aspirin or NSAID tolerance on lithium

[horselover65]

My psychiatrist has said to avoid NSAIDs and aspirin to avoid toxicity issues. My regular GP doc was not concerned about the aspirin content in combo drugs that I have taken (Soma compound and Fiourinal with codeine). When I asked the pharmacist, all she could tell me was that the instructions were to avoid aspirin. At what point does aspirin become a concern? Is an 81mg aspirin daily going to do anything? What about the 325mg (equivalent of ONE regular aspirin) that is in my combo drug? Since we changed my migraine medication, I am not getting any relief. I have taken it for nearly 15 years as needed and having headaches again is severely curtailling my activities - not to mention making me miserable. The Soma compound is important only because I had just filled a prescription before I started the lithium and since we don't have insurance, I have some fairly costly medication sitting around that I may not ever be able to use. Thank you in advance for any insight.

[horselover65]

Thank you. There are minimal amounts of aspirin in the Fiourinal and Soma compound, so I was very confused when one doc said one thing and the other doc said another. I don't usually listen to docs about meds. They often don't know much. I always talk to the pharmacist. Now, the pharmacists have these stupid little handheld computer things and there was no magic number in there.

I had NOT heard of an interaction with the Soma inhibiting uptake. I'll have to ask about that. Thanks a lot for that info.

I don't take either the Soma or the Fiourinal daily or anything like that. I have a chronic back problem and get a lot of injuries, so I always have some kind of muscle relaxer and pain medication on-hand. (I also go to acupuncture and have a portable TENS unit). The Fiorinal is the only thing we've found that works on my migraines and we have switched that to one with acetominophen and no codeine. Has a slightly different name, but it's the same combination substituting acetominophen and lacking codeine. Looks like the codeine will have to make a comeback, though.  (I think that was an oversight on the doctor's part anyway). There is a lot of substance abuse in my family, so I don't take any of the potentially addictive medications too often. Besides, the Fiourinal can lead to rebound headaches with over-use and it is sometimes upsetting to my stomach. I have irritable bowel syndrome, so I already have enough trouble in that dept.

I actually like this doc. Since about 2003 or thereabouts, I've had two before him that were so fixated on Lamictal that they couldn't see anything else. Huge waste of time and money. I'm trying to overcome a lot, above and beyond bipolar, so it's good to have someone who listens for a change. (One of the quack docs gave me sleeping pills for what is basically agoraphobia. Thought that was ridiculous).

thanks again!  

[monkeyc]

I am constantly amazed at the stuff psychiatrists say about lithium, I have no idea where this comes from.

Aspirin is in fact considered a safe NSAID for lithium patients in all the literature I have read, it does not cause an interaction and apparently nor does paracetemol or codeine from what I know.  You can also take ibuprofen (I do regularly because of gout) but you need to ensure you have increased fluid intake and should check with your doctors.

NSAID's are one class of drugs I can talk about with lithium as the gout requires them, basically most of them are bad becasue they can affect the way the kidneys function and cause toxicity and thus if you take them you need levels.

Fiornal is not an NSAID. It is an analgesic with aspirin, butalbital and caffeine in it and its considered a bad drug long term as its addictive.

You should be fine, aspirin not being an issue (I have no idea where this stuff comes from - Ive checked the Australia Prescriber Database and its not listed as an interaction with lithium either)

carisoprodol (soma) on the other hand does have a known interaction with lithium and may inhibit uptake of the drug.  Not to mention its highly addictive as well.

I would make sure if you take it to get your levels checked before just to be safe and get them checked regulary.

Im not a doctor so this should not be relied upon as medical advice.

[horselover65]

If anyone can help, I'd appreciate. I was actually trying to post this for a doctor, but I somehow ended up doing it here.
Thanks.