Check 12-hour trough level timing and local target before acting on a serum lithium result; random levels are misleading.
Dehydration, NSAIDs, ACEi/ARB and diuretics may precipitate toxicity; test renal, thyroid and calcium function and involve specialists.

Source documents: NHS SPS lithium monitoring

Unverified dose status: Additional teaching points are not a substitute for drug- and indication-specific BNF/BNFC, local formulary and pharmacist review; independent sign-off remains outstanding (4 November 2026).

🚨 High-alert / potentially serious prescribing error.

🩺 Common UK hospital use

Bipolar disorder

🔎 Before prescribing

Narrow therapeutic window; check eGFR, thyroid, sodium and interacting NSAIDs/ACEi/diuretics

⚠️ Main safety issue / monitoring

Toxicity with dehydration and renal decline

🧪 Mandatory prescription check: identity, indication, dose, route, formulation, age/weight, allergies, renal/hepatic function, pregnancy, interactions, time of last dose and required observations.

Do not use this card for dosing. Verify the current BNF/BNFC, MedicinesComplete and local NHS formulary before every prescription. For specialist/high-risk drugs use local clinical protocols and pharmacist or consultant review.

📖 Read the existing full Lithium article (legacy content; check currency).

Editorial status: Descriptive teaching summary, not dose-by-dose guideline verified. 3 November 2026.

🧬 How it works / why it matters

Class: Mood stabiliser. Complex neuronal signalling effects, including inositol metabolism modulation.

🧪 Practical prescribing check

Narrow therapeutic index; 12-hour levels, kidney/thyroid/calcium monitoring and dehydration/interaction risks are central.
Always distinguish the indication, specific formulation, route, renal/hepatic adjustments, pregnancy status and potential interactions before using a dose.

UK source-specific point: Lithium trough serum sampling is generally at 12 hours after the last dose; check renal function, thyroid function, calcium, fluids/sodium status and interaction risks. Prescribe by brand.

NHS SPS lithium monitoring (external source; verify current details).

Editorial review required: mechanism/monitoring notes are educational summaries, not a completed pharmacist-approved formulary.

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Lithium — FY prescribing 💊

💊 Lithium — quick prescribing card

🩺 Ward-round / on-call decision points

🩺 Common UK hospital use

🔎 Before prescribing

⚠️ Main safety issue / monitoring

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