Moderate
Suspected
Mô tả
Diltiazem (calcium channel blocker) combined with lithium may increase risk of lithium toxicity and neurotoxic adverse effects including bradycardia.
Cơ chế
Diltiazem may reduce lithium renal clearance; calcium channel blockade may also enhance lithium's neurological effects synergistically.
Ý nghĩa lâm sàng
Case reports describe neurotoxicity and bradycardia with concurrent lithium and diltiazem; the pharmacokinetic component is less well-characterized than with diuretics.
Xử trí
Monitor lithium levels and cardiovascular and neurological status when using diltiazem concurrently; dose adjustments may be needed.