Drug interactions
Amlodipine-perindopril + Lithium
Severity: Major
Amlodipine-perindopril and Lithium: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
ACE inhibitors can increase serum lithium concentrations and have been associated with lithium toxicity, including tremor, confusion, ataxia and arrhythmias. The effect may emerge over days to weeks and is more likely with dehydration or renal impairment.
What this interaction means in plain words
Amlodipine-perindopril and Lithium can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amlodipine-perindopril belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
ACE inhibition reduces sodium and renal lithium clearance, increasing proximal tubular lithium reabsorption.
What to do
Avoid the combination where possible; if used, check serum lithium before and within the first week after starting perindopril and after dose changes. Reduce the lithium dose as needed and monitor renal function.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Amlodipine-perindopril
- Aliskiren + Amlodipine-perindopril Contraindicated
- Amlodipine-perindopril + Protein a column Contraindicated
- Amlodipine-perindopril + Sacubitril / valsartan Contraindicated
- Amifostine + Amlodipine-perindopril Major
- Amiloride + Amlodipine-perindopril Major
- Amlodipine-perindopril + Azilsartan Major
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Amlodipine-perindopril with Lithium?
MediHelp rates the interaction as major. Amlodipine-perindopril and Lithium can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. ACE inhibitors can increase serum lithium concentrations and have been associated with lithium toxicity, including tremor, confusion, ataxia and arrhythmias. The effect may emerge over days to weeks and is more likely with dehydration or renal impairment.
How serious is the interaction between Amlodipine-perindopril and Lithium?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, check serum lithium before and within the first week after starting perindopril and after dose changes. Reduce the lithium dose as needed and monitor renal function.
What other medicines interact with Amlodipine-perindopril?
MediHelp also lists interactions of Amlodipine-perindopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Amlodipine-perindopril page.
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