Priadel And Gliflozins

[Struma]

Does anyone have any experience or information of how these two drugs, Priadel (lithium carbonate) and gliflozins (canagliflozin/empagliflozin/dapagliflozin) work out when taken together?

I have searched fairly hard and come up with nothing. I am particularly concerned as to whether the kidneys end up suffering. Of course, I have read PIL's, but they haven't helped.

After here, I think I will try to contact drug companies themselves.

Thanks.

 

[Jenny15]

Does anyone have any experience or information of how these two drugs, Priadel (lithium carbonate) and gliflozins (canagliflozin/empagliflozin/dapagliflozin) work out when taken together?

I have searched fairly hard and come up with nothing. I am particularly concerned as to whether the kidneys end up suffering. Of course, I have read PIL's, but they haven't helped.

After here, I think I will try to contact drug companies themselves.

Thanks.

I know Lithium on its own can affect the liver, so regular LFT blood tests are usually done while taking it. The Blood Sugar 101 website in my signature has a lot of good info about diabetes meds so a search there may help. Or you could ask a doctor or pharmacist.

 

[SimonCrox]

Theere is a useful drug interactions checker:-

https://www.drugs.com/drug_interactions.html

And one could always Google the SPCs from the EMEA for each drug.

The inteactions checker states that the lithium itself may alter the glucose level but doesn't note any particular interaction known.

Given the increased risk of heart attack and stroke in bipolar disorder, using a diabetic agent that decreases the risk of vascular disease like empagliflozin seems a sensible idea.

The question hinges on renal function; in trials like EMPA-REG, and CANVAS, empagliflozin and canagliflozin preserved renal function which is invaluable; however, during intercurrent illness eg gastro-enteritis tummy bugs, there was an increased risk of renal impairment. If one gets lithium levels into the toxic range, then this can lead to dehydration and renal impairment which would be worsened by the empagliflozin.

One cannot be too careful about interactions with lithium, so if worried, it is eay to check a lithium blood level, and during tummy bugs, drink plenty of fluid and if you cannot keep your food and drink down, get medical advice that day.

The main meds to avoid with lithium are non-steroidal anti-inflammatory drugs eg ibuprofen which for some reason is still available over the counter and diuretics.

Best wishes

 

[Struma]

I know Lithium on its own can affect the liver, so regular LFT blood tests are usually done while taking it. The Blood Sugar 101 website in my signature has a lot of good info about diabetes meds so a search there may help. Or you could ask a doctor or pharmacist.

Thank you for your reply.
I have checked out Blood Sugar 101, it’s not a site I usually use.

 

[Struma]

Theere is a useful drug interactions checker:-

https://www.drugs.com/drug_interactions.html

And one could always Google the SPCs from the EMEA for each drug.

The inteactions checker states that the lithium itself may alter the glucose level but doesn't note any particular interaction known.

Given the increased risk of heart attack and stroke in bipolar disorder, using a diabetic agent that decreases the risk of vascular disease like empagliflozin seems a sensible idea.

The question hinges on renal function; in trials like EMPA-REG, and CANVAS, empagliflozin and canagliflozin preserved renal function which is invaluable; however, during intercurrent illness eg gastro-enteritis tummy bugs, there was an increased risk of renal impairment. If one gets lithium levels into the toxic range, then this can lead to dehydration and renal impairment which would be worsened by the empagliflozin.

One cannot be too careful about interactions with lithium, so if worried, it is eay to check a lithium blood level, and during tummy bugs, drink plenty of fluid and if you cannot keep your food and drink down, get medical advice that day.

The main meds to avoid with lithium are non-steroidal anti-inflammatory drugs eg ibuprofen which for some reason is still available over the counter and diuretics.

Best wishes

Thanks for your comprehensive reply. I feel our thoughts are quite in tune.
I am balking at having a gliflozin added into the pill-mix. I have done very well on Priadel the last few years, and I'm probably too protective of it! Yes, I've never had NSAID since being on it, but renal functioning is now 'straddling the fence' of impairment. Hence my enquiry.
I think the Dr's would put me on a gliflozin, stuff-up my kidneys properly, then say oh it’s lithium you'll have to come off it. For me, the BP is more of a priority than the diabetes.
Thanks again @SimonCrox