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Lithium and NSAID during illness — GPhC CRA MCQ

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HardDrug InteractionsLithium and NSAID during illnessGPhC CRA

A woman taking lithium develops a chest infection and buys ibuprofen for fever. She has reduced oral intake and diarrhoea, and her last lithium level was 0.8 mmol/L. What is the most important interaction to flag?

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Correct answer: D — Ibuprofen and dehydration can increase lithium toxicity risk

NSAIDs can increase lithium levels, and acute illness with dehydration further increases toxicity risk. The pharmacist should advise avoiding ibuprofen, maintaining fluids where possible and seeking medical advice if unwell. Warning symptoms include tremor, diarrhoea, vomiting, ataxia and confusion.

Reference: BNF