Effect of sodium polystyrene sulfonate on lithium bioavailability.

Author(s): Belanger DR, Tierney MG, Dickinson G

Affiliation(s): Department of Pharmacy Services, Ottawa General Hospital, Ontario, Canada.

Publication date & source: 1992-11, Ann Emerg Med., 21(11):1312-5.

Publication type: Clinical Trial; Randomized Controlled Trial

STUDY OBJECTIVE: To examine the effect of a single dose of sodium polystyrene sulfonate and sorbitol on lithium absorption. DESIGN: Prospective, randomized, crossover. SETTING: University teaching hospital. TYPE OF PARTICIPANTS: Healthy volunteers. INTERVENTIONS: Subjects ingested 600 mg lithium carbonate on two occasions, with and without 30 g concomitant sodium polystyrene sulfonate. Blood samples were drawn up to 24 hours after ingestion and assayed for serum lithium concentration. MEASUREMENTS AND MAIN RESULTS: Compared with control, sodium polystyrene sulfonate and sorbitol reduced the area under the lithium serum concentration-time curve by 11.33%, reduced the mean observed peak serum lithium concentration 0.07 +/- 0.08 mmol/L, and delayed the time to the mean observed peak serum lithium concentration by 2.04 +/- 2.40 hours. CONCLUSION: Sodium polystyrene sulfonate and sorbitol may be used in patients immediately or shortly after ingestion of a significant acute overdose of lithium in situations in which hemodialysis cannot be instituted promptly.