Lithium Orotate and medications.
Lithium Orotate is classified as a targeted supplement in the Distil database, evidence Grade C. The page below lists every medication we have explicitly assessed it against.
Lithium orotate is a low-dose lithium supplement marketed for neuroprotection and mood. It is entirely distinct from pharmaceutical lithium carbonate, which is dosed two orders of magnitude higher, and that distinction has to be made clear on any product. The evidence is Grade C and thin. There is an epidemiological signal linking higher water lithium to lower dementia rates, and one clinical study, but that study used a 300 microgram microdose of lithium chloride in people who already had Alzheimer's, not the orotate form and not a prevention trial in healthy people. There is no established supplement dose and no RCT at the doses sold. Commercial products of around 5mg elemental lithium are unstudied and roughly seventeen times that studied microdose, and the orotate form may deliver more lithium than the chloride used in the trial, so treat any dose as uncertain and use the lowest available product dose with clinician awareness. Lithium has a narrow therapeutic window, which is why the dose question matters. Treat it as emerging and an informed personal choice, not an established recommendation. Several exclusions are firm. Anyone on prescribed lithium must not add it, because the load is additive and needs psychiatrist sign-off, and it is excluded in CKD stage 3 or worse since lithium clearance is renal. The interaction list matters: thiazide diuretics, ACE inhibitors, ARBs and NSAIDs all raise lithium retention, and SSRIs or SNRIs add serotonergic risk. Monitor renal function and TSH on longer-term use, and avoid in pregnancy.
Below are the 16 documented pairs we have explicitly assessed for Lithium Orotate: 1 red and 15 amber. The pairs cluster around 2 mechanisms: Additive lithium load and Reduced renal lithium clearance. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 5 August 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive lithium load
Red Does interact with Lithium carbonate?
We do not recommend taking a lithium supplement alongside prescribed lithium. Prescribed lithium is dosed against regular blood tests, and the gap between a helpful level and a toxic one is narrow. Supplemental lithium is not measured by those tests and is not part of the dose your psychiatrist set. At the roughly 5mg found in supplements the added amount is small, so this is not a warning about immediate harm: it is that the whole basis of lithium treatment is a level someone is controlling, and this adds to it uncontrolled. Talk to your prescriber before starting or stopping anything.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Reduced renal lithium clearance
Amber Does interact with Bendroflumethiazide?
Thiazide water tablets such as bendroflumethiazide make the kidneys hold on to lithium and have the strongest lithium-raising effect of these medicines. With prescription lithium this is a recognised cause of toxicity. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take a thiazide diuretic, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Candesartan cilexetil?
Angiotensin receptor blocker blood pressure tablets such as candesartan can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this has caused toxicity in reported cases. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take one of these blood pressure tablets, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Celecoxib?
Anti-inflammatory painkillers such as celecoxib can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Diclofenac sodium?
Anti-inflammatory painkillers such as diclofenac can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Enalapril maleate?
ACE inhibitor blood pressure tablets such as enalapril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Etoricoxib?
Anti-inflammatory painkillers such as etoricoxib can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Ibuprofen?
Anti-inflammatory painkillers such as ibuprofen can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Indapamide?
Thiazide-like water tablets such as indapamide make the kidneys hold on to lithium and have the strongest lithium-raising effect of these medicines. With prescription lithium this is a recognised cause of toxicity. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take a thiazide-like diuretic, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Irbesartan?
Angiotensin receptor blocker blood pressure tablets such as irbesartan can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this has caused toxicity in reported cases. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take one of these blood pressure tablets, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Lisinopril?
ACE inhibitor blood pressure tablets such as lisinopril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Losartan?
Angiotensin receptor blocker blood pressure tablets such as losartan can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this has caused toxicity in reported cases. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take one of these blood pressure tablets, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Naproxen?
Anti-inflammatory painkillers such as naproxen can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Perindopril erbumine?
ACE inhibitor blood pressure tablets such as perindopril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Ramipril?
ACE inhibitor blood pressure tablets such as ramipril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Sacubitril/valsartan?
Sacubitril-valsartan (a heart-failure tablet that contains an angiotensin receptor blocker) can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this type of medicine has caused toxicity in reported cases. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. Check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
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