Interaksi Lisinopril dan hidroklorotiazid dan Litium

• 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 , Lisinopril and Hydrochlorothiazide ).

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

Lithium toxicity was usually reversible upon discontinuation of lithium and the ACE inhibitor.

It is recommended that serum lithium levels be monitored frequently if lisinopril is administered concomitantly with lithium. mTOR (mammalian target of rapamycin) inhibitors Patients receiving coadministration of ACE inhibitor and mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema (see WARNINGS ).

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