Drug interactions
Lithium + Olanzapine / samidorphan
Severity: Moderate
Lithium and Olanzapine / samidorphan: moderate interaction.
Last updated
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
Lithium combined with antipsychotics such as olanzapine has been reported to cause neurotoxicity, extrapyramidal symptoms and rarely neuroleptic malignant syndrome. The combination is used clinically, but the risk is greater at high doses or lithium levels.
What this interaction means in plain words
Lithium and Olanzapine / samidorphan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Possible additive central effects, including dopamine blockade; the exact mechanism is not established.
What to do
Monitor for tremor, rigidity, confusion and fever, and keep lithium levels within the therapeutic range. Reduce doses or stop treatment if neurotoxicity develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Lithium with Olanzapine / samidorphan?
MediHelp rates the interaction as moderate. Lithium and Olanzapine / samidorphan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lithium combined with antipsychotics such as olanzapine has been reported to cause neurotoxicity, extrapyramidal symptoms and rarely neuroleptic malignant syndrome. The combination is used clinically, but the risk is greater at high doses or lithium levels.
How serious is the interaction between Lithium and Olanzapine / samidorphan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tremor, rigidity, confusion and fever, and keep lithium levels within the therapeutic range. Reduce doses or stop treatment if neurotoxicity develops.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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