Drug & supplement interaction

Lithium + Penicillamine

Penicillamine brand names: Cuprimine, Depen Titratable.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Lithium and Penicillamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Penicillamine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Lithium and Penicillamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Penicillamine and Lithium in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Lithium safety at a glance

Lithium overall Use caution Lithium has a narrow safety margin and prescription forms require blood monitoring; supplement forms are not well studied.
Pregnancy Possibly Unsafe When lithium carbonate and lithium citrate are used orally. Lithium can cause fetal toxicity and increases the risk for cardiac and other abnormalities, includi... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Lithium is secreted into breast milk and may cause adverse effects in the nursing infant. Prescription lithium may be used in circumstances wh... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Penicillamine and Lithium? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Penicillamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Penicillamine is filed under 3 classifications — including nephrotoxic drugs, oral drugs. Lithium has documented interactions with 11 drug classes — the most serious being diuretic drugs (major), serotonergic drugs (major) and ace inhibitors (aceis) (moderate) — and none of Penicillamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Lithium Does Interact With Other Medications

Lithium has 259 major, 256 moderate known drug interactions in our database — Penicillamine isn’t one of them. If you take anything else, check it against the full list below.

Major 259 Moderate 256 No known interaction 2,315 (incl. Penicillamine)
Taking anything else?

Check Another of Your Medications Against Lithium

Covers the 2,830 medications we’ve checked against Lithium. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Lithium and Penicillamine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

  • Muscle weakness Worth acting on Additional detail

    Lithium

    “Orally, lithium can cause vertigo, muscle weakness, lethargy, fatigue, and a dazed feeling. These adverse effects often improve with continued use. Fine tremor can occur and may persist with continued use. Chronic use of lithium can cause mild cognitive and memory impairment, particularly in the presence of dehydration or hyponatremia (9,15,97745).”

    Lithium · Natural Medicines adverse-effect record, reported in bipolar disorder.

    6 sources cited
    1. 9. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
    2. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    3. 97745. Foulser P, Abbasi Y, Mathilakath A, Nilforooshan R. Do not treat the numbers: lithium toxicity. BMJ Case Rep. 2017;2017. pii: bcr-2017-220079. PubMed
    4. 105344. Benjelloun R, Motaib I, Otheman Y. Lithium-associated hypercalcemia presenting with neuropsychiatric manifestations in a patient with bipolar disorder. Case Rep Psychiatry. 2020;2020:6630838. PubMed
    5. 111316. Yang Q, Cheng X, Su Z, Sun L, Li M. Electroconvulsive therapy combined with lithium developed reversible pure anomic aphasia: a case report. BMC Psychiatry 2022;22(1):663. PubMed
    6. 111318. Ono R, Nishiguchi S, Kitagawa I. Lithium intoxication-associated mild encephalitis/encephalopathy with a reversible splenial lesion: A case report. Bipolar Disord 2022;24(5):551-552. PubMed

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • Blood clots Worth acting on Additional detail

    Lithium

    “Orally, lithium has been reported to cause bradyarrhythmia. A case of symptomatic bradycardia due to sinoatrial node dysfunction is reported in a patient with bipolar disorder who took lithium orotate 20 mg daily for 5 years, despite a serum lithium level in the therapeutic range. Deep vein thrombosis is also reported in 2 patients with bipolar disorder who experienced toxic serum levels of lithium.”

    Lithium · Natural Medicines adverse-effect record, reported in bipolar disorder.

    2 sources cited
    1. 111327. Sarangi A, Javed S, Paul T, Amor W. Lithium-Induced Sinoatrial Node Dysfunction. Cureus 2021;13(7):e16778. PubMed
    2. 111329. Sogawa R, Tobita S, Monji A, et al. Deep Vein Thrombosis after Lithium Toxicity: A Report of Two Cases and Literature Review. Case Rep Psychiatry 2021;2021:9934037. PubMed

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • A severe skin reaction Worth acting on Additional detail

    Lithium

    “Orally, lithium can cause or exacerbate skin disorders such as hair loss, acne, psoriasis, and rash (9,15,97770). A case of Stevens-Johnson syndrome is also reported in a patient with bipolar disorder who took lithium carbonate at an unknown dose for 17 days.”

    Lithium · Natural Medicines adverse-effect record, reported in acne.

    4 sources cited
    1. 9. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
    2. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    3. 97770. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/017812s028,018421s027lbl.pdf. Accessed Nov. 21, 2018
    4. 111317. Itoh M, Fukuya Y, Endo C, et al. Lithium carbonate-induced Stevens-Johnson syndrome: the first case report. Int J Dermatol 2023;62(3):e165-e167. PubMed

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Lithium

    “Orally, lithium can cause polyuria, polydipsia, and edema (9). Chronic lithium use has been reported to cause central or nephrogenic diabetes insipidus, hypocalciuric hypercalcemia, and nephrotic syndrome. Long-term lithium use is estimated to increase the odds of chronic kidney disease (CKD) by at least 2-fold and may contribute to CKD progression.”

    Lithium · Natural Medicines adverse-effect record, reported in diabetes.

    6 sources cited
    1. 9. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
    2. 104269. Hanna RM, Hasnain H, Sangalang MD, et al. Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management. Case Rep Nephrol Dial. 2019;9(2):108-118. PubMed
    3. 104271. Nwabufor PC, Omoniyi ON, Oyibo SO. A Case of Lithium-Associated Hypocalciuric Hypercalcemia. Cureus. 2020;12(9):e10606. PubMed
    4. 111314. Zhang P, Gandhi H, Kassis N. Lithium-induced nephropathy; One medication with multiple side effects: a case report. BMC Nephrol 2022;23(1):309. PubMed
    5. 111319. Li JJ, Tan S, Kawashita T, Tagle CA, Farmand F. Central Diabetes Insipidus in the Background of Lithium Use: Consider Central Causes Despite Nephrogenic as the Most Common. Am J Case Rep 2023;24:e939034. PubMed
    6. 111315. Kawada T. Lithium use and the risk of chronic kidney disease. Basic Clin Pharmacol Toxicol 2023;132(4):295-296. PubMed

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • Hair loss / A skin rash Additional detail

    Lithium

    Recorded for Lithium in the same Natural Medicines adverse-effect record shown under A severe skin reaction above.

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

  • Anxiety or restlessness Additional detail

    Lithium

    Recorded for Lithium in the same Natural Medicines adverse-effect record shown under Muscle weakness above.

    Penicillamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Penicillamine. Read the label on DailyMed ›

Reported for Lithium but not commonly for Penicillamine: memory problems, a change in thyroid levels, hallucinations and low sodium.

Effects for Penicillamine come from the ADVERSE REACTIONS section of its FDA label; effects for Lithium come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 917 voluntary FDA FAERS reports for Penicillamine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Lithium in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When lithium carbonate and lithium citrate are used orally. Lithium can cause fetal toxicity and increases the risk for cardiac and other abnormalities, including neural tube and urethral defects. However, it does not seem to increase the risk for preterm birth or low birth rate. Some research suggests lithium might increase the risk for spontaneous abortion. Based on a meta-analysis of 2 population studies, taking lithium during pregnancy may increase the risk for spontaneous abortion when compared with the general population, but not when compared with patients with affective disorders not taking lithium during pregnancy. This suggests that it may be the presence of affective disorder itself, or the possible associated use of other teratogenic drugs or substances during pregnancy, which may increase the risk for spontaneous abortion. When the potential benefits to the mother and child outweigh the possible risk to the fetus, prescription lithium may be used with close monitoring by a healthcare professional. The safety of lithium supplements during pregnancy is unknown.

Lactation Likely Unsafe

When used orally. Lithium is secreted into breast milk and may cause adverse effects in the nursing infant. Prescription lithium may be used in circumstances when the potential maternal benefits outweigh the possible risk to the infant. The infant should be closely monitored for signs of lithium toxicity.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Penicillamine Products Have a Food Rule — Lithium Should Not Break It

At least one FDA label for a product containing Penicillamine says to take it on an empty stomach. Most supplements — Lithium included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Penicillamine on its own and move Lithium to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Penicillamine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

DOSAGE AND ADMINISTRATION In all patients receiving penicillamine, it is important that CUPRIMINE be given on an empty stomach, at least one hour before meals or two hours after meals, and at least one hour apart from any other drug, food, or milk.

From the Dosage and Administration section of the FDA label we read for Penicillamine — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Lithium or Penicillamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Lithium or Penicillamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Penicillamine

This page covers Lithium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Penicillamine page lists 26 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Coffee Charcoal (moderate).

By severity: 3 major · 13 moderate · 10 minor.

From our pharmacist’s overview on the Penicillamine page

“People take penicillamine (Cuprimine, Depen) for demanding conditions, Wilson's disease, rheumatoid arthritis, cystinuria, and its 26 supplement interactions are not a list to skim, three of them rated major. Seventeen ingredients can keep an oral dose from being fully absorbed, activated charcoal chief among them, and six more can str…”

Reviewed by 2 · Jul 18, 2026

Open the Penicillamine interaction page

One more smart check

Taking Lithium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 330 real supplement products containing Lithium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lithium. Even though Lithium itself has no known interaction with Penicillamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Lithium and Penicillamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Lithium
Top 25%

#252 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Penicillamine
Steady interest

#2,603 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Lithium reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Lithium and Penicillamine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Lithium

What is Lithium?

Lithium
  • Mood support
  • Bipolar disorder (prescription)
  • Healthy mental function
  • Irritability or stress
  • Sleep support

Lithium is a naturally occurring metal that, in prescription form (lithium carbonate or citrate), is an FDA-approved, well-proven treatment for bipolar disorder. Low-dose supplement forms like lithium orotate are sold for mood support, but there is very little reliable evidence that they work, and even small amounts of lithium can be risky for some people. Always talk to a pharmacist or doctor before taking any lithium product.

Mineral element (not a plant); various lithium salts · Capsules, tablets (lithium orotate, lithium aspartate in supplements; lithium carbonate and citrate as prescription drugs)

An interaction check asks whether these two react with each other — it does not ask whether Lithium is a good idea for someone in your situation. Here is what our Lithium record says about it on its own.

Lithium: dosing

There is no established, well-tested dose for low-dose lithium supplements, and product strengths vary widely between brands.

From our Lithium monograph — the full record covers uses, side effects and every documented interaction.

Read the full Lithium monograph & all interactions
Medication

About Penicillamine

What Is Penicillamine Used For?

Brand names: Cuprimine, Depen Titratable

Penicillamine is used for three distinct conditions. It treats Wilson's disease — a rare genetic disorder in which the body accumulates dangerous levels of copper — by binding to the excess copper and helping the body remove it. It also treats cystinuria, a condition where the amino acid cystine builds up and forms painful kidney stones, by converting cystine into a more soluble form that the body can excrete more easily.

For patients with severe, active rheumatoid arthritis who have not responded adequately to conventional therapies, penicillamine (available as Aagylur, Cuprimine, Depen, and other products) may be used to help suppress disease activity and reduce joint pain, tenderness, and swelling.

See full Penicillamine drug information
Keep checking

Other Drugs & Lithium

Browse every other medication we’ve checked against Lithium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

259Major
256Moderate
0Minor
2,314No known interaction
259 Major 256 Moderate 2,314 No interaction
Major

259 interactions

Showing 60 of 259 major interactions — see all 259 on the Lithium page.

Moderate

256 interactions

Showing 60 of 256 moderate interactions — see all 256 on the Lithium page.

No interaction 2,314 drugs checked — show the list

We also checked Lithium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,314 medications checked with no known interaction — see the full Lithium list.

See the full Lithium interactions page
See every supplement checked against Penicillamine, ranked by severity
Evidence & sources

Lithium References

The 26 references that drive our Lithium monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
  2. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  3. Perlis RH, Sachs GS, Lafer B, et al. Effect of abrupt change from standard to low serum levels of lithium: a reanalysis of double-blind lithium maintenance data. Am J Psychiatry 2002;159:1155-9.. PubMed
  4. Pinelli JM, Symington AJ, Cunningham KA, Paes BA. Case report and review of the perinatal implications of maternal lithium use. Am J Obstet Gynecol 2002;187:245-9.. PubMed
  5. Sawagashira R, Sasagawa Y, Matsukura M, Takamaru Y. Case of myxedema coma induced by lithium carbonate in a patient with schizophrenia. Psychiatry Clin Neurosci. 2018;72(2):131. PubMed
  6. Foulser P, Abbasi Y, Mathilakath A, Nilforooshan R. Do not treat the numbers: lithium toxicity. BMJ Case Rep. 2017;2017. pii: bcr-2017-220079. PubMed
  7. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/017812s028,018421s027lbl.pdf. Accessed Nov. 21, 2018
  8. Fornaro M, Maritan E, Ferranti R, et al. Lithium Exposure During Pregnancy and the Postpartum Period: A Systematic Review and Meta-Analysis of Safety and Efficacy Outcomes. Am J Psychiatry. 2020;177(1):76-92. DOI
  9. Rauf A, Gul S, Nasir M, Arif U, Oyenuga M. A Rare Case of Lithium-induced Partial Nephrogenic Diabetes Insipidus. Cureus. 2020;12(4):e7877. PubMed
  10. Hanna RM, Hasnain H, Sangalang MD, et al. Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management. Case Rep Nephrol Dial. 2019;9(2):108-118. PubMed
  11. Rana P, Alba Aponte P, Babar G. An Adolescent Female with Bipolar Disorder Presenting with Lithium-Induced Hyperthyroidism. Case Rep Endocrinol. 2020;2020:1283464. PubMed
  12. Nwabufor PC, Omoniyi ON, Oyibo SO. A Case of Lithium-Associated Hypocalciuric Hypercalcemia. Cureus. 2020;12(9):e10606. PubMed
  13. Landa E, Wagner S, Makkar A, Liu A, Jung D. An atypical presentation of serotonin syndrome. Cureus. 2021;13(2):e13377. PubMed
  14. Benjelloun R, Motaib I, Otheman Y. Lithium-associated hypercalcemia presenting with neuropsychiatric manifestations in a patient with bipolar disorder. Case Rep Psychiatry. 2020;2020:6630838. PubMed
  15. Nombora O, Samico A, Venâncio Â. Lithium-Induced Dysgeusia and Hyposmia: A Case Report and a Literature Review. Clin Neuropharmacol 2023;46(1):31-33. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Lithium and Penicillamine Together: Common Questions

Is it safe to take Lithium with Penicillamine?
We do not list a known interaction between Lithium and Penicillamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Lithium and Penicillamine have any of the same side effects?
Yes — our sources link each of them separately to 7 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Lithium and Penicillamine at the same time of day?
At least one FDA label for a product containing Penicillamine says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Penicillamine on its own and move Lithium to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
How was the Lithium and Penicillamine combination checked?
Interactions in our licensed database are recorded against drug classes. Penicillamine is filed under 3 classifications, and Lithium has documented interactions with 11 drug classes — none of Penicillamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Lithium interact with any other medications?
Yes. Lithium has 515 documented drug interactions in our database — Penicillamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Penicillamine interact with any supplements?
Yes. Penicillamine has documented interactions with 26 supplements in our database — Lithium is not one of them. The Penicillamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Lithium monograph Uses, safety profile, and every drug interaction in one place Penicillamine drug information The full plain-English guide to this medication Penicillamine supplement interactions Every supplement checked against Penicillamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 26 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Penicillamine and Lithium?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.