Steady‐state pharmacokinetics of lithium carbonate in healthy subjects.

Hunter, Robert

doi:10.1111/j.1365-2125.1988.tb03316.x

Cited by 35 publications

(9 citation statements)

References 20 publications

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“…The pharmacokinetic data concerning lithium in this study are consistent with those of other multiple-dose studies of lithium in healthy volunteers [12,17,19].…”

Section: Discussionsupporting

confidence: 88%

“…The pharmacokinetic data concerning lithium in this study are consistent with those of other multiple-dose studies of lithium in healthy volunteers [12,17,19]. The results of the present investigation indicate that there is a pharmacokinetic interaction between lithium and tenidap in healthy male volunteers, with decreased renal clearance of the lithium resulting in increased serum concentration.…”

Section: Discussionsupporting

confidence: 80%

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Tenidap sodium decreases renal clearance and increases steady‐state concentrations of lithium in healthy volunteers.

Apseloff

Wilner

Deutsch

et al. 1995

Brit J Clinical Pharma

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1. An open‐label, randomised placebo‐controlled study was conducted to determine the effects of tenidap sodium, a novel, cytokine‐modulating anti‐rheumatic drug, on the steady‐state concentrations and renal clearance of lithium carbonate. 2. Eighteen healthy male volunteers received 450 mg lithium carbonate twice daily for 15 days and once on day 16. On days 9‐16 subjects also received either placebo or 120 mg day‐1 tenidap 2 h prior to the morning dose of lithium. 3. Following a single dose of tenidap, the renal clearance of lithium decreased significantly by 0.36 l h‐1 (‐23%) compared with the clearance in the placebo group, which increased by 0.18 l h‐1 (+14%). Steady‐state serum lithium levels increased after a single dose of tenidap by 0.069 mEq l‐ 1 (+13%), and in the placebo group levels increased by 0.003 mEq l‐1 (+0.5%); this difference was not significant. 4. After 7 days' continuous administration of tenidap, the renal clearance of lithium had decreased by 0.38 l h‐1 (‐25%), compared with the placebo group in which clearance had increased by 0.16 l h‐1 (+12%). The steady‐state serum concentration of lithium increased by 0.208 mEq l‐1 (+39%) in the tenidap group and by 0.063 mEq l‐1 (+10%) in the placebo group. Both of these differences were significant. 5. Two subjects who received lithium plus tenidap experienced gastrointestinal side effects, compared with none of those who were administered lithium plus placebo. 6. It is recommended that serum lithium levels be monitored when tenidap and lithium are administered concomitantly.

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“…The pharmacokinetic data concerning lithium in this study are consistent with those of other multiple-dose studies of lithium in healthy volunteers [12,17,19].…”

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 80%

Tenidap sodium decreases renal clearance and increases steady‐state concentrations of lithium in healthy volunteers.

Apseloff

Wilner

Deutsch

et al. 1995

Brit J Clinical Pharma

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“…[46] Furthermore, one study has shown that although lower trough plasma lithium concentrations are observed with a single-dose regimen compared with a multiple-dose regimen, the difference is not statistically significant [46] and, from the clinical perspective, the plasma lithium concentration stays within the therapeutic range with both regimens. [41,55,61] Given that renal function decreases with age, [62] lithium clearance also decreases, which heightens the need to closely monitor these patients. Lower oral doses may be necessary to achieve the desired therapeutic plasma concentrations and prevent lithium toxicity in these patients.…”

Section: Optimal Dosingmentioning

confidence: 96%

Optimal Frequency of Lithium Administration in the Treatment of Bipolar Disorder

2011

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Bipolar disorder is a recurrent chronic illness distinguished by periods of mania and depression. Lithium has been used for about 60 years as a 'mood stabilizer' for bipolar disorder with proven efficacy in preventing relapse of both mania and depression. Despite its long history and ongoing use in current management of bipolar disorder, the optimal dosing of lithium is still the subject of ongoing debate. This article aims to evaluate different dosing schedules, in the light of the unique pharmacokinetic and pharmacodynamic properties of lithium, as well as its adverse-effect and toxicity profiles. This is all the more important given the narrow therapeutic index of lithium. Current recommendations mostly advocate that lithium be administered in multiple daily doses. However, single daily or alternate daily schedules may be viable options for administration. Multiple daily schedules are thought to be advantageous in maintaining more constant plasma lithium concentrations than single daily regimens, which are associated with significant fluctuations throughout the day. When comparing these two schedules with respect to plasma lithium concentrations, adverse-effect profiles and recurrence of symptoms, there are no significant differences between the two regimens. In fact, a single daily regimen may have added advantages in reducing the risk of long-term renal damage and increasing compliance. The evidence for alternate daily dosing is somewhat varied with regard to symptom recurrence; however, this schedule has been shown to be associated with decreased adverse effects, and further research into this issue is therefore warranted. Presently, therefore, clinicians should consider single daily administration of lithium to potentially minimize adverse effects and enhance compliance.

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“…Lithium salts are normally administered orally, and lithium is quickly absorbed through the gastrointestinal tract. Lithium is mainly excreted by the kidneys, with a serum elimination half‐life of about 18 h in healthy humans after a single dose of lithium carbonate . Although the mechanism of action for its calmative effect is not clearly known, lithium has been found to modulate neurotransmission such as stimulating the inhibitory GABAergic neurotransmission and inhibiting the excitatory dopaminergic neurotransmission .…”

Section: Introductionmentioning

confidence: 99%

Doping control analysis of lithium in horse urine and plasma by inductively coupled plasma mass spectrometry

Choi

Wong

et al. 2017

Drug Testing and Analysis

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Lithium salts are commonly prescribed to treat bipolar disorder in humans. They are effective for the treatment of acute mania and the prophylaxis of manic relapses through long-term use. Although there is no reported legitimate therapeutic use of lithium in horses, its potential mood-stabilizing effect, low cost, and ready availability make lithium salt a potential agent of abuse in equine sports, especially for equestrian competition horses. Lithium can be found in soil, plants, and water, as such it is naturally present in the equine body, thus a threshold is necessary to control its misuse in horses. This paper describes the validation of quantification methods for lithium in equine urine and plasma using inductively coupled plasma mass spectrometry (ICP-MS). Based on a population study of lithium in horse urine and an administration study using a single oral dose of lithium chloride (100 mg) to mimic the daily lithium intake from a diet rich in lithium, a urinary threshold of 5 μg/mL was proposed. Applying this urinary threshold to two other administration studies (a single oral dose of 65 g of lithium chloride, and a single intravenous dose of 2.54 g of lithium chloride), excessive lithium in urine could be detected for 8 days and 2.5 days respectively. The concentrations of lithium in plasma following these three lithium chloride administration trials were also studied.

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Steady‐state pharmacokinetics of lithium carbonate in healthy subjects.

Cited by 35 publications

References 20 publications

Tenidap sodium decreases renal clearance and increases steady‐state concentrations of lithium in healthy volunteers.

Tenidap sodium decreases renal clearance and increases steady‐state concentrations of lithium in healthy volunteers.

Optimal Frequency of Lithium Administration in the Treatment of Bipolar Disorder

Doping control analysis of lithium in horse urine and plasma by inductively coupled plasma mass spectrometry

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