Moderate
Suspected
説明
Diltiazem (calcium channel blocker) combined with lithium may increase risk of lithium toxicity and neurotoxic adverse effects including bradycardia.
機序
Diltiazem may reduce lithium renal clearance; calcium channel blockade may also enhance lithium's neurological effects synergistically.
臨床的意義
Case reports describe neurotoxicity and bradycardia with concurrent lithium and diltiazem; the pharmacokinetic component is less well-characterized than with diuretics.
対処法
Monitor lithium levels and cardiovascular and neurological status when using diltiazem concurrently; dose adjustments may be needed.