Drug interactions
Lithium + Salsalate
Severity: Moderate
Lithium and Salsalate: 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
Salsalate, a salicylate prodrug with NSAID properties, may modestly increase serum lithium, though the effect is less pronounced than with other NSAIDs. Toxicity is possible in susceptible patients such as the elderly or those with renal impairment.
What this interaction means in plain words
Lithium and Salsalate 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
Reduced renal prostaglandin synthesis may lower lithium clearance.
What to do
Check lithium concentration at baseline and about a week after starting or changing salsalate dosing. Reduce lithium dose if levels rise and consider paracetamol.
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 Salsalate?
MediHelp rates the interaction as moderate. Lithium and Salsalate 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. Salsalate, a salicylate prodrug with NSAID properties, may modestly increase serum lithium, though the effect is less pronounced than with other NSAIDs. Toxicity is possible in susceptible patients such as the elderly or those with renal impairment.
How serious is the interaction between Lithium and Salsalate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check lithium concentration at baseline and about a week after starting or changing salsalate dosing. Reduce lithium dose if levels rise and consider paracetamol.
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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