Eskalith

(Lithium Carbonate)

The active ingredient in Eskalith is lithium carbonate. Although the exact mechanism of action is not fully understood, lithium works by affecting how neurotransmitters, the chemical messengers in the brain, send signals. It helps restore balance in the levels of serotonin, norepinephrine, and dopamine, which influence mood and behavior.

By stabilizing this chemical activity, Eskalith reduces manic symptoms such as hyperactivity, irritability, and racing thoughts, while also helping to prevent depressive episodes.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Eskalith. However, the following is a synopsis of the general guidelines for the use of Eskalith:

• Take Eskalith exactly as prescribed, usually two to three times daily, or as directed by your healthcare provider.
• The extended-release (Eskalith CR or Lithobid) tablets should be swallowed whole—do not crush, chew, or break them.
• Take doses at the same times each day, preferably with food to help reduce stomach upset.
• Stay well-hydrated and maintain a consistent salt intake. Sudden changes in fluid or sodium levels can affect how lithium is processed in your body.
• Your doctor will order regular blood tests to measure your lithium levels, kidney function, and thyroid function.
• Do not stop taking Eskalith suddenly unless instructed by your healthcare provider, as this can trigger a return of manic or depressive symptoms.

Some mild or common side effects of Eskalith include:

• Nausea or stomach upset.
• Increased thirst or urination.
• Weight gain.
• Tremor in the hands.
• Drowsiness or lightheadedness.
• Dry mouth.
• Swelling in the ankles or hands.

Some individuals may experience serious side effects while using Eskalith. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Signs of lithium toxicity include confusion, slurred speech, blurred vision, severe drowsiness, unsteady movement, muscle weakness, shaking, or vomiting.
• Irregular heartbeat, fainting, or dizziness (may indicate Brugada syndrome).
• Seizures.
• Vision changes or eye pain.
• Signs of hypothyroidism (fatigue, weight gain, hair loss, sensitivity to cold).
• Unusual bleeding, bruising, or signs of infection (possible blood abnormalities).
• Rash, hives, or swelling of the face or throat (allergic reaction).

These are not all of the possible side effects of Eskalith. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Eskalith, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Kidney disease or reduced kidney function.
• Heart problems, including Brugada syndrome or irregular heartbeat.
• Thyroid disorders.
• Severe dehydration or low sodium levels.
• A history of lithium toxicity.
• Neurological conditions such as seizures.
• A low-salt diet or the use of diuretics.
• Any history of serotonin syndrome from taking antidepressants.

Eskalith should not be used in individuals who:

• Have severe kidney disease or significantly impaired kidney function.
• Are dehydrated or have low sodium levels.
• Have known hypersensitivity to lithium or any component of the formulation.
• Have certain heart rhythm abnormalities, including Brugada syndrome.

Eskalith does not work immediately. Most patients begin to notice improvement in manic symptoms such as irritability, restlessness, or overactivity within 1 to 3 weeks of starting treatment.

For long-term stabilization and prevention of mood episodes, it may take several months for the full effects of lithium therapy to be realized. Regular follow-ups and blood tests help your healthcare provider fine-tune your dose for the best balance between effectiveness and safety.

When Eskalith is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• NSAIDs (such as ibuprofen and naproxen) may raise lithium levels and increase toxicity risk.
• Diuretics (water pills), including hydrochlorothiazide or furosemide, can cause dehydration and lithium buildup.
• ACE inhibitors and ARBs (such as enalapril) can increase lithium concentrations.
• Calcium channel blockers (such as verapamil) may alter lithium levels or increase neurological side effects.
• Antipsychotics, when combined with lithium, may increase the risk of tremors or neurotoxicity.
• SSRIs, SNRIs, or serotonergic drugs (such as tramadol, tryptophan, sumatriptan, or St. John’s Wort), which may increase the risk of serotonin syndrome.
• Sodium bicarbonate may lower lithium levels and reduce effectiveness.
• Anticonvulsants such as carbamazepine or phenytoin may increase the risk of side effects like dizziness or coordination problems.
• SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) can increase dehydration and lithium levels.
• Metronidazole may increase lithium concentration.

Eskalith is available in several dosage forms, including:

Immediate-release capsules: 150 mg, 300 mg, and 600 mg

Extended-release tablets (Eskalith CR or Lithobid): 300 mg and 450 mg

Your dose will depend on your age, kidney function, and the condition being treated. Blood test results will help your doctor adjust your dose to maintain safe and effective lithium levels.

Store at room temperature and keep out of reach of children.

Eskalith is manufactured by GlaxoSmithKline (GSK).

Yes. Generic versions of Eskalith are available under the generic name lithium carbonate. These generics are FDA-approved and considered equivalent in quality, strength, and effectiveness to the brand-name product.

Do not stop taking Eskalith without medical advice. Suddenly discontinuing lithium can cause your symptoms of bipolar disorder to return quickly or worsen.

If your doctor decides to end your lithium therapy, they will gradually reduce your dose over time while monitoring your mental health and lithium levels. If you experience signs of lithium toxicity or severe side effects, contact your healthcare provider immediately for instructions.

Lithium can increase the risk of certain birth defects, particularly heart abnormalities, if used during the first trimester. However, untreated bipolar disorder also carries risks for both mother and baby. It should only be used in life-threatening emergencies when no safer drug is available.

Lithium passes into breast milk and may affect a nursing infant. Because lithium can reach significant levels in breastfed babies, your healthcare provider will likely recommend avoiding breastfeeding while taking Eskalith or will closely monitor your baby’s blood levels and kidney function if continued.