Q. My doctor reduced my Lithium dosage due to the creatinine levels. Why?

Answered by
Dr. Ashaq Hussain Parrey
and medically reviewed by iCliniq medical review team.
Published on Nov 20, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

I have been taking Lithium XR 400 mg twice a day and Valprol CR 300 mg twice a day for the last 19 years. I am also taking Geminor M1 once a day since the last two years. My local doctor checks regularly for my creatinine level and lithium level. My last report of creatinine was 1.36 mg/dL and lithium was 0.48 mmol/L. Now, my local doctor said it is too risky and reduced lithium dosage to 200 mg twice a day. I have no pressure or any other symptoms. But, I am worried what is going on.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome to icliniq.com.

I went through your post.

  • The normal range of lithium 12 hours after the last dose is 0.6 to 1.2. Your level is 0.48, which is already low. So, instead of decreasing the dose, you may need to increase it to maintain it at a therapeutic level. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.
  • Your creatinine of 1.36 is not that bad at 50 years of age. So, that is something you need not worry about. There is no risk with lithium at this creatinine. So, take a proper dose. 

Regards.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Perfect answer. But, I am confused that if I save my depression, then I will lose my kidney function and if I save my kidney, then I depression gets worse.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

  • Lithium can cause acute as well as chronic nephropathy. But, you need to do glomerular filtration rate (GFR), possibly a DTPA scan and a repeat KFT (kidney function test) after six weeks. If it is normal or same, then you can continue. Otherwise, if it rises, then you may have to stop and increase the Valprol dose. 

Regards.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Your answer is totally perfect because my local doctor also told that if the next report if creatinine is increased, we will increase the Valprol dose.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

  • Yes, that is what the guidelines for modifying treatment say so.
  • If possible, do a DTPA scan to see how well the kidneys are functioning at present. 

Regards.

For more information consult an internal medicine physician online--->https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Will my mood be covered by Valprol at this dose without any damage to any organs or the kidneys? What is the perfect diet for me?

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

Hello,

Welcome back to icliniq.com.

  • Valproic acid does not have any significant side effects related to kidneys and the dose of Valproic acid can be increased to 20 mg per kg per day.
  • A diet rich in fresh fruits and vegetables alone, with regular exercises, will improve the mood as well as keep the kidney functions normal.

Regards.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

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