Drug interactions
Captopril + Lithium
Severity: Major
Captopril 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 raise serum lithium concentrations and lead to lithium toxicity, with tremor, confusion, ataxia and gastrointestinal symptoms. The effect may emerge over weeks and is more likely in older patients, with dehydration or renal impairment.
What this interaction means in plain words
Captopril 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.
Captopril belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Reduced renal sodium and lithium clearance, with increased proximal tubular lithium reabsorption, due to ACE inhibition.
What to do
Avoid if possible; if combined, measure serum lithium before and within the first week or two after starting captopril and after dose changes. Reduce the lithium dose as needed and counsel the patient on toxicity symptoms.
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 Captopril
- Aliskiren + Captopril Contraindicated
- Captopril + Sacubitril / valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Amifostine + Captopril Major
- Amiloride + Captopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Captopril 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 Captopril with Lithium?
MediHelp rates the interaction as major. Captopril 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 raise serum lithium concentrations and lead to lithium toxicity, with tremor, confusion, ataxia and gastrointestinal symptoms. The effect may emerge over weeks and is more likely in older patients, with dehydration or renal impairment.
How serious is the interaction between Captopril 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 if possible; if combined, measure serum lithium before and within the first week or two after starting captopril and after dose changes. Reduce the lithium dose as needed and counsel the patient on toxicity symptoms.
What other medicines interact with Captopril?
MediHelp also lists interactions of Captopril with, for example, Aliskiren, Sacubitril / valsartan, Sacubitril-valsartan. The full list is on the Captopril page.
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