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Q. Can Lithium and Ibuprofen interaction result in neurological toxicity without kidney damage?

Answered by
Dr. Nagaraj Patil
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jun 30, 2020 and last reviewed on: Apr 12, 2021

Hi doctor,

I am a 27-year-old female. I have been taking Lithium 1200 mg for five years. Last year, I got an injury and it required regular pain management. So I was told to take Ibuprofen at a maximum dose. Within a week, I developed ataxia, muscle weakness, and spasticity, memory loss, polyuria, incontinence, tremors, blue hands, chest pain, weakness, and inability to lift my legs. I was referred for an evaluation for multiple sclerosis and Parkinson's disease. My symptoms began to get reduced when I stopped taking NSAIDS. I have prescribed them again at a maximum dose after surgery and I was hospitalized for the same symptoms. My kidney function was normal. I was unaware that NSAIDS can cause serious complications in lithium users by causing toxicity. My symptoms matched with the symptoms of lithium toxicity. But all the laboratory tests did not demonstrate any kidney problems. Is it possible to have neurological or lithium toxicity due to these medications without involving kidneys?

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Hi,

Welcome to icliniq.com.

It is purely drug to drug interaction and it is well known with lithium. In fact, lithium interacts with many drugs and it is one of the drugs having a narrow therapeutic index. The symptoms of lithium toxicity can develop even with the absence of kidney damage as they are mainly caused due to increased lithium concentration in blood. You have not mentioned the reason for taking Lithium. It is necessary to check your blood levels at regular intervals and do not take any medications without consulting the doctor.


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