Lithium with Tinidazole Interaction Details
Brand Names Associated with Lithium
- Eskalith®
- Eskalith® CR
- Lithium
- Lithobid®
Brand Names Associated with Tinidazole
- Tindamax®
- Tinidazole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 21, 2023
Interaction Effect
Elevated lithium plasma levels and lithium toxicity (weakness, tremor, excessive thirst, confusion)
Interaction Summary
Tinidazole, a nitroimidazole, is chemically-related to metronidazole. Although not specifically studied with tinidazole, similar to metronidazole, concurrent administration of tinidazole and lithium may result in elevated lithium plasma levels and an increased risk of lithium intoxication. Consideration should also be given to periodically assessing serum lithium and creatinine levels after several days of concurrent therapy with tinidazole. Also, consider monitoring patients for signs of lithium toxicity (weakness, tremor, excessive thirst, confusion) with concomitant therapy, making appropriate dose adjustments.
Severity
Moderate
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Coadministration of tinidazole and lithium may result in an increased lithium plasma level. Consider periodic monitoring of serum lithium and creatinine levels after several days of concurrent therapy with tinidazole. Consider monitoring patients for signs of lithium toxicity with concomitant therapy (nausea, diarrhea, polyuria, polydipsia, hand tremor, muscle weakness, confusion, slurred speech), making appropriate lithium dosage adjustments.
Mechanism Of Interaction
Potential reduced renal clearance of lithium
Literature Reports
A) Two case reports have demonstrated that the concurrent use of metronidazole (greater than or equal to 750 mg daily) and lithium may result in increased lithium concentrations and toxicity. Persistent signs of renal damage were evident 5 to 6 months after discontinuation of metronidazole therapy .
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.
Tinidazole Overview
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Tinidazole is used to treat trichomoniasis (a sexually transmitted disease that can affect men and women), giardiasis (an infection of the intestine that can cause diarrhea, gas, and stomach cramps), and amebiasis (an infection of the intestine that can cause diarrhea, gas, and stomach cramps and can spread to other organs such as the liver). Tinidazole is also used to treat bacterial vaginosis (an infection caused by an overgrowth of harmful bacteria in the vagina) in women. Tinidazole is in a class of medications called nitroimidazole antimicrobials. It works by killing the organisms that can cause infection.
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Antibiotics will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
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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.