Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
February 5, 2014
Health Canada has issued new restrictions concerning the use of lithium. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Drowsiness/reduced alertness: Lithium may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.
Fluid intake and diet: It is important to maintain a normal diet, including salt, as well as an adequate fluid intake (2,500 mL to 3,000 mL) at least during the initial period of taking this medication. Side effects have been reported to follow after large amounts of sweating or diarrhea. If this occurs, extra fluids and salt should be taken. Talk to your doctor about the appropriate amounts of fluid and salt to take. If you develop a fever, check with your doctor to see if you should reduce your dose or temporarily stop taking the medication.
Heart disease: If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severe heart disease should not take lithium (see "Who should NOT take this medication?").
Hypercalcemia: Lithium can cause increases in the level of calcium in the blood (hypercalcemia). This may be linked to changes in the function of the parathyroid gland, but sometimes it is not. Tell your doctor if you experience symptoms of hypercalcemia, which include: fatigue, depression, mental confusion, nausea, vomiting, excessive thirst, appetite loss, abdominal pain, frequent urination, muscle and joint aches, and muscle weakness.
Your doctor will order blood tests as part of your treatment with lithium. Calcium may be included in these tests to monitor for changes in the amount of calcium in your blood.
Kidney function: Decreased kidney function may cause this medication to build up in the body, causing unwanted effects. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Long term lithium treatment often leads to a decrease in kidney function as well as symptoms of thirst, excess urination, and weight gain. Contact your doctor if you experience these symptoms.
Lab tests: Lithium toxicity is closely related to the level of lithium in the blood, and can occur at doses that are close to normal. Your doctor will order regular blood tests so that the blood levels of lithium can be monitored.
Stopping the medication: Do not stop taking this medication suddenly without checking with your doctor first. Stopping the medication suddenly may cause withdrawal symptoms.
Thyroid disease: If you have thyroid disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Long-term lithium treatment is sometimes associated with the development of growths in the thyroid gland. Contact your doctor if you develop a swelling in the neck.
Pregnancy: Lithium appears to cause an increase in heart, kidney and thyroid problems in the infants born to mothers who took lithium during pregnancy. Lithium should not be used during pregnancy or by women of childbearing potential unless no other appropriate therapy exists, and, in the opinion of the doctor, the expected benefits outweigh the possible risks.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking lithium, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children less than 12 years of age. The use of lithium is not recommended for this age group.