Trandolapril and Lithium Carbonate: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Trandolapril
Lithium Carbonate
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 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) Severe lithium toxicity (diarrhea, dyspnea, drowsiness, confusion, peripheral vasodilation, and hyperreflexia) developed in a 51-year-old woman after 3 months of perindopril 8 mg/day and bendrofluazide 5 mg/day for hypertension. Lithium carbonate 1.6 grams daily had been given for 7 years for manic depression. Diarrhea, dyspnea, confusion, and hypotension developed over a 2-week period. Her lithium level was 4.28 mmol/L on admission to the hospital. The patient became more alert when the lithium level dropped to 1.6 mmol/L following 3 hemodialysis sessions 2.
Common questions
Can I take Trandolapril and Lithium Carbonate together?
Increased risk of lithium toxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Trandolapril 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 "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 Trandolapril 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 (2)
- Product Information: LITHOBID(R) oral extended release tablets, lithium carbonate oral extended release tablets. ANI Pharmaceuticals, Inc. (per FDA), Baudette, MN, 2016. DailyMed
- Vipond AJ, Bakewell S, Telford R, et al: Lithium toxicity. Anaesthesia 1996; 51:1156-1158.
Keep reading about Trandolapril
Keep reading about Lithium Carbonate
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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