Drug interactions
Azilsartan + Lithium
Severity: Major
Azilsartan 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
Angiotensin II receptor blockers can raise serum lithium concentrations and have caused lithium toxicity. Symptoms include tremor, confusion, ataxia, gastrointestinal upset and, in severe cases, seizures or arrhythmias.
What this interaction means in plain words
Azilsartan 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.
Azilsartan belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Reduced renal sodium and lithium clearance from angiotensin II blockade increases proximal tubular lithium reabsorption.
What to do
Check serum lithium before starting azilsartan and again within about a week or after dose changes, and lower the lithium dose as needed. Consider a different antihypertensive class if lithium levels cannot be kept stable.
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 Azilsartan
- Aliskiren + Azilsartan Contraindicated
- Azilsartan + Sparsentan Contraindicated
- Amifostine + Azilsartan Major
- Amlodipine-benazepril + Azilsartan Major
- Amlodipine-perindopril + Azilsartan Major
- Azilsartan + Benazepril 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 Azilsartan with Lithium?
MediHelp rates the interaction as major. Azilsartan 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. Angiotensin II receptor blockers can raise serum lithium concentrations and have caused lithium toxicity. Symptoms include tremor, confusion, ataxia, gastrointestinal upset and, in severe cases, seizures or arrhythmias.
How serious is the interaction between Azilsartan 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: Check serum lithium before starting azilsartan and again within about a week or after dose changes, and lower the lithium dose as needed. Consider a different antihypertensive class if lithium levels cannot be kept stable.
What other medicines interact with Azilsartan?
MediHelp also lists interactions of Azilsartan with, for example, Aliskiren, Sparsentan, Amifostine. The full list is on the Azilsartan page.
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