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For anyone prescribed lithium, and for the family member who helps with medicines.

Drawing: The tablets, the blood level test, water, salt kept steady, hot weather, and the test dates. — The tablets, the blood level test, water, salt kept steady, hot weather, and the test dates.

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Patient's name Date Your lithium brand and dose Time of the night dose Next lithium level on Your target level

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The blood test

Lithium works only within a narrow range in the blood. Too little does not work. Too much is poisonous.
The sample is taken 12 hours after your last dose. Take the night dose as usual and give blood the next morning, before the morning dose.
At the start and after any dose change, the level is tested every week until it is steady. Then every 3 months for the first year, and every 3 to 6 months after that.
Kidney function, thyroid and calcium are tested every 6 months.

Every day

Take it at the same time each day. Stay on the same brand: different brands release lithium differently.
Missed a dose? If it is less than 6 hours late, take it. If it is later than that, skip it and take the next one at the usual time. Never take a double dose.
Drink fluids regularly, more in hot weather and after exercise or sweating.
Keep your salt intake steady. Do not start a low-salt diet without telling your doctor. Less salt makes the lithium level rise.
If you plan to fast, speak to your doctor first about fluids and the timing of doses.
Limit alcohol.

Medicines that raise the lithium level

Painkillers such as ibuprofen, diclofenac, aceclofenac, naproxen and nimesulide, and combination pain and cold tablets that contain them. Use plain paracetamol instead.
Blood pressure tablets ending in -pril or -sartan, and tablets that make you pass more urine. Do not stop these yourself: tell the doctor who prescribes your lithium, so that your level can be checked.
Some antibiotics, such as metronidazole
Tell every doctor and chemist that you take lithium before any new medicine is started.

Common effects at a normal level

Fine tremor of the hands, thirst, passing more urine, mild nausea, a metallic taste, some weight gain. Tell your doctor at the next visit.

Signs of too much lithium: take no more lithium and go to a hospital now

Vomiting again and again, or severe loose motions
Coarse shaking of the hands, or twitching muscles
Unsteady walking, as if drunk
Slurred speech
Drowsiness or confusion
Blurred vision
A fit, or collapse: call 108

Go to the nearest hospital with an emergency department and say that you take lithium. A lithium level is needed urgently.

Contact your doctor promptly if

You have fever, or mild vomiting or loose motions, without the signs above. Phone the doctor the same day, before your next dose: it may need to be paused.
You are pregnant, planning a pregnancy or breastfeeding. Lithium can affect the baby's heart. Use reliable contraception, and do not stop the tablet on your own.
You want to stop lithium. Stopping suddenly brings a high risk of relapse. It is reduced slowly, over at least 4 weeks.

Questions about this sheet? Call Caspian Healthcare reception on +91 89193 41154. A doctor is on duty at all hours for problems that are not critical. Caspian has no emergency department: in an emergency call 108.

Where this comes from

Prepared by Caspian Healthcare from the sources above. Last reviewed October 2026. General information: your own doctor's written instructions come first.