Eskalith-CR

Generic name: Lithium
Drug class: Antimanic agents

Usage of Eskalith-CR

Lithium is used to treat mania that is part of bipolar disorder (manic-depressive illness). It is also used on a daily basis to reduce the frequency and severity of manic episodes. Manic-depressive patients experience severe mood changes, ranging from an excited or manic state (eg, unusual anger or irritability or a false sense of well-being) to depression or sadness.

It is not known how lithium works to stabilize a person's mood. However, it does act on the central nervous system. It helps you to have more control over your emotions and helps you cope better with the problems of living.

It is important that you and your family understand all the effects of this medicine. These effects depend on your individual condition and response and the amount of lithium you use. You must also know when to contact your doctor if there are problems with using the medicine.

This medicine is available only with your doctor's prescription.

Eskalith-CR side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Confusion, poor memory, or lack of awareness

fainting

fast, pounding, or irregular heartbeat or pulse

frequent urination

increased thirst

slow heartbeat

stiffness of the arms or legs

troubled breathing (especially during hard work or exercise)

unusual tiredness or weakness

weight gain

Rare

Blue color and pain in the fingers and toes

coldness of the arms and legs

dizziness

eye pain

headache

noise in the ears

vision problems

Incidence not known

Blurred vision

burning feeling in the chest or stomach

chills

cloudy urine

cough

decreased urination

difficulty in speaking

drooling

dry mouth

eyeballs bulge out of the eye sockets

fever

flushed, dry skin

fruit-like breath odor

general feeling of illness

increase in heart rate

increased hunger

increased urination

indigestion

irregular heartbeat, recurrent

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

lightheadedness

loss of balance control

loss of strength or energy

muscle pain or weakness

muscle trembling, jerking, or stiffness

paleness or cold feeling in the fingertips and toes

rapid breathing

restlessness or agitation

shakiness and unsteady walk

shuffling walk

sore throat

stomach pain or upset

sugar in the urine

sunken eyes

swelling of the ankles or wrists

tenderness in the stomach area

tingling or pain in the fingers or toes when exposed to the cold

tremor

twisting movements of the bod

twitching

uncontrolled jerking or twisting movements of the hands, arms, or legs

uncontrolled movements, especially of the face, neck, and back

unexplained weight loss

unsteadiness, trembling, or other problems with muscle control or coordination

unusual drowsiness, dullness, or feeling of sluggishness

unusually strong reflexes

wrinkled skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blurred vision

clumsiness or unsteadiness

convulsions (seizures)

diarrhea

drowsiness

increase in the amount of urine

lack of coordination

loss of appetite

muscle weakness

nausea

ringing in the ears

slurred speech

trembling (severe)

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Acne or skin rash

bloated feeling or pressure in the stomach

change in or loss of taste

decreased interest in sexual intercourse

diarrhea

drying and thinning of hair

excess air or gas in the stomach or bowels

full feeling

inability to have or keep an erection

increased watering of the mouth

loss in sexual ability, desire, drive, or performance

passing gas

salivary gland swelling

tooth pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Eskalith-CR

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of lithium extended-release tablets in children younger than 12 years of age or lithium capsules, solution, and tablets in children younger than 7 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies on the relationship of age to the effects of lithium have not been performed in the geriatric population. However, elderly patients are more likely to have age-related heart, kidney, or liver problems, which may require caution and an adjustment in the dose for patients receiving lithium.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac

Acemetacin

Acetazolamide

Acetophenazine

Alacepril

Alclofenac

Alfentanil

Almotriptan

Amifampridine

Amineptine

Amitriptyline

Amitriptylinoxide

Amoxapine

Amphetamine

Amtolmetin Guacil

Anileridine

Aspirin

Azilsartan Medoxomil

Azosemide

Bemetizide

Benazepril

Bendroflumethiazide

Benzhydrocodone

Benzphetamine

Benzthiazide

Bexagliflozin

Bromfenac

Bromperidol

Brompheniramine

Bufexamac

Bumetanide

Butorphanol

Candesartan Cilexetil

Canrenoate

Captopril

Carprofen

Celecoxib

Chlorothiazide

Chlorpheniramine

Chlorpromazine

Chlorprothixene

Chlorthalidone

Choline Salicylate

Cilazapril

Citalopram

Clomipramine

Clonixin

Clozapine

Cocaine

Codeine

Cyclobenzaprine

Dapagliflozin

Desipramine

Desvenlafaxine

Dexibuprofen

Dexketoprofen

Dextroamphetamine

Dextromethorphan

Diazoxide

Dibenzepin

Diclofenac

Difenoxin

Diflunisal

Dihydrocodeine

Diphenoxylate

Dipyrone

Dolasetron

Domperidone

Donepezil

Doxepin

Droperidol

Droxicam

Duloxetine

Eletriptan

Empagliflozin

Enalapril

Enalaprilat

Eprosartan

Ertugliflozin

Escitalopram

Ethacrynic Acid

Ethopropazine

Ethylmorphine

Etodolac

Etofenamate

Etoricoxib

Felbinac

FenBufen

Fenfluramine

Fenoprofen

Fentanyl

Fepradinol

Feprazone

Floctafenine

Flufenamic Acid

Fluoxetine

Flupenthixol

Fluphenazine

Flurbiprofen

Fluvoxamine

Fosinopril

Frovatriptan

Furazolidone

Furosemide

Gepirone

Granisetron

Haloperidol

Hydrochlorothiazide

Hydrocodone

Hydroflumethiazide

Hydromorphone

Hydroxyamphetamine

Hydroxytryptophan

Ibuprofen

Imipramine

Indapamide

Indomethacin

Iproniazid

Irbesartan

Isocarboxazid

Ketobemidone

Ketoprofen

Ketorolac

Lasmiditan

Levomilnacipran

Levorphanol

Linezolid

Lisdexamfetamine

Lisinopril

Lofepramine

Lorcaserin

Lornoxicam

Losartan

Loxapine

Loxoprofen

Lumiracoxib

Meclofenamate

Mefenamic Acid

Melitracen

Meloxicam

Melperone

Meperidine

Mesoridazine

Metaxalone

Methadone

Methamphetamine

Methotrimeprazine

Methyclothiazide

Methylene Blue

Metolazone

Metronidazole

Milnacipran

Mirtazapine

Moclobemide

Moexipril

Molindone

Morniflumate

Morphine

Morphine Sulfate Liposome

Nabumetone

Nalbuphine

Naproxen

Naratriptan

Nefazodone

Nepafenac

Nialamide

Nicomorphine

Niflumic Acid

Nimesulide

Nimesulide Beta Cyclodextrin

Nortriptyline

Olanzapine

Olmesartan Medoxomil

Ondansetron

Opipramol

Opium

Opium Alkaloids

Oxaprozin

Oxycodone

Oxymorphone

Oxyphenbutazone

Palonosetron

Papaveretum

Parecoxib

Paregoric

Paroxetine

Penfluridol

Pentazocine

Periciazine

Perindopril

Perphenazine

Phenelzine

Phenylbutazone

Piketoprofen

Pimozide

Pipamperone

Pipotiazine

Piretanide

Piritramide

Piroxicam

Polythiazide

Pranoprofen

Procarbazine

Prochlorperazine

Proglumetacin

Promazine

Promethazine

Propyphenazone

Proquazone

Protriptyline

Quinapril

Ramipril

Rasagiline

Remifentanil

Remoxipride

Risperidone

Rizatriptan

Rofecoxib

Safinamide

Salicylic Acid

Salsalate

Selegiline

Sertindole

Sertraline

Sibutramine

Sodium Salicylate

Sotagliflozin

Spirapril

Spironolactone

St John's Wort

Sufentanil

Sulindac

Sulpiride

Sumatriptan

Suprofen

Tapentadol

Telmisartan

Tenoxicam

Thiopropazate

Thioproperazine

Thioridazine

Thiothixene

Tianeptine

Tiapride

Tiaprofenic Acid

Tilidine

Tolfenamic Acid

Tolmetin

Topiramate

Torsemide

Tramadol

Trandolapril

Tranylcypromine

Trichlormethiazide

Trifluoperazine

Triflupromazine

Trimeprazine

Trimipramine

Tryptophan

Valdecoxib

Valsartan

Venlafaxine

Vilazodone

Vortioxetine

Xipamide

Ziprasidone

Zofenopril

Zolmitriptan

Zotepine

Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Calcitonin

Carbamazepine

Cisplatin

Diltiazem

Lactulose

Mazindol

Phenytoin

Semaglutide

Succinylcholine

Verapamil

Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Caffeine

Relate drugs

How to use Eskalith-CR

Take this medicine exactly as directed by your doctor. Do not take more or less of it, do not take it more or less often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a Medication Guide. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. You should talk to your doctor if you have any questions.

You might have to take this medicine for several weeks before you begin to feel better. Talk to your doctor if you have any questions.

Make sure that your doctor knows if you are on a low-sodium or low-salt diet. Too little salt in your diet could lead to serious side effects.

Talk to your doctor about the correct amount of fluid to take with this medicine. Some people need to drink extra fluid every day with lithium.

Swallow the extended-release tablet whole. Do not break, crush, or chew it.

Measure the oral solution with a marked measuring spoon, oral syringe, or medicine cup. A regular teaspoon may not measure the correct amount of medicine.

There are several different forms of lithium. The dose for each is different and they are used at different times of the day. Do not change the type of medicine you take without talking to your doctor first.

In order for lithium to work properly, it must be taken every day in regularly spaced doses as ordered by your doctor. This is necessary to keep a constant amount of lithium in your blood. To help keep the amount constant, do not miss any doses and do not stop taking the medicine even if you feel better.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (capsules, solution, and tablets):

For acute mania:

Adults and children 7 years of age and older weighing more than 30 kilograms (kg)—600 milligrams (mg) or 10 milliliters (mL) 2 to 3 times a day. Your doctor may adjust your dose as needed.

Children 7 years of age and older weighing 20 kg to 30 kg—600 mg to 1500 mg or 10 mL to 25 mL given in divided doses per day. Your doctor may adjust your dose as needed.

Children 7 years of age and older weighing less than 20 kg—Use and dose must be determined by your doctor.

Children younger than 7 years of age—Use is not recommended.

For long-term treatment of mania:

Adults and children 7 years of age and older weighing more than 30 kilograms (kg)—300 mg to 600 mg or 5 mL to 10 mL 2 to 3 times a day. Your doctor may adjust your dose as needed.

Children 7 years of age and older weighing 20 kg to 30 kg—600 mg to 1200 mg or 10 mL to 20 mL given in divided doses per day. Your doctor may adjust your dose as needed.

Children 7 years of age and older weighing less than 20 kg—Use and dose must be determined by your doctor.

Children younger than 7 years of age—Use is not recommended.

For oral dosage form (extended-release tablets):

For acute mania:

Adults and children 12 years of age—900 milligrams (mg) 2 times a day, or 600 mg 3 times a day.

Children younger than 12 years of age—Use is not recommended.

For long-term treatment of mania:

Adults and children 12 years of age—600 milligrams (mg) 2 times a day, or 3 times a day up to 1200 mg per day.

Children younger than 12 years of age—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted side effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Call your doctor right away if you have diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination. These may be symptoms of lithium toxicity.

Make sure your doctor knows if you have a heart disorder called Brugada syndrome. Brugada syndrome can be life-threatening and requires immediate medical attention. Call your doctor or the emergency department right away if you have a fast, pounding, or uneven heartbeat, unexplained fainting, lightheadedness, or troubled breathing after using this medicine.

This medicine may cause pseudotumor cerebri (increased pressure in the brain). Call your doctor right away if you have blurred or double vision, dizziness, eye pain, severe headache, or nausea and vomiting.

Encephalopathic syndrome (brain problem) may occur in patients using this medicine together with a medicine to treat mental illness (eg, chlorpromazine [Thorazine®], clozapine [Clozaril®], fluphenazine [Prolixin®], haloperidol [Haldol®], perphenazine [Trilafon®], risperidone [Risperdal®], thioridazine [Mellaril®]). Check with your doctor right away if you have the following symptoms while using this medicine: fever, confusion, drowsiness, difficulty with speaking, uncontrolled body movements, and unusual tiredness or weakness.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Use extra care in hot weather and during activities that cause you to sweat heavily, such as hot baths, saunas, or exercising. If you have an infection or illness that causes heavy sweating, vomiting, diarrhea, shakiness, or muscle weakness, check with your doctor right away. The loss of too much water and salt from your body could lead to serious side effects from this medicine.

Do not go on a diet to lose weight and do not make a major change in your diet without first checking with your doctor. Improper dieting could cause the loss of too much water and salt from your body and could lead to serious side effects from this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

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