Alkalith 450mg Tablet CR (Lithium Carbonate): Complete Medicine Guide

[{"condition":"Bipolar disorder — acute mania","description":"This medicine is used to reduce the severity of manic episodes, including elevated mood, agitation, reduced need for sleep, and impulsive behaviour, in people with bipolar disorder.","evidence":"Well-established"},{"condition":"Bipolar disorder — maintenance treatment","description":"This medicine is used long term to prevent or reduce the frequency of manic and depressive relapses and to support stable mood in people with bipolar disorder.","evidence":"Well-established"},{"condition":"Bipolar depression","description":"This medicine may be used, often with other medicines, to treat depressive episodes in bipolar disorder and to reduce the risk of recurrence.","evidence":"Moderate"},{"condition":"Augmentation in treatment-resistant depression","description":"This medicine is sometimes added to an antidepressant when standard treatment has not worked well enough, under specialist supervision.","evidence":"Moderate"},{"condition":"Suicide risk reduction in mood disorders","description":"Long-term treatment with this medicine has been associated with reduced risk of suicidal behaviour in people with bipolar disorder or recurrent mood disorders.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Cluster headache prevention","description":"This medicine is sometimes prescribed off-label to reduce the frequency and severity of cluster headache attacks, usually in a specialist setting.","evidence":"Limited"},{"condition":"Schizoaffective disorder","description":"This medicine may be used off-label as part of mood stabilization in some people with schizoaffective disorder.","evidence":"Limited"},{"condition":"Aggression and impulsivity in selected patients","description":"This medicine has been used off-label in some patients with severe impulsivity or aggression, but this is not a standard first-line use.","evidence":"Limited"}]

Primary treatment for: Bipolar disorder

Also treats: Acute mania, Bipolar depression, Treatment-resistant depression (as an add-on), Recurrent mood disorders with suicide risk

Generic Name(s)	Lithium carbonate
Brand Name	Alkalith 450mg tablet CR
Manufacturer	Surge Pharmaceuticals Pvt Ltd
Packaging / Form	Varies by brand (Allopathy)
Therapeutic Class	NEURO CNS
Action Class	Mood stabilizers
Route of Administration	Oral. This medicine is taken by mouth as a controlled-release tablet and should be swallowed whole with water
Storage	Store this medicine at room temperature, away from direct sunlight, heat, and moisture. Keep it in the original container with the lid tightly closed, and do not remove the desiccant if one is provided. Do not store it in the bathroom or near the kitchen sink. Keep it out of reach of children and pets.
Shelf Life	The shelf life of this medicine is usually 24 to 36 months from the date of manufacture, depending on the manufacturer and pack. Always check the expiry date printed on the pack, and do not use the medicine after that date. Do not use the tablet if it is broken, discoloured, or shows signs of moisture damage.
WHO Guideline	Not established from the available information for this specific product. International guidelines generally recognize lithium as a first-line mood stabilizer for bipolar disorder, but the exact recommendations depend on the guideline and clinical context.
ICMR Guideline	Not established from the available information for this specific product. Clinicians in India generally follow standard psychiatric practice and international guidance for the use of lithium in bipolar disorder.

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Drug	Severity	Effect
Hydrochlorothiazide	Major
ACE inhibitors	Major
NSAIDs	Major
Furosemide	Major
Carbamazepine	Major
Verapamil	Major
SSRIs	Moderate
Metronidazole	Moderate
Tetracyclines	Moderate
Theophylline	Moderate

🚫 Contraindications

["Known allergy or severe hypersensitivity to lithium carbonate or any component of this medicine","Severe kidney disease or significantly reduced kidney function","Severe heart disease, especially conditions that affect heart rhythm or fluid balance","Significant dehydration or severe sodium depletion","Certain rare inherited conditions that affect sodium handling in the body","Use in children below the age for which safety and effectiveness have been established, unless directed by a specialist","Concurrent use with certain medicines that significantly raise lithium levels, unless under close specialist supervision"]

⚠️ Warnings & Precautions

["This medicine has a narrow therapeutic window, so blood levels must be monitored regularly to avoid toxicity.","Dehydration from fever, vomiting, diarrhoea, heavy sweating, or reduced fluid intake can raise lithium levels and cause serious side effects.","Tell all healthcare professionals that you take this medicine, because many common medicines can interact with it.","Do not stop this medicine suddenly, because doing so can trigger a relapse of mania or depression.","Use with caution in older adults, who are more sensitive to lithium side effects and may need lower doses.","Use with caution in people with kidney disease, heart disease, thyroid disease, or electrolyte problems.","Avoid alcohol and recreational drugs while taking this medicine.","Keep all scheduled blood tests even when you feel well, because problems can develop without obvious symptoms.","Tell your clinician if you are pregnant, planning pregnancy, or breastfeeding.","Store this medicine safely away from children and in the original packaging."]

🤱 Lactation Safety

This medicine passes into breast milk, and breastfed infants can receive a meaningful amount of lithium. Breastfeeding while taking this medicine should only be considered after a full discussion with the treating clinician and a pediatrician, and it usually requires monitoring of the infant's lithium level, kidney function, and thyroid function. In some situations, formula feeding may be recommended instead. The decision should be individualized and reviewed regularly.

Additional Safety Advice

If you are planning pregnancy, speak to your clinician before you conceive. This medicine should be reviewed carefully, because it can affect the developing baby, especially in early pregnancy, but stopping it suddenly can also be risky for your mental health. Your clinician may adjust the dose, arrange more frequent blood tests, and coordinate care with an obstetric team. Folic acid supplementation and additional monitoring may be recommended. Do not make any changes to your treatment without medical advice.

Tell your surgical and anaesthetic team that you take this medicine before any operation. Surgery, fasting, and changes in fluid balance can affect lithium levels, so your clinician may check your blood levels before and after the procedure and adjust the dose if needed. Some medicines used during and after surgery can interact with this medicine. Follow your clinician's instructions about when to take your dose around the time of surgery, and report any confusion, tremor, or unsteadiness afterwards.

Tell your dentist that you take this medicine before any dental procedure. Dental work itself does not usually require stopping this medicine, but some pain relievers and antibiotics used around dental procedures can interact with it. If you need a procedure that involves fasting or sedation, discuss your dose timing with your clinician. Keep up your fluid intake during dental visits, and report any unusual symptoms afterwards.

Moderate exercise is generally encouraged, but heavy sweating during intense exercise or in hot weather can cause dehydration and raise lithium levels. Drink water regularly during and after exercise, and avoid very strenuous activity in extreme heat unless you can keep your fluid intake steady. If you feel dizzy, unsteady, or unusually weak during exercise, stop and seek medical advice. Tell your clinician about your exercise routine so that your monitoring can be adjusted if needed.

This medicine can cause drowsiness, tremor, or unsteadiness, especially when treatment is started or when blood levels are high. Avoid driving or operating heavy machinery until you know how it affects you. Most people are able to continue their usual work and daily activities once the dose is stable, but jobs that require fine hand control or alertness may need extra caution. Regular sleep and a steady routine can help you function better at work. If your job involves shift work, discuss it with your clinician, because disrupted sleep can affect mood stability.

Do not stop this medicine on your own. Stopping suddenly can cause your mood symptoms to return and may increase the risk of relapse. Your clinician may consider stopping or changing treatment if you develop serious side effects, significant kidney or thyroid problems, or if your clinical situation changes, such as during pregnancy planning. Any decision to stop should be made together with your clinician and usually involves a gradual, carefully monitored plan.

Long-term use of this medicine can affect kidney function and thyroid function in some people, which is why regular blood tests are an important part of treatment. Most people who need this medicine continue it for months or years to prevent relapses, and the dose is kept as low as possible while still controlling symptoms. Long-term treatment has been associated with a reduced risk of suicidal behaviour in people with mood disorders. If kidney or thyroid changes are detected early, they can often be managed with dose adjustment, additional treatment, or specialist review. Regular follow-up with your clinician is essential for safe long-term use.

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[{"medicine":"This medicine (lithium carbonate)","class":"Mood stabilizer","main_uses":"Mania, bipolar maintenance, suicide risk reduction","key_monitoring":"Lithium levels, kidney function, thyroid function","notable_side_effects":"Tremor, thirst, urination, nausea, toxicity at high levels"},{"medicine":"Sodium valproate","class":"Mood stabilizer / anticonvulsant","main_uses":"Mania, bipolar maintenance, epilepsy","key_monitoring":"Liver function, blood counts, valproate levels","notable_side_effects":"Weight gain, tremor, hair loss, liver and blood effects"},{"medicine":"Carbamazepine","class":"Mood stabilizer / anticonvulsant","main_uses":"Mania, bipolar maintenance, epilepsy, trigeminal neuralgia","key_monitoring":"Blood counts, liver function, drug levels","notable_side_effects":"Dizziness, rash, blood count changes, many drug interactions"},{"medicine":"Lamotrigine","class":"Mood stabilizer / anticonvulsant","main_uses":"Bipolar depression, maintenance","key_monitoring":"Clinical review for rash","notable_side_effects":"Rash, headache, dizziness, rarely serious skin reactions"}]