General Information
onsumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about Lithicarb. It does not contain all the information that is known about Lithicarb. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking Lithicarb against the benefits they expect it will have for you.
If you have any concerns about taking this medicine ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What Lithicarb is used for
Lithicarb is used to both treat and prevent episodes of a condition called manic-depressive or bipolar disorder, in which there are sustained mood swings either up (manic) or down (depression).
Lithicarb is also used in the treatment of schizo-affective illness and chronic schizophrenia.
Lithium is a powerful mood stabiliser, however, the exact way that lithium works to stabilise a person's mood is not known. It helps you to have more control over your emotions and helps you cope better.
Your doctor, however, may have prescribed Lithicarb for another purpose.
Ask your doctor if you have any questions about why Lithicarb has been prescribed for you.
There is no evidence that Lithicarb is addictive.
This medicine is available only with a doctor's prescription.
Before you take Lithicarb
When you must not take it
Do not take Lithicarb if you have an allergy to:
any medicine containing lithium
any of the ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Do not take Lithicarb after the expiry date (EXP) printed on the pack.
Do not take Lithicarb if the packaging is torn or shows signs of tampering.
Do not take Lithicarb to treat any other complaints unless your doctor has instructed you to do so.
Before you start to take it
A medical examination and some laboratory tests are usually performed before you begin therapy with Lithicarb. They are usually repeated at regular intervals while you continue to take Lithicarb.
Tell your doctor if:
1. you have allergies to any other medicines, foods, preservatives or dyes.
2. you have or have had any of the following medical conditions:
severe heart or kidney disease
low activity of the adrenal gland (eg. Addison's disease)
an underactive thyroid gland.
low levels of sodium in your body (eg. if you are dehydrated or on a low salt diet).
conditions for which you take diuretics (fluid tablets).
Vomiting or diarrhoea.
Two infections occurring at the same time.
It may not be safe for you to take Lithicarb if you have any of these medical conditions.
3. you become pregnant or plan to become pregnant or are breastfeeding.
Do not take Lithicarb if you are pregnant or breastfeeding unless you and your doctor have discussed the risks and benefits involved.
If you have not told your doctor about any of the above, tell him/her before you start taking Lithicarb.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Lithicarb interacts with many other medicines. This can cause a change in the blood levels of either the lithium or of the other medicine, increasing the chance of side effects or lithium toxicity. Lithium toxicity may occur if the level of lithium in your blood becomes too high. If you are taking a medication which interacts with Lithicarb your blood lithium levels will need to be monitored closely.
Some medicines in common use that may interfere with Lithicarb include:
medicines for removal of fluid (diuretics)
some medicines for high blood pressure and other heart drugs (eg captopril and enalapril, calcium channel blockers, methyldopa, Atacand and Cozaar
some types of tranquillisers (diazepam)
some medicines for depression (fluoxetine, imipramine)
some medicines for arthritis or pain (indomethacin, piroxicam, celecoxib, rofecoxib)
appetite suppressants
some medicines for epilepsy (carbamazepine and phenytoin)
medicines used to treat respiratory illness (theophylline)
medicines that change the acidity of the urine (sodium bicarbonate)
medicines used to treat certain mental conditions (haloperidol) or ziprasidone which can interact with lithium to affect the heart.
medicines containing steroids (eg prednisolone)
medicines used to treat glaucoma (acetazolamide)
medicines used to treat skin disorders (urea)
some antibiotics (metronidazole)
These medicines may be affected by Lithicarb or may affect how well it works. You may need to take different amounts of your medicine or you may need to take different medicines.
Your doctor or pharmacist has a more complete list of medicines to be careful with or avoid while taking Lithicarb.
If you have not told your doctor about any of these things, tell them before you take Lithicarb.
Lithium should always be taken with care and under your doctor's supervision because serious side effects may occur if the level of lithium in your blood becomes too high (toxicity). This can happen if you are taking too much lithium or if there are major changes to your normal health or lifestyle.
There are a number of things you can do during therapy with Lithicarb to help prevent lithium toxicity. You should:
maintain a normal diet with adequate salt and fluid
avoid reducing your salt intake quickly
avoid heavy exercise which may lead to excessive sweating and water loss
watch for signs of lithium toxicity if you have an infection or have symptoms such as fever, vomiting or diarrhoea.
watch for signs of lithium toxicity if your regular dose of Lithicarb is increased or changed or if you start taking another medication.
You and your family should be able to recognise the signs of lithium toxicity and know what to do if they occur. If you are not already aware of the signs of lithium toxicity you should ask your doctor.
Use in children
Do not give Lithicarb to children.
Lithicarb is not recommended for children as there is no specific information about such use. Always ask your doctor before giving medicines to children.
Use in elderly
Elderly patients may be more sensitive to the effects or side effects of Lithicarb. If you are elderly you need to watch carefully for signs of side effects or lithium toxicity. Elderly patients may require a lower dosage than younger patients.
How to take Lithicarb
How much to take
Follow all directions given to you by your doctor or pharmacist carefully.
Your doctor will tell you how much Lithicarb to take. Take the amount your doctor tells you to.
The dose required to reach an effective level in the blood varies between individuals. For this reason the dose needs to be adjusted to suit you. The daily dose can vary between 250mg and 2000mg.
In the early stages of your treatment your doctor will arrange several blood tests to establish your blood level of lithium and the dose of Lithicarb that is correct for you. You will need to have regular blood tests to monitor your blood lithium level.
Your body's requirements of lithium may change and it may be necessary for your doctor to change the amount of Lithicarb taken to effectively control your mood swings.
How to take it
Lithicarb should be taken with a meal or snack to prevent stomach upset.
When to take it
Lithicarb is usually taken two or three times a day. In order for Lithicarb to work properly it is best if you can have the doses evenly spaced throughout the day. This is necessary to keep the amount of lithium in your blood constant.
Do not miss any doses and do not stop taking the medication even if you do feel better as this may make your symptoms worse.
How long to take it
Lithicarb is not a cure. To control mood swings you may need to take it for a long period of time. Only after several months or even years can you and your doctor decide whether taking Lithicarb is still necessary.
What to expect
When you start taking Lithicarb your mood swings should become less frequent, less severe and less prolonged.
Sometimes Lithicarb must be taken for one to several weeks before you begin to feel better. However, it may take six to twelve months before the full benefits of lithium therapy become apparent. To maximise its effectiveness it is most important that you take the prescribed dose of Lithicarb regularly.
If you forget to take it
If you miss a dose and it is more than two hours before your next dose is due, take it straight away, then continue as you normally would.
If it is less than 2 hours to your next dose, skip the dose you have missed but be sure to take the next dose when you are meant to.
Do not try to make up for missed doses by taking more than one dose at a time.
If you take too much (Overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Lithicarb. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
While you are taking Lithicarb
Things you must do
Lithium blood level tests
When you first start taking Lithicarb, you may require blood tests as often as twice a week. Once your lithium levels are stable, you should need tests about 4 times a year to check that your blood lithium level is stable. If your Lithicarb dose is changed or if you have signs of lithium toxicity you may need more frequent blood tests.
The blood test must be done twelve hours after a dose, usually before you have taken your morning tablets.
A level between 0.4 - 1.5 mmol/L is sufficient to control most people's mood swings.
Take Lithicarb exactly as your doctor has prescribed.
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Lithicarb.
Tell your doctor immediately if you become pregnant while taking Lithicarb.
Tell all doctors, dentists and pharmacists who are treating you, that you are taking Lithicarb.
Things you must not do
Do not give this medicine to anyone else, even if they have the same condition as you.
Do not stop taking Lithicarb suddenly. If you stop taking Lithicarb suddenly, your mood swings will return. If you want to stop taking Lithicarb, your doctor will tell you how to do it gradually over several weeks or months.
Things to be careful of
Be careful driving or operating machinery until you know how Lithicarb affects you. Lithicarb may cause drowsiness, poor co-ordination and blurred vision in some patients, especially when you first start to take it. Make sure you know how you react to Lithicarb before you drive a car, operate machinery, or do anything else that could be dangerous.
Be careful when drinking alcohol while you are taking Lithicarb. If you drink alcohol while you are taking Lithicarb, side effects such as drowsiness may become worse.
Side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Lithicarb. Lithicarb helps most people with mood swings or schizophrenia, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
stomach upset with mild nausea (feeling sick) and diarrhoea.
feeling dazed, dizzy or lightheaded
muscle weakness
fine tremor of the hands
fluid retention
thirst
passing more urine than is normal for you.
unusual tiredness or weakness
loss of appetite
vomiting
increased saliva
stomach pain
stomach problems with pain , nausea, vomiting, vomiting blood and blood in the bowel motions
constipation
slurred speech
slightly altered taste
dry mouth
headache
impotence
rash
worsening of skin diseases such as acne or psoriasis
numbness, tingling and colour change in fingers and toes when exposed to cold
These are all common side effects of Lithicarb. Most of these will improve or resolve with time.
When Lithicarb is taken for long periods of time the following side effects can occur:
thyroid changes (goitre)
weight gain
mild forgetfulness
hair thinning
Your doctor may suggest some dietary or lifestyle changes to help reduce these effects.
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following symptoms:
irregular heart beat
excessive thirst
passing large amounts of urine
severe stomach cramps or pain
vomiting or diarrhoea
severe drowsiness or dizziness
ringing in the ears
confusion
staggering and slurred speech
severe tremor
increased muscle twitches or weakness
blurred vision or agitation
swelling of the face, mouth lips, tongue or throat which may cause difficulty in breathing or swallowing
These are all serious side effects. They are possible signs of high levels of lithium in the blood (toxicity). You may need urgent medical attention or hospitalisation.
Tell your doctor if you notice anything else that is making you feel unwell. Some people may get other side effects while taking Lithicarb.
After taking Lithicarb
Storage
Keep Lithicarb tablets in a cool dry place where the temperature stays below 30 degrees C.
Do not store Lithicarb or any other medicine in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat and dampness can destroy some medicines.
Keep Lithicarb where young children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Disposal
If your doctor tells you to stop taking this medicine, or the expiry date has passed, ask your pharmacist what to do with any Lithicarb that is left over.
Product description
What it looks like
Lithicarb tablets are white, oval shaped tablets with 'Li / 250' on one side with the break bar and blank on the other. The tablets are available in bottles of 100.
Ingredients
Each Lithicarb tablet contains 250mg lithium carbonate as the active ingredient. Lithicarb also contains:
wheat starch
dextrin
lactose
macrogol 6000
sodium starch glycollate
talc
sodium lauryl sulphate
magnesium stearate
hypromellose
Distributor
Aspen Pharmacare Australia Pty Ltd
34-36 Chandos St
St Leonards NSW 2065
Australia
Australian Registration Number:
AUST R 49625
This leaflet was prepared in December 1998.
Last revised August 2008.