dosage adjustment and increased glucose monitoring may be required.isocarboxazidlithium, isocarboxazid. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.isoniazidisoniazid and lithium both increase serotonin levels. Use Caution/Monitor.isradipinelithium and isradipine both increase QTc interval. Use Caution/Monitor.itraconazoleitraconazole and lithium both increase QTc interval. Use Caution/Monitor.ketoprofenketoprofen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.ketorolacketorolac increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.ketorolac intranasalketorolac intranasal increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.L-tryptophanL-tryptophan and lithium both increase serotonin levels. Use Caution/Monitor.lapatiniblithium and lapatinib both increase QTc interval. Use Caution/Monitor.leuprolidelithium and leuprolide both increase QTc interval. Use Caution/Monitor.levofloxacinlithium and levofloxacin both increase QTc interval. Use Caution/Monitor.levomilnacipranlevomilnacipran and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.linezolidlithium, linezolid. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.lisdexamfetaminelithium, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).lisinoprillisinopril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.lofepraminelofepramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lofexidinelithium and lofexidine both increase QTc interval. Use Caution/Monitor.loperamidelithium and loperamide both increase QTc interval. Use Caution/Monitor.lornoxicamlornoxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.loxapinelithium, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).loxapine inhaledlithium, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lsdlithium and lsd both increase serotonin levels. Use Caution/Monitor.lurasidonelithium, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).maprotilinemaprotiline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.meclofenamatemeclofenamate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.mefenamic acidmefenamic acid increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.meloxicammeloxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.meperidinelithium and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.metforminmetformin decreases levels of lithium by Other (see comment). Use Caution/Monitor. Comment: SGLT2 inhibitors with lithium may decrease serum lithium concentrations; monitor serum lithium concentration more frequently during therapy initiation and dosage changes.methyclothiazidemethyclothiazide increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.metolazonemetolazone increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.midazolam intranasalmidazolam intranasal, lithium. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.milnacipranmilnacipran and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.mirtazapinelithium and mirtazapine both increase serotonin levels. Use Caution/Monitor.moexiprilmoexipril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.molindonelithium, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).morphinelithium and morphine both increase serotonin levels. Use Caution/Monitor.nabumetonenabumetone increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.naproxennaproxen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.naratriptannaratriptan and lithium both increase serotonin levels. Use Caution/Monitor.nefazodonenefazodone and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.nortriptylinenortriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and nortriptyline both increase QTc interval. Use Caution/Monitor.octreotidelithium and octreotide both increase QTc interval. Use Caution/Monitor.ofloxacinlithium and ofloxacin both increase QTc interval. Use Caution/Monitor.olanzapinelithium, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lithium and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesoliceridinelithium, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.osilodrostatosilodrostat and lithium both increase QTc interval. Use Caution/Monitor.oxaprozinoxaprozin increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.paliperidonelithium, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).parecoxibparecoxib increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.paroxetineparoxetine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and paroxetine both increase QTc interval. Use Caution/Monitor.pasireotidelithium and pasireotide both increase QTc interval. Use Caution/Monitor.pentazocinelithium and pentazocine both increase serotonin levels. Use Caution/Monitor.perindoprilperindopril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.perphenazinelithium, perphenazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.lithium, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lithium and perphenazine both increase QTc interval. Use Caution/Monitor.phenelzinelithium, phenelzine. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.pimavanserinlithium, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).pimozidelithium, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).piroxicampiroxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.posaconazolelithium and posaconazole both increase QTc interval. Use Caution/Monitor.potassium iodidepotassium iodide, lithium. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Concomitant use with antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of potassium iodide.primaquinelithium and primaquine both increase QTc interval. Use Caution/Monitor.procarbazinelithium, procarbazine. Mechanism: unknown. Use Caution/Monitor.prochlorperazinelithium, prochlorperazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.lithium and prochlorperazine both decrease QTc interval. Use Caution/Monitor.promazinelithium, promazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.promethazinelithium, promethazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.lithium and promethazine both decrease QTc interval. Use Caution/Monitor.protriptylineprotriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and protriptyline both increase QTc interval. Use Caution/Monitor.quetiapinelithium, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).quinaprilquinapril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.ramiprilramipril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.ranolazinelithium and ranolazine both increase QTc interval. Use Caution/Monitor.rilpivirinelithium and rilpivirine both increase QTc interval. Use Caution/Monitor.risperidonelithium, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lithium and risperidone both increase QTc interval. Use Caution/Monitor.rizatriptanrizatriptan and lithium both increase serotonin levels. Use Caution/Monitor.romidepsinlithium and romidepsin both increase QTc interval. Use Caution/Monitor.salicylates (non-asa)salicylates (non-asa) increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.salsalatesalsalate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.SAMelithium and SAMe both increase serotonin levels. Use Caution/Monitor.selegilineselegiline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.selegiline transdermalselegiline transdermal and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.sertralinesertraline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and sertraline both increase QTc interval. Use Caution/Monitor.solifenacinlithium and solifenacin both increase QTc interval. Use Caution/Monitor.sotagliflozinsotagliflozin will decrease the level or effect of lithium by Other (see comment). Modify Therapy/Monitor Closely. Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations; monitor serum lithium concentration more frequently during therapy initiation and dosage changesSt John's Wortlithium and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.sulfasalazinesulfasalazine increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.sulindacsulindac increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.sumatriptansumatriptan and lithium both increase serotonin levels. Use Caution/Monitor.sumatriptan intranasalsumatriptan intranasal and lithium both increase serotonin levels. Use Caution/Monitor.sunitiniblithium and sunitinib both increase QTc interval. Use Caution/Monitor.tacrolimuslithium and tacrolimus both increase QTc interval. Use Caution/Monitor.teduglutideteduglutide increases levels of lithium by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.telavancinlithium and telavancin both increase QTc interval. Use Caution/Monitor.thioridazinelithium, thioridazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.thiothixenelithium, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).lithium and thiothixene both increase QTc interval. Use Caution/Monitor.tinidazoletinidazole increases effects of lithium by unknown mechanism. Use Caution/Monitor. Metronidazole has been reported to elevate serum lithium levels. Tinidazole effects on lithium are unknown. Consider monitoring serum lithium and creatinine levels after several days of concomitant use with lithium and tinidazole to detect potential lithium intoxication.tolfenamic acidtolfenamic acid increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.tolmetintolmetin increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.topiramatetopiramate increases levels of lithium by unspecified interaction mechanism. Use Caution/Monitor. Increase in lithium exposure may occur with doses of up to 600 mg/day; monitor lithium levels when coadministered with high-dose topiramate .tramadollithium and tramadol both increase serotonin levels. Use Caution/Monitor.trandolapriltrandolapril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.tranylcyprominelithium, tranylcypromine. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.trazodonetrazodone and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.triclabendazolelithium and triclabendazole both increase QTc interval. Use Caution/Monitor.trifluoperazinelithium, trifluoperazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.lithium, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin