Major
Lithium × Losartan
Psycholeptics. Lithium×Angiotensin II receptor blockers (sartans)
Mechanism
Losartan, like ACE inhibitors, reduces lithium renal clearance via angiotensin blockade of the efferent arteriole. Lithium rises 20–40%. Effect described for all ARBs.
Symptoms
Tremor, nausea, confusion within 1–3 weeks of losartan start.
Management
Check lithium on day 7, day 14 and at one month. Lithium may need a 25–50% reduction.
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.