Lithium Carbonate and Diuretics

…Lithium removal from the body is achieved almost exclusively via renal means. As a result, any medication that alters glomerular filtration rates or affects electrolyte exchange in the nephron may influence the pharmacokinetic disposition of lithium. Concomitant (伴隨的) use of diuretics has long been associated with the development of lithium toxicity, but the risk of significant interactions varies with the site of pharmacological action of the diuretic in the renal tubule. Thiazide diuretics have demonstrated the greatest potential to increase lithium concentrations, with a 25 to 40% increase in concentrations often evident after initiation of therapy…Loop diuretics and potassium-sparing agents have minor variable effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) have also been associated with lithium toxicity…A growing body of evidence also suggests that ACE inhibitors (a high blood pressure medication) may impair lithium elimination, but further investigations are needed to identify patients at risk…

CA;, F. P. M. (n.d.). Clinical relevance of drug interactions with lithium. Clinical pharmacokinetics. https://pubmed.ncbi.nlm.nih.gov/8521679/