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LISKONUM is a brand name for Lithium Carbonate. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Liskonum is a controlled-release tablet, designed to reduce fluctuations in serum lithium levels and the likelihood of adverse reactions. It is indicated for the treatment of acute episodes of mania or hypomania and for the prophylaxis of recurrent manic-depressive illness.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology:
Adults only: Liskonum should be given twice a day. Treatment of acute mania or hypomania Patients should be started on one or one-and-a-half tablets twice a day. 5 mmol/l. Serum concentration of lithium should be measured after four to seven days’ treatment and then at least once a week until dosage has remained constant for four weeks.
When the acute symptoms have been controlled, recommendations for prophylaxis should be followed.
Prophylaxis:
The usual starting dosage is one tablet twice a day. 0 mmol/l is maintained. Serum concentration of lithium should be measured after four to seven days’ treatment and then every week until dosage has remained constant for four weeks.
4). Blood samples for measurement of serum lithium concentration should be taken just before a dose is due and not less than 12 hours after the previous dose. Levels of more than 2 mmol/l must be avoided.
Elderly:
Use with caution. 4). The full prophylactic effect of lithium may not be evident for six to 12 months, and treatment should be continued through any recurrence of the illness.
Paediatric population:
The safety and efficacy of liskonum in children under 12 years of age have not yet been established and therefore is not recommended for use in this age group.
Method of Administration:
Oral. Planned Discontinuation of Liskonum Gradual withdrawal of lithium (over a period of at least 2 weeks) is recommended, as it may delay recurrence of the patient's underlying symptoms. 4).
Initial therapy:
Fine tremor of the hands, polyuria thirst and nausea may occur. The frequency classifications for these adverse reactions cannot be accurately estimated from the available clinical trial data.
Blood and lymphatic system disorders:
Leukocytosis Endocrine disorders: Euthyroid goitre, hypothyroidism, hyperthyroidism, hyperparathyroidism, parathyroid adenoma, parathyroid hyperplasia (frequency: not known) hypercalcaemia (frequency: very frequent) Metabolism and nutrition disorders: Hyperglycemia, hypercalcemia, weight gain, anorexia, polydipsia Psychiatric disorders: Hallucinations, somnolence, memory loss Nervous system disorders: Tremor, ataxia, peripheral sensorimotor neuropathy, hyperactive deep tendon reflexes, extrapyramidal symptoms, seizures, slurred speech, dizziness, vertigo, giddiness, nystagmus, stupor, coma, pseudotumor cerebri, dysgeusia, myasthenia gravis Eye disorders: Scotomata, blurred vision Cardiac disorders: Cardiac arrhythmia, of which bradycardia due to sinus node dysfunction is most frequent, and oedema.
ECG changes: reversible flattening and inversion of T-waves. Brugada syndrome (Unmasking/aggravation) (frequency: not known) Vascular disorders: Peripheral circulatory collapse, hypotension, Raynaud's phenomena Gastrointestinal disorders: Nausea, vomiting, diarrhoea, gastritis, excessive salivation, dry mouth Skin and subcutaneous tissue disorders: Alopecia, folliculitis, pruritus, psoriasis exacerbation, rash and other signs of skin hypersensitivity, acneiform eruptions, papular skin disorder.
Frequency not known: lichenoid drug reaction. Drug reaction with eosinophilia and systemic symptoms (DRESS) (frequency: not known) Musculoskeletal and connective tissue disorders: Muscle weakness, arthralgia, myalgia Renal and urinary disorders: Symptoms of nephrogenic diabetes insipidus, and after long-term therapy, histological renal changes (including tubulointerstitial nephropathy) and impaired renal function.
Vomiting, diarrhoea, intercurrent infection, fluid deprivation and drugs likely to upset electrolyte balance, such as diuretics, may all reduce lithium excretion and thereby precipitate intoxication; reduction of dosage may be required.
Use with care in elderly patients as lithium excretion may also be reduced. The possibility of hypothyroidism and of renal dysfunction arising during prolonged treatment should be borne in mind and periodic assessments made. Brugada syndrome Lithium may unmask or aggravate Brugada syndrome, a hereditary disease of the cardiac sodium channel with characteristic electrocardiographic changes (right bundle branch block and ST segment elevation in right precordial leads), which may lead to cardiac arrest or sudden death.
3). Caution is advised in patients with a family history of cardiac arrest or sudden death. Histological changes (including tubulointerstitial nephropathy) have been reported after long-term treatment with lithium. These changes may lead to impaired renal function.
It is unclear if these changes are always reversible on stopping lithium. It is advisable to monitor renal function periodically. Lithium therapy may lower the seizure threshold and increase the risks of neurological adverse effects following electroconvulsive therapy (ECT).
4-1 mmol/l) and a low electrical dose at the first treatment should be considered. Patients receiving neuroleptics concomitantly with lithium should be monitored closely for early evidence of neurologic toxicity and treatment discontinued promptly if symptoms appear.
On extremely rare occasions, the concurrent administration of lithium with neuroleptics may result in an encephalopathic syndrome, (characterised by delirium, seizures or an increased incidence of extrapyramidal symptoms) which may be similar to or the same as neuroleptic malignant syndrome.
In some instances, the syndrome was followed by irreversible brain damage. 8), of the urgency of immediate action should these symptoms appear, and also of the need to maintain a constant and adequate salt and water intake. Outpatients should be warned to take their medication at the stipulated time.
1. 4). Lithium should not be given to patients with low body sodium levels, including, for example, dehydrated patients, those on low sodium diets, or those with Addison's disease.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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4). g. QT/QTc prolongation. g. vomiting, diarrhoea. g. drowsiness, lack of co-ordination and/or a coarse tremor of the extremities and lower jaw may occur, especially with serum levels above the therapeutic range. Ataxia, giddiness, blurred vision, dysarthria, tinnitus, muscle hyperirritability, choreoathetoid movements peripheral neuropathy, hypoactive or absent deep tendon reflexes, and toxic psychosis have also been described.
If any of the above symptoms appear, treatment should be stopped immediately and arrangements made for serum lithium measurement. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
If a dose is missed, the patient should wait until the next scheduled time of dosing. A double dose to make up for the dose that has been missed should not be taken. 8). Acute renal failure has been reported rarely with lithium toxicity.
8). Patients with the rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take Liskonum. In patients who have undergone bariatric surgery, a lower maintenance dose of lithium may be required.
Lithium levels should be closely monitored due to the risk of lithium toxicity until weight has stabilized. Lithium should be used with particular care in the elderly since this group may be particularly susceptible to toxicity due to decreasing renal function and hence elimination (see Dosage and Administration).
Patients with bipolar disorder may experience worsening of their depressive symptoms and/or the emergence of suicidal ideation and behaviours (suicidality) whether or not they are taking medications for bipolar disorder. Patients should be closely monitored for clinical worsening and suicidality, especially at the beginning of a course of treatment, or at the time of dose changes.
Patients (and caregivers of patients) should be alerted about the need to monitor for any worsening of their condition and/or the emergence of suicidal ideation/behaviours or thoughts of harming themselves and to seek medical advice immediately if these symptoms present.