Always take lithium as your doctor tells you to.
Dosage
There are 2 different types of lithium – lithium carbonate and lithium citrate. It's important not to change to a different type unless your doctor has recommended it. This is because different types are absorbed differently in the body.
Lithium carbonate comes as standard tablets and slow-release tablets (the medicine is released into your body more slowly).
Standard tablets come as 250mg strength tablets. Slow-release tablets come as 200mg, 400mg and 450mg strength tablets.
Lithium citrate comes as a liquid. This is usually only prescribed for people who have trouble swallowing tablets.
Starting doses vary depending on your age, why you're taking it and the type of lithium your doctor recommends.
If you have kidney problems your doctor will monitor the level of lithium in your blood even more closely and change your dose if necessary.
Changes to your dose
When you start your treatment, you'll need to have a blood test every week to make sure the level of lithium in your blood is not too high or too low. Your doctor may change your dose depending on the results of your blood test.
Once the doctor is happy, you'll have a blood test every 3 to 6 months to check your levels are stable.
Once you find a dose that suits you, it usually stays the same, unless your condition changes, or your doctor prescribes another medicine that may affect the way lithium works.
How to take it
Swallow tablets whole with a drink of water or juice. Do not chew them.
You can take lithium with or without food.
If you're taking liquid, use the plastic syringe or spoon that comes with your medicine to measure the correct dose. If you do not have one, ask your pharmacist. Do not use a kitchen teaspoon as it will not measure the right amount.
You'll usually take your lithium once a day, at night. This is because when you have your regular blood test, you need to have it 12 hours after taking your medicine. You can choose when you take your lithium – just try to keep to the same time every day.
How long to take it for
As long as it's working well to control your condition, you'll generally take lithium for a long time. Some people need to take it for many years.
Important
Do not stop taking lithium suddenly or change your dose without speaking to your doctor first. It's important to keep taking it, even if you feel better. If you suddenly stop, it you could become unwell again very quickly.
Stopping lithium
If you or your doctor decide to stop your lithium, it must be reduced gradually over a number of weeks or months.
Do not stop taking lithium suddenly even if you feel better, or because you think the dose is too little or too much. The symptoms of your condition are likely to come back.
However, you must stop taking it if you have symptoms such as loss of appetite, problems with your eyesight or feeling very thirsty. These could be signs of lithium toxicity or an allergic reaction. If this happens it's important to stop taking lithium straight away and get medical help.
If you have an infection or illness
If you feel unwell or become unwell while you're taking lithium, it can affect your medicine.
Urgent advice: Call 111 now if you:
- have an illness that causes severe diarrhoea, vomiting, a high temperature or sweating
- have a urinary tract infection (UTI)
- are not eating and drinking much
Infections and illnesses like colds and flu can also make you dehydrated. This can affect the levels of lithium in your blood.
Information about your lithium treatment
When you start taking lithium, you'll get a lithium treatment pack (usually a purple folder or book) with a record booklet. You need to show your record booklet every time you see your doctor, go to hospital, or collect your prescription.
When you go to the doctor for blood tests, you or your doctor will write in the record booklet:
- your dose of lithium
- your lithium blood levels
- any other blood test results
- your weight
The treatment pack also has a lithium alert card. You'll need to carry this card with you all the time. It tells healthcare professionals that you're taking lithium. This can be useful for them to know in an emergency.
Tell your doctor or pharmacist if you've lost your treatment pack or did not get one.
If you forget to take it
If you usually take tablets or slow-release tablets and it's less than 6 hours since you were supposed to take your medicine, take it as soon as you remember. If it's more than 6 hours, just skip the missed dose and take your next one at the usual time.
If you forget to take a dose of lithium liquid, just skip the missed dose and take your next one at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
Taking too much lithium can be dangerous. This is because very high amounts of lithium can cause problems with your kidneys and other organs. It can cause symptoms such as:
- feeling or being sick
- problems with your eyesight (blurred vision)
- increased need to pee, lack of control over pee or poo
- feeling faint, lightheaded or sleepy
- confusion and blackouts
- shaking or muscle weakness, muscle twitches, jerks or spasms affecting the face, tongue, eyes or neck
Immediate action required: Call 999 or go to A&E if:
you take more than your prescribed dose of lithium, even if you do not feel any different
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the lithium packet or the leaflet inside it, plus any remaining medicine, with you.