NSAIDs and Lithium: Risks, Interactions, and What You Need to Know
When you take NSAIDs, nonsteroidal anti-inflammatory drugs used for pain and inflammation, including ibuprofen, naproxen, and diclofenac. Also known as pain relievers, they help with headaches, arthritis, and muscle pain. and lithium, a mood stabilizer used for bipolar disorder that requires careful blood level monitoring. Also known as lithium carbonate, it helps prevent extreme mood swings. together, you’re not just adding two meds—you’re changing how your body handles one of them. The problem isn’t that NSAIDs make lithium less effective. It’s that they can cause lithium to build up to toxic levels in your blood, sometimes without you feeling any warning signs until it’s too late.
This happens because both drugs rely on your kidneys. Lithium is cleared through your kidneys, and NSAIDs reduce blood flow to them. Less blood flow means your kidneys can’t flush out lithium like they should. Even a few days of regular ibuprofen can push lithium levels up by 25% or more. That’s enough to cause tremors, confusion, nausea, or worse. People on long-term lithium often don’t realize their pain meds are putting them at risk. And it’s not just over-the-counter pills—prescription NSAIDs like celecoxib or naproxen carry the same danger.
Some people think switching to acetaminophen is safe, and it often is—but not always. If you have liver issues or take other meds, even acetaminophen can be risky. The real fix isn’t swapping one painkiller for another. It’s knowing when to avoid NSAIDs altogether and what alternatives actually work. For example, physical therapy, heat packs, or low-dose antidepressants like amitriptyline can help with chronic pain without touching your lithium levels. Your doctor might also adjust your lithium dose if you need short-term pain relief, but only after checking your blood levels.
It’s not just about avoiding pills. Dehydration makes this interaction worse. If you’re sick with the flu, sweating in hot weather, or cutting back on water to lose weight, your kidneys are already working harder. Add NSAIDs on top, and lithium can spike fast. That’s why people on lithium are told to drink plenty of fluids and avoid salty snacks or diuretics. Even a mild case of food poisoning can trigger lithium toxicity if you’ve been taking naproxen for back pain.
There’s a reason your pharmacist asks if you’re on lithium every time you pick up a new pain med. It’s not a formality—it’s a lifesaver. Many cases of lithium toxicity go undiagnosed because doctors assume symptoms are just the bipolar disorder flaring up. But tremors, slurred speech, or frequent urination could be your body screaming that your lithium level is too high. If you’ve been taking NSAIDs and notice any of these, stop the NSAID and call your doctor right away.
The posts below cover real-world cases, what doctors actually recommend, and how to talk to your provider about safer pain options without feeling dismissed. You’ll find guides on how to read your lab results, what blood tests matter most, and which medications are safest when you’re on lithium. Whether you’re managing bipolar disorder, chronic pain, or just trying to avoid a hospital visit, this collection gives you the facts you need to make smart choices—not guesses.
