Toxicity is more likely to occur in the following: Older patients Patients with decreased creatinine clearance Those with sodium loss (eg, due to fever, vomiting, diarrhea, or use of diuretics) Thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin may contribute to hyperlithemia.