blockade
Interaction Deep Dive
Prolongation of neuromuscular blockade following succinylcholine administration in a patient receiving chronic lithium carbonate therapy for manic-depressive psychosis has been reported1. Apnea developed for a period of four hours following the administration of succinylcholine for a cesarean section. However, prolonged recovery from succinylcholine was not demonstrated in patients receiving lithium and electroconvulsive therapy 2. Caution should be observed when administering succinylcholine to patients undergoing surgery who are stabilized on lithium therapy until this interaction can be better defined.
Why it happens (mechanism)
Unknown
Literature reports
2 reports — tap to read
a) A 38-year old manic-depressive woman was stabilized on lithium carbonate 1500 mg daily, with a serum lithium level of 1.2 mEq/L. She presented to the hospital in active labor, and an emergency cesarean section was performed due to fetal bradycardia. Anesthesia was induced with pancuronium 0.5 mg, thiopental 350 mg, and succinylcholine 150 mg intravenously, followed by a continuous succinylcholine drip which delivered approximately 310 mg of succinylcholine in two hours. The patient remained apneic for four hours following the birth, and signs of phase 2 block were evident. Serum pseudocholinesterase levels were determined to be normal the day following surgery 1.
b) During a 5 1/2 year period review, 766 patients were treated with electroconvulsive therapy (ECT) at one psychiatric hospital, and 17 of these patients were also receiving lithium. A succinylcholine dose ranging from 30 mg to 200 mg was used prior to ECT therapy, and no patients had toxic serum lithium levels. No observations of prolonged recovery from succinylcholine was observed in any of these patients 2.
Common questions
Can I take Lithium Carbonate and Succinylcholine together?
Prolongation of succinylcholine-induced neuromuscular blockade Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lithium Carbonate and Succinylcholine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
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 Lithium Carbonate or Succinylcholine 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 anything you'd monitor while I'm on both?
References (2)
- Hill GE, Wong KC, & Hodges MR: Potentiation of succinylcholine neuromuscular blockade by lithium carbonate. Anesthesiology 1976; 44:439-442. PubMed
- Martin BA & Kramer PM: Clinical significance of the interaction between lithium and a neuromuscular blocker. Am J Psychiatry 1982; 139:1326-1328. PubMed
Keep reading about Lithium Carbonate
Keep reading about Succinylcholine
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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