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Safer lithium therapy

Reference number
0921
Central Alert System (CAS) reference
NPSA/2009/PSA005
Issue date01 December 2009
Action date (if applicable) (date field)31 December 2010
DH Gateway reference
13099
TypeAlert

Some patients taking lithium have been harmed because they have not had their dosage adjusted based on recommended regular blood tests. If patients are not informed of the known side effects or symptoms of toxicity, they cannot manage their lithium therapy safely.

 

Regular blood tests are important. Clinically significant alterations in lithium blood levels occur with commonly prescribed and over-the-counter medicines. The blood level of lithium is dependent on kidney function and lithium has the potential to interfere with kidney (renal) and thyroid functions.

 

All healthcare organisations in the NHS where lithium therapy is initiated, prescribed, dispensed and monitored are asked to ensure that by 31 December 2010:

 

  • patients prescribed lithium are monitored in accordance with NICE guidance;

 

  • there are reliable systems to ensure blood test results are communicated between laboratories and prescribers;

 

  • at the start of lithium therapy and throughout their treatment patients receive appropriate ongoing verbal and written information and a
    record book to track lithium blood levels and relevant clinical tests*; 

 

  • prescribers and pharmacists check that blood tests are monitored regularly and that it is safe to issue a repeat prescription and/or
    dispense the prescribed lithium; 

 

  • systems are in place to identify and deal with medicines that might adversely interact with lithium therapy.

 

* The NPSA has developed a patient information  booklet, lithium alert card and record book for tracking blood tests.

 

Ordering details

Supplies of the patient information booklet, lithium alert card and record book are available from the current NHS Forms and Print Contract. Orders can be placed as follows: 
 
Telephone 0845 610 1112
 
Email: nhsforms@mmm.com
 
If you have access to the electronic ordering system, you can place your orders this way (www.nhsforms.co.uk). This contract is managed by Kay Ellermeyer, National Programme Manager, NHS Print and Forms.  You can contact her via email kay.ellermeyer@nhs.net

Safer lithium therapy
Safer lithium therapy - 166 KB 0921 | Safer lithium therapy | lithium therapy | 2009-12-01 | v1
Safer lithium therapy supporting information
Safer lithium therapy supporting information - 241 KB NRLS A | Safer lithium therapy supporting information | lithium | 2010-01-12 | v1
Lithium record booklet
Lithium record booklet - 302 KB 0921B | Lithium record booklet | lithium | 2009-12-01 | v1
Lithium patient information booklet
Lithium patient information booklet - 610 KB 0921C | Lithium patient information booklet | lithium | 2009-12-01 | v1
Lithium patient information booklet (Welsh)
Lithium patient information booklet (Welsh) - 549 KB 0921D | Lithium patient information booklet (Welsh) | lithium | 2009-12-01 | v1
Lithium Alert card
Lithium Alert card - 85 KB 0921E | Lithium Alert card | lithium | 2009-12-01 | v1
NPA / NPSA Standard Operating Procedure for the Supply of Lithium Therapy by Community Pharmacy
NPA / NPSA Standard Operating Procedure for the Supply of Lithium Therapy by Community Pharmacy - 1.91 MB Joint guidance produced in collaboration with the National Pharmacy Association