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