title: The effect of flurbiprofen on steady-state plasma lithium levels.
abstract: OBJECTIVE
  To evaluate the effects of flurbiprofen therapy on the pharmacokinetics of lithium.
  
  
  METHODS
  Placebo-controlled, single-blind, crossover study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Eleven healthy women with bipolar disorder.
  
  
  METHODS
  The subjects received therapeutic doses of lithium administered as an immediate-release capsule every 12 hours. In addition, they received one placebo tablet every 12 hours during phase I and flurbiprofen 100 mg every 12 hours during phase II of the study.
  
  
  RESULTS
  Steady-state pharmacokinetic parameters were measured for each phase. Lithium trough plasma concentration (Cmin) and area under the curve were statistically significantly increased (p < 0.05) when patients received flurbiprofen. Flurbiprofen also caused decreases in lithium clearance and 24-hour lithium urine excretion, although the changes did not reach statistical significance. Clinically significant increases in Cmin appeared to be associated with a greater than 1000-microgram/24 hour decrease in urinary excretion of prostaglandin E2.
  
  
  CONCLUSIONS
  Patients with clinically normal renal function may experience an increase in lithium levels with the initiation of flurbiprofen therapy.
authors.affiliation: School of Pharmacy, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298-0533, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Hughes
authors.forename: R E
authors.initials: RE
authors.lastname: Small
authors.forename: D
authors.initials: D
authors.lastname: Brink
authors.forename: N D
authors.initials: ND
authors.lastname: McKenzie
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D018692:Antimanic Agents / Q000097:blood* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy; D018592:Cross-Over Studies; D004347:Drug Interactions; D005260:Female; D005480:Flurbiprofen / Q000494:pharmacology*; D006801:Humans; D016651:Lithium Carbonate / Q000097:blood* / Q000627:therapeutic use; D016037:Single-Blind Method
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018692:Antimanic Agents; D016651:Lithium Carbonate; D005480:Flurbiprofen