Lithium poisoning caused by interaction between lithium carbonate and irbesartan and hydrochlorothiazide
10.3760/cma.j.cn114015-20201009-01023
- VernacularTitle:碳酸锂与厄贝沙坦氢氯噻嗪相互作用致锂中毒
- Author:
Dongyan QU
1
;
Zhongli SUN
;
Xiaoye PENG
Author Information
1. 上海市嘉定区精神卫生中心精神科，上海 201806
- Publication Type:Journal Article
- Keywords:
Lithium carbonate;
Irbesartan;
Hydrochlorothiazide;
Poisoning;
Drug interactions
- From:
Adverse Drug Reactions Journal
2021;23(4):212-213
- CountryChina
- Language:Chinese
-
Abstract:
A 47-year-old male patient with bipolar disorder was given olanzapine tablets 10 mg orally once daily combined with lithium carbonate sustained-release tablets 0.3 g orally once daily due to manic episode. On the 6th day of medication, the patient received irbesartan and hydrochlorothiazide (containing irbesartan 150 mg and hydrochlorothiazide 12.5 mg in each tablet) 1 tablet orally once daily due to elevated blood pressure. Due to the aggravation of the patient′s manic symptoms, the dose of lithium carbonate was increased to 0.9 g/d from the 11th day of medication. After 13 days of combination therapy, the patient′s body temperature rised (up to 39.0 ℃) and headache and tremor of both hands appeared. Laboratory test showed that his lithium concentration was 1.58 mmol/L (target plasma concentration was 0.80-1.20 mmol/L) and lithium poisoning was diagnosed. Lithium carbonate sustained-release tablets and other oral drugs were stopped immediately and symptomatic and supportive treatments such as rehydration, cooling, and diuresis were given. Meanwhile, vital signs were monitored. On the 2nd day of drug withdrawal, the plasma lithium concentration decreased to 1.14 mmol/L, the body temperature returned to normal, and the tremor of hands was relieved. On the 8th day after drug withdrawal, the plasma lithium concentration decreased to 0.45 mmol/L, and the symptoms and abnormal signs disappeared.
