Lithium with Calcitonin Interaction Details
Brand Names Associated with Lithium
- Eskalith®
- Eskalith® CR
- Lithium
- Lithobid®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 21, 2023
Interaction Effect
Decreased lithium concentrations and loss of lithium efficacy
Interaction Summary
The co-administration of calcitonin and lithium has caused a significant decrease in the mean values of lithium plasma levels, with the average decrease reaching a maximum of 30%. Both of the patients who participated in the lithium urinary clearance part of the study also had an increase in renal lithium clearance. While none of the four patients experienced adverse effects from the decrease in their lithium levels, chronic administration of calcitonin may be able to reduce lithium plasma levels below the therapeutic range.. Concomitant use of calcitonin and lithium may decrease lithium plasma concentrations due to increased urinary clearance. A lithium dosage adjustment may be necessary .
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Lithium levels should be closely monitored in patients receiving calcitonin therapy. Lithium dose adjustments may be necessary.
Mechanism Of Interaction
Increased renal lithium excretion and/or decreased lithium intestinal absorption
Literature Reports
A) Four manic-depressive patients stabilized on lithium therapy for at least ten years were given salmon calcitonin 100 IU subcutaneously once daily for three days. When compared with baseline levels, calcitonin caused a significant decrease in the mean values of lithium plasma levels, with the average decrease reaching a maximum of 30%. Both of the patients who participated in the lithium urinary clearance part of the study also had an increase in renal lithium clearance. While none of the four patients experienced adverse effects from the decrease in their lithium levels, chronic administration of calcitonin may be able to reduce lithium plasma levels below the therapeutic range .
Lithium Overview
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Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Lithium is in a class of medications called antimanic agents. It works by decreasing abnormal activity in the brain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.