lithium

Adult Dosing .

Dosage forms:  CAP: 150 mg, 300 mg, 600 mg; TAB: 300 mg; ER TAB: 300 mg, 450 mg; SOL: 8 mEq per 5 mL

Special Note

[strength clarification]

Info: 8 mEq lithium ion = 300 mg lithium carbonate; doses expressed as carbonate salt, except immediate-release SOL

bipolar I disorder, maintenance tx

[immediate-release CAP/TAB]

Dose: 600-1800 mg/day PO divided bid-tid; Start: 300 mg PO tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[immediate-release SOL]

Dose: 16-48 mEq/day PO divided bid-tid; Start: 8 mEq PO tid, may incr. by 8 mEq/day q3 days; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[extended-release form]

Dose: 900-1200 mg/day ER PO divided bid-tid; Start: 900 mg/day ER PO divided bid-tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew ER tab

bipolar I disorder, acute manic/mixed

[immediate-release CAP/TAB]

Dose: 1200-1800 mg/day PO divided bid-tid; Start: 300 mg PO tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[immediate-release SOL]

Dose: 32-48 mEq/day PO divided bid-tid; Start: 8 mEq PO tid, may incr. by 8 mEq/day q3 days; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[extended-release form]

Dose: 1800 mg/day ER PO divided bid-tid; Info: adjust dose q3 days based on tx response and serum levels; do not cut/crush/chew ER tab

schizoaffective disorder (off-label)

[immediate-release CAP/TAB]

Dose: 900-1200 mg/day PO divided tid-qid; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[immediate-release SOL]

Dose: 24-32 mEq/day PO divided tid-qid; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum

[extended-release form]

Dose: 900-1200 mg/day ER PO divided bid-tid; Info: adjust dose based on tx response and serum levels; dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew ER tab

renal dosing

[immediate-release form]

CrCl 30-89: decr. usual start dose, amount not defined; CrCl <30: avoid use; Info: titrate slowly

HD/PD: not defined

[extended-release form]

renal impairment: not defined; Info: consider IR form

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  CAP: 150 mg, 300 mg, 600 mg; TAB: 300 mg; ER TAB: 300 mg, 450 mg; SOL: 8 mEq per 5 mL

Special Note

[strength clarification]

Info: 8 mEq lithium ion = 300 mg lithium carbonate; doses expressed as carbonate salt, except immediate-release SOL

bipolar I disorder, maintenance tx

[immediate-release CAP/TAB, 7 yo and older, 20-30 kg]

Dose: 600-1200 mg/day PO in divided doses; Start: 300 mg PO bid, may incr. by 300 mg/day qwk; Info: adjust dose based on tx response and serum levels

[immediate-release SOL, 7 yo and older, 20-30 kg]

Dose: 16-32 mEq/day PO in divided doses; Start: 8 mEq PO bid, may incr. by 8 mEq/day qwk; Info: adjust dose based on tx response and serum levels

[immediate-release CAP/TAB, 7 yo and older, >30 kg]

Dose: 600-1800 mg/day PO divided bid-tid; Start: 300 mg PO tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels

[immediate-release SOL, 7 yo and older, >30 kg]

Dose: 16-48 mEq/day PO divided bid-tid; Start: 8 mEq PO tid, may incr. by 8 mEq/day q3 days; Info: adjust dose based on tx response and serum levels

[extended-release form, 12 yo and older]

Dose: 900-1200 mg/day ER PO divided bid-tid; Start: 900 mg/day ER PO divided bid-tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels; do not cut/crush/chew ER tab

bipolar I disorder, acute manic/mixed

[immediate-release CAP/TAB, 7 yo and older, 20-30 kg]

Dose: 600-1500 mg/day PO in divided doses; Start: 300 mg PO bid, may incr. by 300 mg/day qwk; Info: adjust dose based on tx response and serum levels

[immediate-release SOL, 7 yo and older, 20-30 kg]

Dose: 16-40 mEq/day PO in divided doses; Start: 8 mEq PO bid, may incr. by 8 mEq/day qwk; Info: adjust dose based on tx response and serum levels

[immediate-release CAP/TAB, 7 yo and older, >30 kg]

Dose: 1200-1800 mg/day PO divided bid-tid; Start: 300 mg PO tid, may incr. by 300 mg/day q3 days; Info: adjust dose based on tx response and serum levels

[immediate-release SOL, 7 yo and older, >30 kg]

Dose: 32-48 mEq/day PO divided bid-tid; Start: 8 mEq PO tid, may incr. by 8 mEq/day q3 days; Info: adjust dose based on tx response and serum levels

[extended-release form, 12 yo and older]

Dose: 1800 mg/day ER PO divided bid-tid; Info: adjust dose q3 days based on tx response and serum levels; do not cut/crush/chew ER tab

renal dosing

[immediate-release form]

CrCl 30-89: decr. usual start dose, amount not defined; CrCl <30: avoid use; Info: titrate slowly

HD/PD: not defined

[extended-release form]

renal impairment: not defined; Info: consider IR form

HD/PD: not defined

hepatic dosing

[not defined]