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. In Great Britain lithium is not one of the minerals allowed in food supplements, so lithium orotate should not be on sale here as one, although you may still see it sold, and the duty to follow that rule sits with the seller, not with you. It is entirely distinct from pharmaceutical lithium carbonate, which is prescribed at doses carrying many times more lithium, 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 a handful of controlled trials of low prescription doses in people with memory problems or dementia, including the one our grade rests on, which gave a 300 microgram daily microdose of lithium chloride to people who already had Alzheimer's; none used the orotate form or tested prevention in healthy people. There is no established supplement dose, and the doses sold have barely been tested: one short controlled trial of a lithium supplement, lithium aspartate at 10 to 15mg a day for three weeks in people with long COVID, found no benefit, and none has tested the orotate form. Commercial products of around 5mg elemental lithium carry about seventeen times the lithium of that Alzheimer's microdose, or about a hundred times if its 300 micrograms was the weight of the salt rather than of the lithium. The other reports of people taking lithium supplements, the orotate form included, are uncontrolled. The orotate form may also deliver more lithium than the chloride used in that Alzheimer's trial, so if you already take it, treat any dose as uncertain and keep to the lowest product dose with your clinician aware. Lithium has a narrow therapeutic window, which is why the dose question matters. Treat the evidence as emerging, not as 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 18 documented pairs we have explicitly assessed for Lithium Orotate: 1 red, 15 amber, and 2 green. 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 28 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 Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Green Does Lithium Orotate interact with Lamotrigine?
The reason we hold back a lithium supplement alongside prescribed lithium is that prescribed lithium is dosed against blood tests and supplemental lithium is not measured by them, and that argument is about lithium itself rather than about lamotrigine, so our curated interaction database records no interaction between lithium orotate and lamotrigine. Lamotrigine is cleared by a liver conjugation step, and lithium is an inorganic salt that the body does not metabolise at all, so the two travel separate routes. If you take lamotrigine it is still sensible to tell your prescriber about any supplement you start, because they are managing the whole picture.
Evidence: No direct study of this exact combination yet; the assessment rests on what is known about each of the two.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Green Does Lithium Orotate interact with Sodium valproate?
The reason we hold back a lithium supplement alongside prescribed lithium is that prescribed lithium is dosed against blood tests and supplemental lithium is not measured by them, and that argument is about lithium itself rather than about valproate, so we treat this pair as safe to combine. Full prescription-strength lithium is routinely given alongside valproate in bipolar care and has been studied that way for up to two years, and the lithium in a supplement is a small fraction of a prescribed dose. If you take valproate it is still sensible to tell your prescriber about any supplement you start, because they are managing the whole picture.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Reduced renal lithium clearance
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Lithium Orotate 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: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
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