英文药名: Eskalith CR(Lithium Carbonate)

中文药名: 碳酸锂缓释片

生产品牌药厂家: Glaxo Smith Kline
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药品名称

【通用名称】碳酸锂
【英 文 名】Lithium　Carbonate　Tablets
【成 份】碳酸锂
【性 状】本品为白色片。
药理毒理

本品以锂离子形式发挥作用，其抗躁狂发作的机制是能抑制神经末梢Ca2+依赖性的去甲肾上腺素和多巴胺释放，促进神经细胞对突触间隙中去甲肾上腺素的再摄取，增加其转化和灭活，从而使去甲肾上腺素浓度降低，还可促进5-羟色胺合成和释放，而有助于情绪稳定。
药代动力学

口服吸收快而完全,生物利用度为100%，表观分布容积(Vd)0.8L/kg，血浆清除率(CL)0.35ml/(min•kg)，单次服药后经0.5小时血药浓度达峰值。按常规给药约5～7日达稳态浓度,脑脊液达稳态浓度则更慢。锂离子不与血浆和组织蛋白结合，随体液分布于全身，各组织浓度不一，甲状腺、肾脏浓度最高，脑脊液浓度约为血浓度的一半。成人体内的半衰期(t1/2)为12～24小时，少年为18小时，老年人为36～48小时.本品在体内不降解，无代谢产物，绝大部分经肾排出，80%可由肾小管重吸收，锂的肾廓清率颇稳定为15～30ml/min，随着年龄的增加,排泄时间减慢，可低至10～15ml/min，消除速度因人而异，特别与血浆内的钠离子有关,钠盐能促进锂盐经肾排出，有效血清锂浓度为0.6～1.2mmol/L。可自母乳中排出.晚期肾病患者半衰期延长，肾衰时需调整给药剂量。
适 应 症

主要治疗躁狂症,对躁狂和抑郁交替发作的双相情感性精神障碍有很好的治疗和预防复发作用，对反复发作的抑郁症也有预防发作作用。也用于治疗分裂-情感性精神病。
用法用量

口服
成人用量按体重20～25mg/kg计算，躁狂症治疗剂量为一日600～2000mg，分2～3次服用，宜在饭后服，以减少对胃的刺激，剂量应逐渐增加并参照血锂浓度调整，维持剂量一日500～1000mg。
任何疑问，请遵医嘱！
不良反应

1、常见不良反应口干，烦渴，多饮，多尿，便秘，腹泻，恶心，呕吐，上腹痛。
2、神经系统不良反应有双手细震颤，萎靡，无力，嗜睡，视物模糊，腱反射亢进。
3、可引起白细胞升高。上述不良反应加重可能是中毒的先兆，应密切观察。
禁 忌

肾功能不全者，严重心脏疾病患者禁用。
注意事项

由于锂盐的治疗指数低，治疗量和中毒量较接近，应对血锂浓度进行监测，帮助调节治疗量及维持量，及时发现急性中毒。治疗期应每1～2周测量血锂一次，维持治疗期可每月测定一次。取血时间应在次日晨即末次服药后12小时。急性治疗的血锂浓度为0.6～1.2mmol/L，维持治疗的血锂浓度为0.4～0.8mmol/L，1.4mmol/L视为有效浓度的上限，超过此值容易出现锂中毒。脑器质性疾病、严重躯体疾病和低钠血症患者慎用本品。服本品患者需注意体液大量丢失，如持续呕吐、腹泻、大量出汗等情况易引起锂中毒。服本品期间不可用低盐饮食。长期服药者应定期检查肾功能和甲状腺功能。
孕妇及哺乳期妇女用药

妊娠头三个月禁用。哺乳期妇女使用本品期间应停止哺乳。
儿童用药

12岁以下儿童禁用。12岁以上儿童从小剂量开始，根据血锂浓度缓慢增加剂量。
老年用药

按情况酌减用量，从小剂量开始，缓慢增加剂量，密切关注不良反应的出现。
药物相互作用

(1)本品与氨茶碱、咖啡因或碳酸氢钠合用，可增加本品的尿排出量，降低血药浓度和药效。
(2)本品与氯丙嗪及其他吩噻嗪衍生物合用时，可使氯丙嗪的血药浓度降低。
(3)本品与碘化物合用，可促发甲状腺功能低下。
(4)本品与去甲肾上腺素合用，后者的升压效应降低。
(5)本品与肌松药(如琥珀胆碱等)合用，肌松作用增强，作用时效延长。
(6)本品与吡罗昔康合用，可导致血锂浓度过高而中毒。

Eskalith
Generic name: Lithium carbonate
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Why is Eskalith prescribed?
Eskalith is used to treat the manic episodes of manic-depressive illness, a condition in which a person's mood swings from depression to excessive excitement. A manic episode may involve some or all of the following symptoms:
Aggressiveness
Elation
Fast, urgent talking
Frenetic physical activity
Grandiose, unrealistic ideas
Hostility
Little need for sleep
Poor judgment
Once the mania subsides, Eskalith treatment may be continued over the long term, at a somewhat lower dosage, to prevent or reduce the intensity of future manic episodes.
Some doctors also prescribe lithium for premenstrual tension, eating disorders such as bulimia, certain movement disorders, and sexual addictions.
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Most important fact about Eskalith
If the Eskalith dosage is too low, you will derive no benefit; if it is too high, you could suffer lithium poisoning. You and your doctor will need to work together to find the correct dosage. Initially, this means frequent blood tests to find out how much of the drug is actually circulating in your bloodstream. As long as you take Eskalith, you will need to watch for side effects. Signs of lithium poisoning include vomiting, unsteady walking, diarrhea, drowsiness, tremor, and weakness. Stop taking the drug and call your doctor if you have any of these symptoms.
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How should you take Eskalith?
To avoid stomach upset, take Eskalith immediately after meals or with food or milk.
Do not change from one brand of lithium to another without consulting your doctor or pharmacist. Take the drug exactly as prescribed.
While taking Eskalith, you should drink 10 to 12 glasses of water or fluid a day. To minimize the risk of harmful side effects, eat a balanced diet that includes some salt and lots of liquids. If you have been sweating a great deal or have had diarrhea, make sure you get extra liquids and salt.
If you develop an infection with a fever, you may need to cut back on your Eskalith dosage or even quit taking it temporarily. While you are ill, keep in close touch with your doctor.
Long-acting forms of lithium, such as Eskalith CR or Lithobid, should be swallowed whole. Do not chew, crush, or break.
If you miss a dose.
Ask your doctor what to do; requirements vary for each individual. Do not take 2 doses at once.
Storage instructions...
Store at room temperature.
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What side effects may occur?
The possibility of side effects varies with the level of lithium in your bloodstream. If you experience unfamiliar symptoms of any kind, inform your doctor as soon as possible.
Side effects that may occur when you start taking lithium include:
Discomfort, frequent urination, hand tremor, mild thirst, nausea
Other side effects may include:
Diarrhea, drowsiness, lack of coordination, muscle weakness, vomiting
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Why should Eskalith not be prescribed?
Although your doctor will be cautious under certain conditions, lithium may be prescribed for anyone.
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Special warnings about Eskalith
Eskalith may affect your judgment or coordination. Do not drive, climb, or perform hazardous tasks until you find out how this drug affects you.
Your doctor will prescribe Eskalith with extra caution if you have a heart or kidney problem, brain or spinal cord disease, or a weak, run-down, or dehydrated condition.
Also make sure your doctor is aware of any medical problems you may have, including diabetes, epilepsy, thyroid problems, Parkinson's disease, and difficulty urinating.
You should be careful in hot weather to avoid activities that cause you to sweat heavily. Also avoid drinking large amounts of coffee, tea, or cola, which can cause dehydration through increased urination. Do not make a major change in your eating habits or go on a weight loss diet without consulting your doctor. The loss of water and salt from your body could lead to lithium poisoning.
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Possible food and drug interactions when taking Eskalith
If Eskalith is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Eskalith with the following:
ACE-inhibitor blood pressure drugs such as captopril or enalapril
Acetazolamide
Amphetamines such as dextroamphetamine
Antidepressant drugs that boost serotonin levels, including fluoxetine, paroxetine, and sertraline
Antipsychotic drugs such as chlorpromazine and haloperidol
Bicarbonate of soda
Caffeine
Calcium-blocking blood pressure drugs such as verapamil and diltiazem
Carbamazepine
Diuretics such as furosemide or hydrochlorothiazide
Fluoxetine
Iodine-containing preparations such as potassium iodide
Methyldopa
Metronidazole
Nonsteroidal anti-inflammatory drugs such as celecoxib, ibuprofen, indomethacin, and piroxicam
Phenytoin
Sodium bicarbonate
Tetracyclines
Theophylline
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Special information if you are pregnant or breastfeeding
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The use of Eskalith during pregnancy can harm the developing baby. If you are pregnant or plan to become pregnant, inform your doctor immediately.

Eskalith appears in breast milk and is considered potentially harmful to a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding while you are taking it.
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Recommended dosage for Eskalith
ADULTS
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Acute Episodes
The usual dosage is a total of 1,800 milligrams per day. Immediate-release forms are taken in 3 or 4 doses per day; long-acting forms are taken twice a day.
Your doctor will individualize your dosage according to the levels of the drug in your blood. Your blood levels will be checked at least twice a week when the drug is first prescribed and on a regular basis thereafter.
Long-term Control
Dosage will vary from one individual to another, but a total of 900 milligrams to 1,200 milligrams per day is typical. Immediate-release forms are taken in 3 or 4 doses per day; long-acting forms are taken twice a day.
Blood levels in most cases should be checked every 2 months.
CHILDREN
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Safety and effectiveness of Eskalith in children under 12 years of age have not been established.
OLDER ADULTS
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Older people often need less Eskalith and may show signs of overdose at a dosage younger people can handle well.
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Overdosage
Any medication taken in excess can have serious consequences. If you suspect symptoms of an overdose of Eskalith, seek medical attention immediately.
The harmful levels are close to those that will treat your condition. Watch for early signs of overdose, such as diarrhea, drowsiness, lack of coordination, vomiting, and weakness. If you develop any of these signs, stop taking the drug and call your doctor.