Excreted Unchanged %
Renal
Half-Life (Normalesrd) Hours
14-28/40
Plasma Protein Binding %
None
Volume Of Distribution L/Kg
0.5-0.9
Dose For Normal Renal Function
0.9-1.2 g q24h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50-75% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
25-50% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis, [B]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [A]
References
Arancibia A, Corvalan F, Mella F, Concha L. Absorption and disposition kinetics of lithium carbonate following administration of conventional and controlled release formulations. Int J Clin Pharmacol Ther Toxicol. 1986; 24: 240-5. [PMID: 3089949] / Beckmann U, Oakley PW, Dawson AH, Byth PL. Efficacy of continuous venovenous hemodialysis in the treatment of severe lithium toxicity. J Toxicol Clin Toxicol. 2001; 39: 393-7. [PMID: 11527234] / Hardy BG, Shulman KI, Mackenzie SE, Kutcher SP, Silverberg JD. Pharmacokinetics of lithium in the elderly. J Clin Psychopharmacol. 1987; 7: 153-8. [PMID: 3110219] / Hazouard E, Ferrandiè re M, Rateau H, Doucet O, Perrotin D, Legras A. Continuous veno-venous haemofiltration versus continuous veno-venous haemodialysis in severe lithium self-poisoning: a toxicokinetics study in an intensive care unit [Letter]. Nephrol Dial Transplant. 1999; 14: 1605-6. [PMID: 10383041] / Luisier PA, Schulz P, Dick P. The pharmacokinetics of lithium in normal humans: expected and unexpected observations in view of basic kinetic principles. Pharmaco-psychiatry. 1987; 20: 232-4. [PMID: 3118402] / Meyer RJ, Flynn JT, Brophy PD, Smoyer WE, Kershaw DB, Custer JR, et al. Hemodialysis followed by continuous hemofiltration for treatment of lithium intoxication in children. Am J Kidney Dis. 2001; 37: 1044-7. [PMID: 11325688] / Shelley RK, Silverstone T. Single dose pharmacokinetics of 5 formulations of lithium: a controlled comparison in healthy subjects. Int Clin Psychopharmacol. 1986; 1: 324-31. [PMID: 3104448] / Thornhill DP. Serum levels and pharmacokinetics of ordinary and sustained-release lithium carbonate in manic patients during chronic dosage. Int J Clin Pharmacol Ther Toxicol. 1986; 24: 257-61. [PMID: 3089950] / van Bommel EF, Kalmeijer MD, Ponssen HH. Treatment of life-threatening lithium toxicity with high-volume continuous venovenous hemofiltration. Am J Nephrol. 2000; 20: 408-11. [PMID: 11093000]
Toxicity Notes
Nephrotoxic. Nephrogenic diabetes insipidus, nephrotic syndrome, renal tubular acidosis, interstitial fibrosis. Acute toxicity when serum levels >1.2 mEq/L. Serum levels should be measured periodically 12 hr after dose. T1/2 does not reflect extensive tissue accumulation. Plasma levels rebound after dialysis. Toxicity enhanced by volume depletion, NSAIDs, and diuretics.