التداخل بين إنالابريل وهيدروكلوروثيازيد وليثيوم

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

Drugs Having Clinically Important Interactions with Lithium Table 4: Clinically Important Drug Interactions with Lithium Diuretics Clinical Impact: Diuretic-induced sodium loss may reduce lithium clearance and increase serum lithium concentrations .

Lithium generally should not be given with thiazides (see PRECAUTIONS, Drug Interactions, Enalapril Maleate and Hydrochlorothiazide ).

Lithium Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors.

A few cases of lithium toxicity have been reported in patients receiving concomitant enalapril and lithium and were reversible upon discontinuation of both drugs.

It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium.

Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.