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Eskalith (Lithium Carbonate) Buyer and Patient Handbook in South Africa

What is Eskalith?

Eskalith is a Lithium carbonate tablet used to stabilise mood in people with Bipolar Disorder. It belongs to the mood-stabilising class of psychotropic agents and is approved by SAHPRA (formerly MCC) for this indication. The medication is supplied as a solid oral pill, typically 300 mg per tablet.

Who Should Use Eskalith?

• Adults diagnosed with Bipolar I or II disorder who need long-term mood stabilisation.
• Individuals whose clinician has determined that lithium therapy is appropriate for managing Mania or preventing depressive episodes.
• Patients who can adhere to regular blood-level monitoring (lithium requires therapeutic drug monitoring).

How Does It Work?

Lithium carbonate acts on neuronal signaling pathways, reducing excessive firing in brain circuits that trigger mood swings. Think of it as a “traffic regulator” that slows down overstimulated signals, helping to keep mood on a steady road. While effective, lithium has a narrow therapeutic window, so regular blood tests are essential to avoid toxicity.

Why Choose Eskalith?

• Brand reliability: Eskalith is produced by a well-established pharmaceutical company and meets stringent quality standards.
• Proven track record: Clinical trials have shown lithium to be one of the most effective mood stabilisers for bipolar disorder.
• Cost-effective alternative: Generic lithium carbonate tablets are widely available in South Africa and provide the same clinical effect at a lower price.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• Typical adult maintenance dose: 300 mg taken once or twice daily, adjusted according to blood-level results.

How to Take

• Swallow the tablet whole with a full glass of water.
• Take the dose at the same times each day to maintain stable blood concentrations.

Missed Dose

• If you remember within 6 hours, take the missed tablet.
• If it is later than 6 hours, skip it and continue with the next scheduled dose-do not double-dose.

Overdose

• Seek emergency medical care immediately if a large amount is taken.
• Call 10111 (South Africa’s emergency number) and inform staff that lithium was ingested.

Special Populations

• Elderly: Start at a lower dose (e.g., 150 mg) and monitor closely.
• Renal impairment: Lithium is cleared by the kidneys; dose reduction and frequent blood-level checks are required.
• Pregnancy & breastfeeding: Use only if benefits outweigh risks; discuss with a healthcare professional.

Lifestyle & Diet

• Maintain adequate hydration; dehydration raises lithium levels.
• Avoid excessive salt intake, as low sodium can increase lithium concentration.
• Grapefruit juice does not significantly affect lithium, but limit alcohol as it can impair kidney function.

Precautions and Warnings

• Regular blood-level monitoring (typically every 2-4 weeks) is mandatory to keep lithium within the therapeutic range (.6-1.2 mmol/L).
• Do not use if you have uncontrolled thyroid disease, severe Renal Failure, or a known hypersensitivity to lithium.
• Inform your clinician about any changes in diet, fluid intake, or concomitant medications that affect kidney function.

Drug Interactions

Potential Side Effects

Common Side Effects

• Thirst, increased urination
• Tremor of hands
• Mild gastrointestinal upset (nausea, diarrhoea)

Less Common Side Effects

• Weight gain
• Mild cognitive slowing (foggy feeling)
• Skin rash

Serious Side Effects

• Lithium toxicity: confusion, severe tremor, slurred speech, rapid heartbeat - seek medical help immediately.
• Significant thyroid dysfunction (hypothyroidism) - requires lab monitoring.
• Renal impairment - monitor kidney function regularly.

Who Should Avoid This Medication?

• Patients with severe renal disease (eGFR < 30 mL/min/1.73 m²)
• Those with untreated hyperthyroidism or severe hypothyroidism
• Individuals with known allergy to lithium salts
• Patients taking other lithium-containing products

Storage Instructions

• Keep tablets in the original container, tightly closed.
• Store at room temperature (15-25 °C); protect from moisture and direct sunlight.
• Keep out of reach of children and pets.

Eskalith Alternatives

Frequently Asked Questions

How long does it take for Eskalith to start working?

Most people notice mood-stabilising effects within 1-2 weeks, but full benefit may require 4-6 weeks of consistent use.

Can I drink coffee while taking Eskalith?

Moderate coffee intake is generally safe, but excessive caffeine can increase urine output and potentially affect lithium levels. Keep hydration steady.

Is Eskalith safe to use with my blood-pressure medication?

Some antihypertensives (especially ACE inhibitors) can raise lithium concentrations. Your clinician should monitor lithium levels when these drugs are combined.

What should I do if I feel a tremor after starting Eskalith?

A mild tremor is common; if it interferes with daily activities, contact your clinician for possible dose adjustment.

Does Eskalith cause weight gain?

Weight gain can occur in a minority of users. Maintaining a balanced diet and regular exercise can help manage this side effect.

Can I become pregnant while on Eskalith?

Lithium crosses the placenta and may increase the risk of cardiac defects in the fetus. Discuss family planning with your clinician to weigh risks and benefits.

How often must my blood be tested?

Initially, lithium levels are checked weekly until stable, then typically every 2-4 weeks, and less frequently once a stable dose is confirmed.

What happens if I miss a dose for several days?

Lithium levels will fall, potentially leading to mood destabilisation. Resume the prescribed dose under clinician guidance and arrange an earlier blood-level check.

Are there any foods I must avoid?

No specific foods are prohibited, but maintain consistent salt intake and stay well-hydrated to keep lithium levels steady.

Can Eskalith be taken on an empty stomach?

It can, but taking it with a light meal may reduce gastrointestinal discomfort for some people.

Glossary

• Therapeutic window: The blood-level range where a drug is effective without being toxic.
• Neuronal firing: Electrical activity of brain cells that transmits signals.
• Blood-level monitoring: Laboratory test measuring the concentration of lithium in the blood.

Disclaimer

The information provided here is for general educational purposes only and does not constitute medical advice. Off-label use, dosage adjustments, and monitoring should be discussed with a qualified healthcare professional. Our online pharmacy service facilitates the purchase of legally approved medicines in South Africa, but the ultimate responsibility for safe medication use rests with the individual user. Always consult a doctor or pharmacist before starting, changing, or stopping any medication.