Описание
ACE inhibitors like lisinopril reduce renal lithium excretion, causing potentially dangerous lithium toxicity.
Механизм
Lisinopril reduces glomerular filtration by inhibiting angiotensin II, reducing renal sodium handling and enhancing proximal tubular lithium reabsorption, increasing lithium levels by 30–70%.
Клиническое значение
Lithium toxicity is well-documented after ACE inhibitor initiation; symptoms include confusion, tremor, ataxia, and cardiovascular instability.
Тактика ведения
Monitor lithium levels within 1 week of initiating or changing lisinopril dose; reduce lithium dose preemptively and adjust based on levels.
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.