There is also some evidence that other nonsteroidal anti-inflammatory agents may have a similar effect. When such combinations are used, increased plasma lithium level monitoring is recommended. Concurrent use of metronidazole with lithium may provoke lithium toxicity due to reduced renal clearance. Patients receiving such combined therapy should be monitored closely. When such combinations are used, lithium dosage may need to be decreased, and plasma lithium levels should be measured more often.
Caution is recommended.
The following drugs can lower serum lithium concentrations by increasing urinary lithium excretion acetazolamide, urea , xanthine preparations and alkalinizing agents such as sodium bicarbonate.