What is a potential effect of combining lithium (Eskalith) with acetazolamide (Diamox)?

Combining lithium (Eskalith) with acetazolamide (Diamox) can lead to an increased risk of toxicity due to the pharmacologic interactions between the two drugs. Acetazolamide is a carbonic anhydrase inhibitor that promotes bicarbonate excretion and can lead to metabolic acidosis, which in turn can affect lithium levels in the body.

Lithium is primarily excreted by the kidneys, and its clearance can be influenced by changes in renal function and electrolyte balance. Acetazolamide alters the acid-base balance and may decrease renal clearance of lithium, potentially leading to elevated serum lithium levels. This elevation increases the risk of lithium toxicity, which can manifest with symptoms such as tremors, confusion, ataxia, and nausea.

Thus, monitoring lithium levels becomes crucial when acetazolamide is prescribed alongside lithium therapy, making the understanding of this interaction vital for safe medication management.