detemirMonitor Closely (1)lithium, insulin detemir. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin glargineMonitor Closely (1)lithium, insulin glargine. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin glulisineMonitor Closely (1)lithium, insulin glulisine. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin inhaledMonitor Closely (2)lithium, insulin inhaled. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required. lithium, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Lithium may either increase or decrease the blood glucose lowering effect of antidiabetic agents.insulin isophane human/insulin regular humanMonitor Closely (1)lithium, insulin isophane human/insulin regular human. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin lisproMonitor Closely (1)lithium, insulin lispro. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin lispro protamine/insulin lisproMonitor Closely (1)lithium, insulin lispro protamine/insulin lispro. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin NPHMonitor Closely (1)lithium, insulin NPH. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.insulin regular humanMonitor Closely (1)lithium, insulin regular human. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.iodinated glycerolMinor (1)iodinated glycerol, lithium. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypothyroid effects.iodineMinor (1)iodine, lithium. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypothyroid effects.irbesartanSerious - Use Alternative (1)irbesartan increases toxicity of lithium by decreasing renal clearance. Avoid or Use Alternate Drug.isocarboxazidMonitor Closely (1)lithium, isocarboxazid. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.Serious - Use Alternative (1)isocarboxazid and lithium both increase serotonin levels. Avoid or Use Alternate Drug.isofluraneSerious - Use Alternative (1)isoflurane and lithium both increase QTc interval. Avoid or Use Alternate Drug.isoniazidMonitor Closely (1)isoniazid and lithium both increase serotonin levels. Use Caution/Monitor.isradipineMonitor Closely (1)lithium and isradipine both increase QTc interval. Use Caution/Monitor.Minor (1)isradipine increases toxicity of lithium by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of neurotoxicity.itraconazoleMonitor Closely (1)itraconazole and lithium both increase QTc interval. Use Caution/Monitor.ivosidenibSerious - Use Alternative (1)lithium and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.ketoprofenMonitor Closely (1)ketoprofen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.ketorolacMonitor Closely (1)ketorolac increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.ketorolac intranasalMonitor Closely (1)ketorolac intranasal increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.L-tryptophanMonitor Closely (1)L-tryptophan and lithium both increase serotonin levels. Use Caution/Monitor.lapatinibMonitor Closely (1)lithium and lapatinib both increase QTc interval. Use Caution/Monitor.lefamulinSerious - Use Alternative (1)lefamulin and lithium both increase QTc interval. Avoid or Use Alternate Drug.lenvatinibSerious - Use Alternative (1)lithium and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.leuprolideMonitor Closely (1)lithium and leuprolide both increase QTc interval. Use Caution/Monitor.levofloxacinMonitor Closely (1)lithium and levofloxacin both increase QTc interval. Use Caution/Monitor.levomilnacipranMonitor Closely (1)levomilnacipran and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)levomilnacipran, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.linezolidMonitor Closely (1)lithium, linezolid. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.Serious - Use Alternative (1)linezolid and lithium both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.lisdexamfetamineMonitor Closely (1)lithium, 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).lisinoprilMonitor Closely (1)lisinopril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.lofepramineMonitor Closely (1)lofepramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)lithium, lofepramine. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.lofexidineMonitor Closely (1)lithium and lofexidine both increase QTc interval. Use Caution/Monitor.loperamideMonitor Closely (1)lithium and loperamide both increase QTc interval. Use Caution/Monitor.lopinavirSerious - Use Alternative (1)lithium and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.lorcaserinSerious - Use Alternative (1)lithium and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lornoxicamMonitor Closely (1)lornoxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.losartanSerious - Use Alternative (1)losartan increases toxicity of lithium by decreasing renal clearance. Avoid or Use Alternate Drug.loxapineMonitor Closely (1)lithium, 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 inhaledMonitor Closely (1)lithium, 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).lsdMonitor Closely (1)lithium and lsd both increase serotonin levels. Use Caution/Monitor.lurasidoneMonitor Closely (1)lithium, 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).macimorelinSerious - Use Alternative (1)lithium and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.maprotilineMonitor Closely (1)maprotiline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)lithium and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)lithium, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.meclofenamateMonitor Closely (1)meclofenamate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.mefenamic acidMonitor Closely (1)mefenamic acid increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of lithium by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.meloxicamMonitor Closely (1)meloxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.meperidineMonitor Closely (1)lithium and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.metforminMonitor Closely (1)metformin 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.methadoneSerious - Use Alternative (1)lithium and methadone both increase QTc interval. Avoid or Use Alternate Drug.methyclothiazideMonitor Closely (1)methyclothiazide increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.methyldopaMinor (1)methyldopa increases toxicity of lithium by unknown mechanism. Minor/Significance Unknown.metoclopramide intranasalSerious - Use Alternative (1)lithium, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metolazoneMonitor Closely (1)metolazone increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.metronidazoleMinor (1)metronidazole increases levels of lithium by decreasing metabolism. Minor/Significance Unknown.midazolam intranasalMonitor Closely (1)midazolam 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.midostaurinSerious - Use Alternative (1)lithium and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.mifepristoneSerious - Use Alternative (1)lithium and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.milnacipranMonitor Closely (1)milnacipran and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)milnacipran, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.mirtazapineMonitor Closely (1)lithium and mirtazapine both increase serotonin levels. Use Caution/Monitor.Serious - Use Alternative (1)lithium and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibSerious - Use Alternative (1)lithium and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.moexiprilMonitor Closely (1)moexipril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.molindoneMonitor Closely (1)lithium, 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).morphineMonitor Closely (1)lithium and morphine both increase serotonin levels. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)lithium and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.nabumetoneMonitor Closely (1)nabumetone increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.naproxenMonitor Closely (1)naproxen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.naratriptanMonitor Closely (1)naratriptan and lithium both increase serotonin levels. Use Caution/Monitor.nefazodoneMonitor Closely (1)nefazodone and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)nefazodone, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.nicardipineMinor (1)nicardipine increases toxicity of lithium by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of neurotoxicity.nifedipineMinor (1)nifedipine increases toxicity of lithium by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of neurotoxicity.nilotinibSerious - Use Alternative (1)lithium and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.nisoldipineMinor (1)nisoldipine increases toxicity of lithium by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of neurotoxicity.nortriptylineMonitor Closely (2)lithium and nortriptyline both increase QTc interval. Use Caution/Monitor. nortriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)lithium, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.octreotideMonitor Closely (1)lithium and octreotide both increase QTc interval. Use Caution/Monitor.ofloxacinMonitor Closely (1)lithium and ofloxacin both increase QTc interval. Use Caution/Monitor.olanzapineMonitor Closely (2)lithium, 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 instancesoliceridineMonitor Closely (1)lithium, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.olmesartanSerious - Use Alternative (1)olmesartan increases toxicity of lithium by decreasing renal clearance. Avoid or Use Alternate Drug.olopatadine intranasalSerious - Use Alternative (1)lithium and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. onabotulinumtoxinAMinor (1)lithium increases effects of onabotulinumtoxinA by unknown mechanism. Minor/Significance Unknown.ondansetronSerious - Use Alternative (1)lithium and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.osilodrostatMonitor Closely (1)osilodrostat and lithium both increase QTc interval. Use Caution/Monitor.osimertinibSerious - Use Alternative (1)lithium and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.oxaliplatinSerious - Use Alternative (1)lithium and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.oxaprozinMonitor Closely (1)oxaprozin increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.ozanimodSerious - Use Alternative (2)ozanimod increases toxicity of lithium by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use. lithium and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.paliperidoneMonitor Closely (1)lithium, 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