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Lithium and NSAID — GPhC CRA MCQ

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HardDrug InteractionsLithium and NSAIDGPhC CRA

A 50-year-old man taking lithium for bipolar disorder presents a prescription for naproxen 500 mg twice daily for sciatica. His last lithium level was within range and eGFR is 62 mL/min/1.73 m2. What is the most important interaction to flag?

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Correct answer: D — Naproxen may increase lithium concentrations and toxicity risk

NSAIDs can reduce renal lithium clearance and increase lithium concentrations. This can precipitate toxicity, particularly with dehydration or renal impairment. The prescriber should consider alternatives and arrange closer lithium and renal monitoring if an NSAID is used.

Reference: BNF; NICE CKS