The ingestion of marked amounts of sodium can prevent the establishment or maintenance of adequate serum lithium
Warn patients not to take non-prescription antacids
or urinary alkalinisers without first seeking informed advice. Sodium bicarbonate comes in various guises and disguises e.g. Alka-Seltzer (55.8%), Andrews Salts (22.6%), Eno (46.4%), Jaap's Health Salts (21.3%), or Peptac (28.8%). Substantial amounts of sodium also occur in some urinary alkalinising agents (e.g. Citralka, Citravescent). An antacid containing aluminium/magnesium hydroxide with simeticone has been found to have no effect on the bioavailability of lithium
carbonate, and so antacids
of this type may be suitable alternatives.