Medical Editor: John P. Cunha, DO, FACOEP
Eskaltih (lithium) is an antimanic agent used for treating manic episodes due to bipolar disorder. Eskaltih is also combined with antidepressants to treat depression. Generic formulations of Eskaltih are available. Common side effects of Eskaltih are:
- mild hand tremor,
- lack of coordination,
- dry mouth,
- altered taste perception,
- weight gain,
- increased thirst,
- increased frequency of urination,
- mild nausea or vomiting,
- loss of appetite,
- stomach pain or upset,
- decreased libido,
- thinning or drying of the hair,
- itching skin, and
- kidney abnormalities.
Lithium doses vary widely and are adjusted based on measurements of the levels of lithium in the blood. Most patients require 900-1200 mg daily in 2-3 divided doses. Lithium interacts with non-steroidal anti-inflammatory drugs (NSAIDs), hydrochlorothiazide, ACE inhibitors, and methyldopa. Eskaltih can cause harm to a fetus. Do not use Eskaltih without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment with Eskaltih. Talk to your doctor about using birth control while you are taking Eskaltih. Eskaltih can pass into breast milk and may harm a nursing baby. Consult your doctor before breastfeeding.
Our Eskaltih (lithium) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking lithium and call your doctor at once if you have any of these serious side effects:
- extreme thirst, urinating more or less than usual;
- weakness, fever, feeling restless or confused, eye pain and vision problems;
- restless muscle movements in your eyes, tongue, jaw, or neck;
- pain, cold feeling, or discoloration in your fingers or toes;
- feeling light-headed, fainting, slow heart rate;
- hallucinations, seizure (blackout or convulsions);
- fever with muscle stiffness, sweating, fast or uneven heartbeats; or
- early signs of lithium toxicity, such as nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears.
Less serious side effects may include:
- mild tremor of the hands;
- weakness, lack of coordination;
- mild nausea, vomiting, loss of appetite, stomach pain or upset;
- thinning or drying of the hair; or
- itching skin.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Eskalith (Lithium Carbonate)
The occurrence and severity of adverse reactions are generally directly related to serum lithium concentrations as well as to individual patient sensitivity to lithium, and generally occur more frequently and with greater severity at higher concentrations.
Adverse reactions may be encountered at serum lithium levels below 1.5 mEq/L. Mild to moderate adverse reactions may occur at levels from 1.5 to 2.5 mEq/L, and moderate to severe reactions may be seen at levels of 2.0 mEq/L and above.
Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. Transient and mild nausea and general discomfort may also appear during the first few days of lithium administration.
These side effects usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, cessation of lithium therapy may be required.
Diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination may be early signs of lithium intoxication, and can occur at lithium levels below 2.0 mEq/L. At higher levels, ataxia, giddiness, tinnitus, blurred vision, and a large output of dilute urine may be seen. Serum lithium levels above 3.0 mEq/L may produce a complex clinical picture, involving multiple organs and organ systems. Serum lithium levels should not be permitted to exceed 2.0 mEq/L during the acute treatment phase.
The following reactions have been reported and appear to be related to serum lithium levels, including levels within the therapeutic range:
Neuromuscular/Central Nervous System: Tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreo-athetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus, hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes, myasthenia gravis (rarely).
Dermatologic: Drying and thinning of hair, alopecia, anesthesia of skin, acne, chronic folliculitis, xerosis cutis, psoriasis or its exacerbation, generalized pruritus with or without rash, cutaneous ulcers, angioedema.
Autonomic: Blurred vision, dry mouth, impotence/sexual dysfunction.
Thyroid Abnormalities: Euthyroid goiter and/or hypothyroidism (including myxedema) accompanied by lower T3 and T4. I131 uptake may be elevated. (See PRECAUTIONS.) Paradoxically, rare cases of hyperthyroidism have been reported.
EEG Changes: Diffuse slowing, widening of the frequency spectrum, potentiation and disorganization of background rhythm.
EKG Changes: Reversible flattening, isoelectricity or inversion of T-waves. Miscellaneous: Fatigue, lethargy, transient scotomata, exophthalmos, dehydration, weight loss, leukocytosis, headache, transient hyperglycemia, hypercalcemia, hyperparathyroidism, excessive weight gain, edematous swelling of ankles or wrists, metallic taste, dysgeusia/taste distortion, salty taste, thirst, swollen lips, tightness in chest, swollen and/or painful joints, fever, polyarthralgia, dental caries.
Some reports of nephrogenic diabetes insipidus, hyperparathyroidism, and hypothyroidism which persist after lithium discontinuation have been received.
A few reports have been received of the development of painful discoloration of fingers and toes and coldness of the extremities within one day of the starting of treatment with lithium. The mechanism through which these symptoms (resembling Raynaud's syndrome) developed is not known. Recovery followed discontinuance.
Cases of pseudotumor cerebri (increased intracranial pressure and papilledema) have been reported with lithium use. If undetected, this condition may result in enlargement of the blind spot, constriction of visual fields, and eventual blindness due to optic atrophy. Lithium should be discontinued, if clinically possible, if this syndrome occurs.
Read the entire FDA prescribing information for Eskalith (Lithium Carbonate)
© Eskalith Patient Information is supplied by Cerner Multum, Inc. and Eskalith Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.