NEXOLITH SR-400 (Lithium Carbonate 400mg Tablets)

DESCRIPTION

NEXOLITH is a mood stabilizer and hence it is used for control of both manic and depressive episodes in manic depressive psychosis.

DOSAGE

Generally started at 600 mg per day or 15mg/kg body weight per day and gradually increased to yield therapeutic plasma levels; 900-1800 mg per day. The drug should be given in divided doses.

CLINICAL PHARMACOLOGY

NEXOLITH appears to stabilize nerve cells. Lithium accelerates reuptake of NA, causing a shift towards intra neuronal degradation. Lithium inhibits adenylate cyclase mediated responses to catecholamine release. Readily absorbed from GIT and peak plasma concentrations obtained within 2-4 hours. Distributed in the intra and extra cellular fluid. Excretion is mainly through the kidney but tubular re-absorption occurs if an adequate intake of salt is not maintained.

INDICATIONS

Acute hypomania, mania, recurrent mania and recurrent depressive episodes in MDP. Effective prophylactic for episodes of mania and depression in bipolar illness. NEXOLIITH can be used for impulsive control, aggressive behaviors, cluster headaches and cyclic neuropsychiatric disorders.

CONTRA INDICATIONS

Patients with renal disease, cardiovascular disease, Addison’s disease, pregnancy and hypersensitivity to the drug.

PRECAUTIONS

The ability to tolerate lithium is greater during the acute manic phase and decreases when manic symptoms subside. Blood level estimation should be carried out 4-5 days after starting medication and 4-5 days after a dose change. Lithium may impair mental and/or physical abilities, thus caution should be exercised if patient is engaged in activities requiring alertness (eg. Operating vehicles or machinery). Lithium may cause foetal harm when administered to a pregnant woman. If possible, lithium should be withdrawn for at least first trimester. Lithium is excreted in human milk. Nursing should not be undertaken during lithium therapy. Safety and effectiveness of lithium in children under 12 years not established.                                                                              

SIDE EFFECTS

Tremors, abdominal cramps, nausea, vomiting, muscle weakness, fatigue, sleeplessness and weight gain. These symptoms disappear on continuation of therapy. Goitre might occur in rare situations.

DRUG INTERACTIONS

Lithium may prolong the effects of neuromuscular blocking agents hence, neuromuscular blocking agents should be given with caution to patients receiving lithium. Serum lithium concentrations may increase during concomitant therapy with indomethacin or tetracycline. Caution should be used when lithium and diuretics or ACE inhibitors are used concomitantly.

OVER DOSAGE

Acute intoxication is characterized by vomiting, profuse diarrhea, coarse tremors, ataxia, coma and convulsions. The side effects involve mental confusion, giddiness, gross tremor, dysarthria, seizures, cardiac arrhythmia hypotension and albuminuria. The treatment consist of administration of osmotic diuretics or intravenous sodium bicarbonate solution. Dialysis is probably the most effective means.

AVAILABILITY

NEXOLITH is available in strips of  ten  sustained release uncoated tablets containing Lithium  Carbonate IP 400mg.