MajorThiazide diuretics×Psycholeptics. Lithium
Updated · Methodology
Mechanism
Hydrochlorothiazide increases sodium and lithium reabsorption in the distal tubule. Lithium plasma concentration rises 25–40% (up to 100% in some patients). Lithium toxicity develops within 1–2 weeks.
Symptoms
Tremor, nausea, diarrhea, confusion; in severe cases seizures and coma.
Management
For hypertension in a lithium patient, choose another class: calcium channel blocker (amlodipine) or a potassium-sparing diuretic with caution. If thiazide is required, halve lithium and check level on days 5–7 and at 2 weeks.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Lithium carbonate tablet (Glenmark Pharmaceuticals Inc., USA) – Prescribing Information (2016)– ; DailyMed setid 1b65d27e-5086-4a87-8387-c49f3d060978
- AEMPS: Ficha técnica: Hidroclorotiazida (nº registro 86487), sección 4.5 (2026)– AEMPS, CIMA, nº registro 86487, revisión 09/2026, sección 4.5