DIURETICS AND LITHIUM - LOOP DIURETICS

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.
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