التداخل بين تحت سترات البزموت وميترونيدازول وتتراسيكلين وليثيوم

• Diuretics, NSAID, renin-angiotensin system antagonists, or metronidazole may increase lithium serum concentrations.

Lithium In patients stabilized on relatively high doses of lithium, short-term use of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride may cause elevation of serum lithium concentrations and signs of lithium toxicity due to the interaction between metronidazole and lithium.

Monitor serum lithium and serum creatinine concentrations daily for several days after beginning treatment with bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride to detect any increase that may precede clinical symptoms of lithium toxicity [see Drug Interactions ( 7.5 )] .

Lithium: Increased lithium serum concentrations; measure serum lithium and serum creatinine concentrations during therapy.

Serum lithium and serum creatinine concentrations should be monitored several days after beginning treatment with bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride to detect any increase that may precede clinical symptoms of lithium toxicity [see Warnings and Precautions ( 5.14 )] .