The concurrent use of
lithium and
furosemide can be safe and uneventful, but serious
lithium toxicity has been described. Bumetanide interacts similarly. The risk of
lithium toxicity with a loop diuretic is greatly increased during the first month of concurrent use.
It would be imprudent to give
furosemide or
bumetanide to patients stabilised on
lithium unless the effects can be well monitored because some patients may develop serious
toxicity. Patients taking
lithium should be aware of the
symptoms of
lithium toxicity and told to report them immediately should they occur. Consider increased monitoring of
lithium levels in patients newly started on this combination.