Drug General Information (ID: DDIX0IBKLJ)
Drug Name			Tromethamine		Drug Info		Lithium carbonate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Genitourinary Tract Agents				Antimanic Agents
Structure

Mechanism of Tromethamine-Lithium carbonate Interaction (Severity Level: Moderate)
Altered urine pH Click to Show/Hide Mechanism Graph
Drug Name		Tromethamine				Lithium carbonate
Mechanism		Urine alkalinizer Increase renal excretion				Urine pH sensitive
Key Mechanism Factor 1
		Factor Name		Urine pH
		Factor Description		The normal range of urine pH is between 4.5 and 8, depending mainly on the hydrogen ion concentration. Changes in urine pH may significantly affect drug reabsorption and excretion.
Mechanism Description		Altered elimination of Lithium carbonate caused by Tromethamine mediated altered urine pH

Recommended Action
Management		Monitoring of lithium concentrations and therapeutic effect is recommended during concurrent use.

References
1	Parfrey PS, Ikeman R, Anglin D, Cole C. Severe lithium intoxication treated by forced diuresis. Can Med Assoc J. 1983 Nov 1;129(9):979-80
2	Arthur RK "Lithium levels and "Soda Bic"." Med J Aust 2 (1975): 918
3	Thomsen K, Schou M "Renal lithium excretion in man." Am J Psychol 215 (1968): 823-7