- Toxicity closely related to serum concentrations and may occur at doses close to therapeutic levels
- Equipped Facilities should be identified prior to initiation of therapy to provide prompt and accurate serum concentration data
MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA
- Dosage must be individualized according to serum levels and clinical response. Regular monitoring of the patient's clinical state and serum lithium levels is necessary.
- Acute Mania: Desirable serum lithium levels are 1 to 1.5 mEq/L. Determine serum levels twice per week during acute phase, and until the serum levels and clinical condition have stabilized
- Long term control: Desirable serum lithium levels are 0.6 to 1.2 mEq/L. In uncomplicated cases receiving maintenance therapy, determine serum levels at least every two months.
- Blood samples for serum lithium determinations should be drawn immediately prior to the next dose when concentrations are relatively stable. Total reliance must not be based on serum levels alone. Patient evaluation is required.
Updated January 2018