Drug interactions
Lithium + Telmisartan-amlodipine
Severity: Major
Lithium and Telmisartan-amlodipine: 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 receptor blockers such as telmisartan can raise serum lithium concentrations and have caused lithium toxicity. Signs include tremor, confusion, ataxia, vomiting and, in severe cases, seizures or arrhythmias.
What this interaction means in plain words
Lithium and Telmisartan-amlodipine 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.
Lithium belongs to Central Nervous System; Telmisartan-amlodipine belongs to Cardiovascular.
Why it happens
Reduced renal sodium and lithium clearance with increased proximal tubular lithium reabsorption due to angiotensin II blockade.
What to do
If coadministration is needed, check lithium levels at baseline and within the first week after starting or changing the dose, and reduce the lithium dose as needed. Educate the patient about toxicity symptoms 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 Telmisartan-amlodipine
- Aliskiren + Telmisartan-amlodipine Contraindicated
- Sparsentan + Telmisartan-amlodipine Contraindicated
- Amifostine + Telmisartan-amlodipine Major
- Amiloride + Telmisartan-amlodipine Major
- Benazepril + Telmisartan-amlodipine Major
- Candesartan + Telmisartan-amlodipine 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 Lithium with Telmisartan-amlodipine?
MediHelp rates the interaction as major. Lithium and Telmisartan-amlodipine 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 receptor blockers such as telmisartan can raise serum lithium concentrations and have caused lithium toxicity. Signs include tremor, confusion, ataxia, vomiting and, in severe cases, seizures or arrhythmias.
How serious is the interaction between Lithium and Telmisartan-amlodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If coadministration is needed, check lithium levels at baseline and within the first week after starting or changing the dose, and reduce the lithium dose as needed. Educate the patient about toxicity symptoms and monitor renal function.
What other medicines interact with Telmisartan-amlodipine?
MediHelp also lists interactions of Telmisartan-amlodipine with, for example, Aliskiren, Sparsentan, Amifostine. The full list is on the Telmisartan-amlodipine page.
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