Описание
NSAIDs markedly increase lithium plasma levels, potentially causing lithium toxicity (tremor, ataxia, confusion, cardiac arrhythmias).
Механизм
Lithium is renally excreted in parallel with sodium; NSAID-induced sodium retention reduces renal lithium clearance, raising serum lithium to potentially toxic levels.
Клиническое значение
Lithium levels can increase 15–66% within days of NSAID initiation; toxicity at levels >1.5 mEq/L can cause irreversible neurological damage.
Тактика ведения
Avoid NSAIDs in lithium-treated patients; use acetaminophen for pain. If NSAID is essential, check lithium levels within 3–5 days and adjust dose. Sulindac may be safer (less effect on renal prostaglandins).
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.