CAMCOLIT-400MG TABS 100``S

Camcolit 400 contains lithium carbonate — a mood-stabilising mineral salt that has been one of the cornerstones of psychiatric treatment for over 50 years. It is used to control and prevent the extreme mood swings of bipolar disorder (manic-depressive illness), reducing both manic episodes (periods of abnormally elevated mood, impulsivity, and hyperactivity) and depressive episodes over the long term.

Lithium has a narrow therapeutic window — the difference between an effective dose and a toxic dose is small. This is why regular blood tests are essential throughout treatment to ensure levels remain in the safe range.

Approved Uses

•     Treatment and prevention (prophylaxis) of mania and manic episodes in bipolar disorder

•     Treatment and prevention of bipolar manic-depressive illness (both manic and depressive phases)

•     Prophylaxis of recurrent unipolar depression (in patients who have not responded to other treatments)

•     Reduction of aggressive or self-mutilating behaviour

Dosing

•     Acute mania (hospital initiation): 600–900 mg daily, then adjusted to achieve serum lithium 0.6–1.0 mmol/L (measured 12 hours after the last dose)

•     Prophylaxis (long-term): Usually 300–400 mg/day initially for 7 days; titrated to maintain serum lithium 0.4–0.8 mmol/L

•     Elderly: Lower doses; target serum level 0.4–0.7 mmol/L — toxic symptoms appear at lower concentrations

•     Children: NOT recommended

Administration

•     Usually taken twice daily with meals to reduce nausea

•     Once levels are stable, once-daily dosing at night may be appropriate — discuss with your doctor

•     Swallow tablets whole — do not crush

•     Blood samples MUST be taken exactly 12 hours after the last dose for accurate monitoring

•     Maintain consistent fluid intake and salt (sodium) intake — changes in either can dramatically alter your lithium level

If You Miss a Dose

•     Take it as soon as you remember — unless it has been more than 6 hours since the missed dose, in which case skip it and continue normally. Never double up.

Common (may affect more than 1 in 10 patients)

•     Excessive thirst and frequent urination — very common, affects 30–50% of patients

•     Fine hand tremor — common at the start, usually improves over time

•     Nausea, vomiting, diarrhoea — common initially, usually settles

•     Dry mouth, weight gain (with long-term use)

•     Mild cognitive effects — slight memory or concentration changes

Serious — Tell Your Doctor Immediately

•     Hypothyroidism (1–4% of patients): Monitor thyroid function regularly — lifelong therapy may be needed

•     Kidney damage: Monitor kidney function regularly, especially after 10+ years of use

•     Rare kidney tumours with very long-term use (over 10 years)

•     Do not take if you have severe kidney disease

•     Do not take if you have cardiac arrhythmias or Brugada syndrome (including family history)

•     Do not take if you have low sodium levels in the blood (hyponatraemia) — including from dehydration, low-salt diet, or Addison's disease

•     Do not take if you have untreatable hypothyroidism

•     Do not take while breastfeeding

•     Do not take if you are allergic to lithium

Pregnancy

Lithium in early pregnancy significantly increases the risk of cardiac malformations in the baby — particularly Ebstein's anomaly. Use only if benefits clearly outweigh the risks under specialist supervision. Cardiac monitoring of the fetus is recommended.

Breastfeeding

CONTRAINDICATED. Lithium passes into breast milk in significant amounts and can cause toxicity in the nursing infant.

Dehydration, Sweating, Diarrhoea

These conditions reduce sodium levels in the body, causing the kidneys to retain lithium — this can rapidly cause toxicity. Drink plenty of fluids and contact your doctor if you become unwell.

Diet

Maintain consistent salt (sodium) intake. Do not start a low-salt diet while on lithium without discussing with your doctor. Fasting, strict dieting, or excessive sweating (e.g. during intense exercise or hot weather) all change lithium levels.

•     NSAIDs (e.g. ibuprofen, diclofenac): Significantly increase lithium toxicity risk — avoid without medical supervision

•     ACE inhibitors (ramipril, lisinopril) and ARBs (losartan): Increase lithium levels — potentially fatal

•     Diuretics (water tablets): Increase lithium toxicity risk — including herbal diuretics

•     Metronidazole, trimethoprim, tetracyclines: Increase lithium levels

•     SSRIs (fluoxetine, paroxetine) and TCAs: Increased risk of neurotoxicity

•     Antipsychotics (haloperidol, clozapine): Increased risk of neurotoxicity and cardiac arrhythmias

•     Theophylline, high-sodium preparations: Decrease lithium levels, reducing effectiveness

•     Store below 25°C, away from moisture and light

•     Keep in the original container with the desiccant sachet

•     Keep out of reach of children

POM — Prescription Only Medicine. Initiation and dose adjustment must be performed by a specialist psychiatrist. Regular blood level monitoring and kidney/thyroid function tests are required throughout therapy.

•     Carry a lithium treatment card or medical ID stating you are taking lithium

•     Tell all healthcare providers (including dentists, surgeons, and A&E staff) that you take lithium

•     Avoid alcohol and recreational drugs

•     Drink at least 2 litres of water daily in hot weather or when exercising

•     Therapeutic range: Acute mania 0.6–1.0 mmol/L; Prophylaxis 0.4–0.8 mmol/L; Elderly 0.4–0.7 mmol/L — always measured 12 hours post-dose

•     Toxic levels: >1.5 mmol/L causes significant toxicity; >2.0 mmol/L is potentially fatal — treat as medical emergency

•     Baseline investigations: eGFR, thyroid function (TSH, FT4), ECG, FBC, serum calcium, weight

•     Monitoring schedule: Serum lithium every 3–6 months when stable; eGFR and TFTs annually (or 6-monthly if any decline)

•     Lithium is renally cleared — any reduction in renal function (dehydration, illness, new nephrotoxic drug) requires immediate reassessment of dosing

•     Drug alert: NSAIDs and ACE inhibitors are the most common causes of iatrogenic lithium toxicity — pharmacy-level screening is essential

•     Controlled-release formulation: do not substitute with immediate-release lithium without specialist guidance — bioavailability and dosing frequency differ

Q: Why do I need blood tests every few months?

A: Lithium has a very narrow range between a therapeutic dose and a toxic dose — blood tests are the only reliable way to confirm your levels are safe and effective. Even when you feel well, the test is essential to catch silent changes in kidney function or lithium accumulation.

Q: What should I do if I think I have lithium toxicity?

A: If you experience coarse tremor, confusion, drowsiness, slurred speech, or muscle twitching — stop taking Camcolit immediately and go to the nearest emergency department. Take your medication packaging with you.

Q: Can I drink alcohol while taking Camcolit?

A: Alcohol can worsen lithium side effects including dizziness and cognitive impairment, and dehydration from alcohol can increase lithium levels. You should avoid or significantly limit alcohol during lithium therapy.