Which combination is an example of a Beers Criteria interaction to avoid involving lithium?

Which combination is an example of a Beers Criteria interaction to avoid involving lithium?

• A. Lithium + ACE inhibitors, ARBs, or ARNIs
• B. Lithium + acetaminophen
• C. Lithium + ibuprofen
• D. Lithium + statins

Answer: (A)

Beers Criteria highlights drug–drug interactions that raise adverse event risk in older adults. Lithium is cleared by the kidneys, so anything that affects renal function or sodium balance can raise lithium levels and increase toxicity risk. ACE inhibitors, ARBs, and ARNIs can alter kidney perfusion and sodium handling, which reduces lithium clearance and increases its reabsorption in the proximal tubule. This combination thus poses a clear risk and is the Beers Criteria interaction to avoid. Acetaminophen doesn’t meaningfully affect lithium levels; NSAIDs like ibuprofen can raise lithium toxicity risk through reduced clearance, and statins don’t have a direct lithium interaction, but the specific Beers Criteria example here is the combination with ACE inhibitors, ARBs, or ARNIs.

Beers Criteria highlights drug–drug interactions that raise adverse event risk in older adults. Lithium is cleared by the kidneys, so anything that affects renal function or sodium balance can raise lithium levels and increase toxicity risk. ACE inhibitors, ARBs, and ARNIs can alter kidney perfusion and sodium handling, which reduces lithium clearance and increases its reabsorption in the proximal tubule. This combination thus poses a clear risk and is the Beers Criteria interaction to avoid. Acetaminophen doesn’t meaningfully affect lithium levels; NSAIDs like ibuprofen can raise lithium toxicity risk through reduced clearance, and statins don’t have a direct lithium interaction, but the specific Beers Criteria example here is the combination with ACE inhibitors, ARBs, or ARNIs.