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INFORMATION FOR PATIENTS
PRIADEL TABLETS and PRIADEL 200 TABLETS
(lithium carbonate)

Please read this leaflet carefully before you start to take your medicine. This information is not designed to replace your doctors instructions but to guide you in the safe use of this medicine. If you would like to know more about Priadel Tablets ask your doctor or pharmacist.

About Priadel Tablets.
The name of your medicine is Priadel Tablets. The active ingredient is lithium carbonate. Priadel contains 400mg lithium carbonate per tablet and Priadel 200 contains 200mg lithium carbonate per tablet. Lithium carbonate is an antimanic medicine.
The tablets also contain Precirol, Imwitor (Priadel 200 only), mannitol, acacia powder, sodium lauryl sulphate, magnesium stearate, maize starch, Primojel.
Priadal and Priadel 200 are available in packs of 100 tablets.

How can Priadel help?
Priadel is used to control the symptoms of
1. Mania (a state of high excitability and exaggerated emotions) and hypomania (a mild form of mania).
2. Bipolar depression (where the mood changes between mania and depression) when treatment with other antidepressant drugs has not been successful.
3. Aggressive behaviour or intentional self?harm.
It is also used to prevent mood problems which occur frequently.
It is strongly recommended that you do not take Priadel while pregnant but if it is absolutely necessary, your doctor might decide to keep you on it.

Before taking Priadel.
If you are pregnant, intend to become pregnant or are breastfeeding you should discuss it with your doctor before taking Priadel.
Do not take Priadel if you have kidney or heart problems, Addison's disease or untreated hypothyroidism. It is all right to take Priadel if you have certain heart problems but your doctor will tell you whether or not it is suitable in your case.
If you are in any doubt about whether you have any of these conditions, do ask your doctor. Your doctor should check your kidney, heart and thyroid function before starting Priadel treatment.

Safe use of Priadel.
Your doctor should check your blood level of lithium not more than 5 days after starting treatment. It should
be checked every week until you have reached a constant blood level. When it is stable it is recommended that you have a blood test every three months. Blood tests should be taken exactly 12 or 24 hours after your last dose of Priadel.
It is recommended that you only take one type of medicine containing lithium but if you are taking others, your doctor should check your blood level before starling you on Priadel.
It is not advisable to go on a diet while taking Priadel as this may affect your blood lithium level. If you want to diet do consult your doctor first. It is also important to drink plenty of liquids, especially if you are in a hot environment, but avoid too much alcohol.
Do not take any other medicines, including those that you can buy without a prescription, without talking to your doctor or pharmacist (chemist) about it first.

Are there any drug interactions?
Priadel can interact with some other drugs. Diuretics (water tablets) can cause increased blood levels of lithium. If you need to take diuretics your doctor may have to lower your dose of Priadel while you are taking them.
Steroids should be avoided while taking Priadel. Other drugs which alter mood (psychotropics) can be taken at the same time as Priadel, but only low doses should be taken (your doctor will know what a low dose is for any particular drug).
Non-steroidal anti-inflammatory drugs (NSAIDS) can change lithium blood levels. If it is necessary to take them your lithium blood level should be checked more often than usual. The same applies if you stop taking NSAIDS. NSAIDS include drugs such as aspirin, ibuprofen, diclofenac etc; they are painkillers and can be used for headaches, period pain, toothache, arthritis and other types of pain.
There have been a few cases of interactions with Diazepam (used to treat anxiety, insomnia or as a muscle relaxant), methyldopa (for high blood pressure), tetracyclines (antibiotics), phenytoin and carbamazepine (for epilepsy), indomethacin (an NSAID, see details above) and drugs having the same method of action as indomethacin.
Because of the number of drugs which can interact with Priadel you should always talk to your doctor before taking other drugs with Priadel.

How to take Priadel Tablets.
The dose range for Priadel Tablets is between one and three tablets of Priadel a day or between two and six tablets a day of Priadel 200 (equivalent to 400 to 1200mg lithium carbonate a day). Ideally this dose should be taken once a day, either in the morning or on going to bed.
Do not crush or chew the tablets. Do not take the tablets with hot liquid. Take your dose at the same time each day. Do not change it without talking to your doctor first. If you forget to take a dose do not double the next dose; leave it out and continue taking your medicine at the usual dose. Do not stop taking Priadel without asking your doctor. Your illness may return if you do.
Priadel Tablets are not recommended for children.

What to do if you take too many Priadel tablets.
CONTACT A DOCTOR IMMEDIATELY AND SAY HOW MUCH HAS BEEN TAKEN,

Does Priadel have side effects?
There are some side effects which can occur in some but not all patents, especially at the start of treatment. Side effects are related to blood levels of lithium, and are not frequent at the recommended blood level (that is below 1 millimole per litre (mmol/l).
Mild side effects which can occur are: nausea, vertigo (dizziness), muscle weakness and a dazed feeling at the start of treatment but usually disappear when you reach a stable blood level. Side effects which can remain after this are light hand tremors, passing more urine than usual and mild thirst.
Weight gain or oedema may occur in some patients. Oedema is swelling, especially of the lower legs due to excess water in the body.
There have been a few reports of high blood levels of calcium and magnesium.
Some skin conditions including acne, psoriasis, generalised pustular psoriasis and leg ulcers have sometimes been aggravated by lithium treatment.
After several years treatment with lithium there is a risk of changed thyroid function, including overactive thyroid, under-active thyroid and goitre (a swelling at the front base of the neck). Memory problems may occur. Changes in your heart rate may occur, most commonly a slow heart beat.
It you notice any side effects not mentioned in this leaflet do tell your doctor or pharmacist as soon as possible.

Effects on the kidney.
Up to one-third of patients on lithium may pass more urine than usual. This usually returns to normal when you stop taking lithium. However, long term use of lithium can cause permanent changes in kidney function. This can usually be avoided if your kidney function is tested regularly by your doctor.
If your blood lithium level get too high you may begin to experience the symptoms of toxicity. These symptoms affect two main areas:
1. Stomach : lack of appetite, diarrhoea, vomiting.
2. Nervous system : muscle weakness, lack of coordination, drowsiness or lethargy, dizziness, difficulty in walking, tinnitus (ringing in the ears), blurred vision, difficulty in speaking, muscle twitching and shaking.
If you have any of these symptoms, contact your doctor or local hospital casualty department immediately. In this case you should stop taking Priadel and consult your doctor before starting it again.

Storage instruction
Keep this medicine in a cool dry place where children cannot reach it.
Do not take this medicine after the month shown on the pack.

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The Four Agreements
We Are Not Alone - July 2002
Written Words Of Life
Hanging On In Quiet Desperation
Depression Link
Becalmed and Bemused
Huddersfield One - Depression, December 2002
Innervisions page
The Roaring Silence
Chemical Kaleidoscope
The Void
Giving Up
Treading Water
Slowly SInking

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