Question 1

How can I lower the cost of my lithium

Accepted Answer

You can lower cost of your lithium using one of the 4 following drug savings programs: Rx Advantage Card for lithium, Canadian Prescription Savings for lithium, lithium Drug Coupons, lithium Patient Assistance Programs

Question 2

What dosages is lithium available in?

Accepted Answer

lithium is available as a 300 mg extended-release tablet.

Question 3

What is lithium used for?

Accepted Answer

lithium is a mood stablizer that is used in the treatment of manic episodes of bipolar disorder or the long-term maintenance treatment of bipolar disorder.

Question 4

How does lithium work?

Accepted Answer

lithium is a mood stabilizer. It’s not known exactly how lithium works, but it’s thought to affect the levels of certain chemicals in the brain that regulate mood.

Question 5

How do I take lithium?

Accepted Answer

The typical dose of lithium is 900 mg by mouth 2 times a day, or 600 mg 3 times a day. The total daily dose is 1,800 mg.
For long-term control: The typical dose is 600 mg by mouth 2 times a day. The total daily dose is 1,200 mg. Your provider will adjust your lithium dose based on if you have kidney problems, how well your bipolar symptoms are responding to the medication, if you’re having side effects, and your blood lithium level.

Question 6

Is it safe for me to take lithium?

Accepted Answer

lithium is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Question 7

lithium Common Side Effects

Accepted Answer

Common side effects of lithium:  Hand trembling Excessive urination More thirst Nausea General discomfort when you start treatment Tremor Muscle twitches Restlessness Vomiting Diarrhea

Question 8

lithium Serious Side Effects

Accepted Answer

Serious side effects are rare with lithium. Contact your healthcare provider immediately if you experience any of the following.  Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, distress, seizures, hallucinations, coma Lithium toxicity: trouble breathing, seizures, coma, kidney failure, abnormal heart rhythm, dizziness, confusion, blurry vision, poor balance, poor speech, poor coordination Kidney damage: more frequent urination, swelling in legs, fatigue High pressure in the brain and swelling in the eye: severe headaches behind eyes, ringing in the ears, blurred or double vision, and blindness Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren’t real), seizures, unconsciousness High blood calcium levels: fatigue, muscle weakness, loss of appetite, nausea, vomiting, constipation, bone pain, depression, confusion Brugada syndrome (life-threatening heart rhythm problem): abnormal ECG findings, unexplained fainting, and irregular heartbeat (palpitations)

Question 9

Effects of other drugs, drug classes and over-the-counter products on lithium

Accepted Answer

The following medications may interact with lithium:

Diuretic-, ACE-, and ARB-induced sodium loss may increase serum lithium concentrations. Start with
lower doses of lithium or reduce dosage, while frequently monitoring serum lithium concentrations and
signs of lithium toxicity
Concomitant administration of lithium with serotonergic drugs can precipitate serotonin syndrome. Monitor patients for signs and symptoms of serotonin syndrome, particularly during lithium initiation. Examples of serotonergic drugs include selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRI), and monoamine oxidase inhibitors (MAOI)
Concomitant administration of methyldopa, phenytoin, or carbamazepine with lithium may increase the risk of adverse reactions with these drugs

The following drugs can lower serum lithium concentrations: acetazolamide, urea, xanthine preparations, and alkalinizing agents such as sodium bicarbonate.

Concomitant extended use of iodide preparations, especially potassium iodide, with lithium may produce hypothyroidism
Concurrent use of calcium channel blocking agents with lithium may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus
Concurrent use with metronidazole may provoke lithium toxicity. Patients receiving such combined therapy should be monitored closely
Concurrent use of fluoxetine with lithium has resulted in both increased and decreased serum lithium concentrations. Patients receiving such combined therapy should be monitored closely

Nonsteroidal anti-inflammatory drugs (NSAIDs): lithium levels should be closely monitored when

patients initiate or discontinue NSAID use

Question 10

Who makes lithium?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is lithium safe in pregnancy?

Accepted Answer

lithium may cause fetal harm when administered to a pregnant woman. You should talk to your healthcare provider before taking this medication if you are pregnant.

Question 12

What is the brand name for lithium?

Accepted Answer

LITHOBID

Question 13

How can NowPatient help me to lower the cost of my lithium prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your lithium prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient lithium savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient lithium savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for lithium	Canadian Prescription Savings* for lithium	lithium Drug Coupon*	lithium Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of lithium?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for lithium	Canadian Prescription Savings* for lithium	lithium Drug Coupon*	lithium Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the lithium savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the lithium drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for lithium, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the lithium prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, lithium is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed lithium for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the lithium prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the lithium prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for lithium

If you are having trouble paying for your lithium medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for lithium you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
lithium is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers lithium
If lithium is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for lithium

If you are having trouble paying for your lithium medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for lithium you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers lithium
If lithium is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for lithium

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your lithium treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for lithium you will need to meet the following criteria:

You must be currently insured and have coverage for lithium
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.