What is the therapeutic range for lithium in different conditions?

Acute mania: 0.8-1.2 mEq/L; maintenance (bipolar I): 0.6-1.0 mEq/L; augmentation for depression: 0.4-0.8 mEq/L; geriatric patients: 0.4-0.8 mEq/L due to reduced renal clearance.

What drugs increase lithium levels and cause toxicity?

NSAIDs (reduce renal clearance by 20-40%), ACEi/ARBs, thiazide diuretics, and dehydration all increase lithium levels; loop diuretics and acetazolamide reduce lithium levels.

What are signs of lithium toxicity at different levels?

Mild toxicity (1.5-2.5 mEq/L): nausea, tremor, ataxia; moderate (2.5-3.5 mEq/L): confusion, hyperreflexia, seizures; severe (>3.5 mEq/L): coma, arrhythmia, cardiovascular collapse; ESRD dialysis threshold 2.5-3.0.

How is lithium clearance estimated without a pharmacokinetics workup?

Lithium clearance ≈25% of CrCl (mL/min); approximate maintenance dose = target level × Cl_Li; actual levels should always be checked after any dose change, aiming for 12-hour trough sample.

What long-term renal effects does lithium cause?

Nephrogenic diabetes insipidus (polyuria/polydipsia) in 40%; chronic tubulointerstitial nephritis with progressive CKD occurs after decades of use; amiloride reduces NDI without reducing lithium levels.

Lithium Dose Adjustment and Target Level Calculator

Calculates lithium dosing based on creatinine clearance, serum level at steady state, target therapeutic window (0.6-1.0 mEq/L for maintenance), and acute intoxication management thresholds.

Use the full interactive calculator below, or

Related Calculators

Vancomycin Dosing

Medical Calculators

Renal Drug Dosing

Medical Calculators

Aminoglycoside Dosing

Medical Calculators

Lithium Dose Adjustment and Target Level Calculator

Related Calculators

Frequently Asked Questions

What is the therapeutic range for lithium in different conditions?

What drugs increase lithium levels and cause toxicity?

What are signs of lithium toxicity at different levels?

How is lithium clearance estimated without a pharmacokinetics workup?

What long-term renal effects does lithium cause?