Buy Eskalith Online

Eskalith Information

Introduction

Eskalith is a lithium carbonate formulation that belongs to the class of mood‑stabilising agents, often grouped with antidepressants because of its efficacy in preventing depressive relapses in bipolar disorder. In Hong Kong, Eskalith is prescribed primarily for the long‑term management of bipolar I disorder and, in some cases, for augmentation of treatment‑resistant unipolar depression. The active ingredient, lithium carbonate, exerts its therapeutic effect through multiple cellular pathways that stabilize neuronal signaling. While the product is manufactured under the Eskalith brand, the same active compound is available from other manufacturers under names such as Lithobid and generic lithium carbonate tablets.

What is Eskalith?

Eskalith is a tablet preparation containing lithium carbonate, a monovalent alkali metal salt. It was originally developed in the 197s as one of the first mood stabilisers approved for psychiatric use. The brand is produced by a series of licensed pharmaceutical companies; in many markets the label lists Novartis (or its successors) as the original developer, although production may be outsourced to contract manufacturers that meet international Good Manufacturing Practice (GMP) standards.

Eskalith is classified as a mood stabiliser and is listed among agents used for bipolar disorder management in the World Health Organization’s Anatomical Therapeutic Chemical (ATC) system (N05AN01). In Hong Kong, the Drug Office of the Department of Health registers Eskalith as a prescription‑only medication, reflecting the need for laboratory monitoring of blood lithium levels throughout therapy.

How Eskalith Works

Lithium carbonate’s exact mechanism of action remains partially understood, but several inter‑related biochemical effects have been documented:

• Modulation of second messenger systems – Lithium inhibits inositol monophosphatase, reducing the turnover of phosphatidylinositol bisphosphate (PIP₂). This dampens overactive intracellular signaling that can precipitate mood swings.
• Neuroprotective effects – Lithium enhances the expression of brain‑derived neurotrophic factor (BDNF) and glycogen synthase kinase‑3β (GSK‑3β) inhibition, promoting neuronal resilience and synaptic plasticity.
• Stabilisation of ion channels – By altering sodium and calcium channel function, lithium reduces neuronal hyperexcitability that is associated with manic episodes.

Clinically, these actions translate into a gradual onset of mood‑stabilising effect, typically emerging after 1–2 weeks of therapeutic dosing. The drug’s half‑life ranges from 18 to 36 hours, allowing once‑ or twice‑daily dosing. Steady‑state concentrations are usually achieved after 5–7 days of consistent administration, at which point serum lithium levels guide dose adjustments.

Conditions Treated with Eskalith

• Bipolar I Disorder (Manic and Depressive Phases) – Lithium remains the gold‑standard prophylactic agent for preventing both manic relapses and depressive recurrences. In Hong Kong, epidemiological data estimate that ≈.5 % of the adult population experiences bipolar disorder, creating a sizable patient base for Eskalith therapy.
• Bipolar II Disorder – Although less robust than in Bipolar I, lithium reduces the frequency of hypomanic and depressive episodes in Bipolar II patients.
• Treatment‑Resistant Unipolar Depression – As an augmentation strategy, low‑dose lithium can enhance the antidepressant response of SSRIs or tricyclic agents, particularly when other augmentation options have failed.
• Schizoaffective Disorder (Mood‑Dominant Subtype) – Lithium may be used adjunctively to control mood components of the illness.

The therapeutic benefit of Eskalith arises from its ability to smooth the extremes of mood, thereby improving functional outcomes, reducing hospitalisations, and lowering suicide risk—a critical concern in Hong Kong’s high‑density urban environment.

Who is Eskalith For?

Eskalith is most appropriate for adult patients (≥18 years) who meet the diagnostic criteria for bipolar disorder and who require long‑term mood stabilisation. Specific scenarios where Eskalith is frequently selected include:

• Patients with a clear history of manic episodes – Lithium’s anti‑mania potency makes it a first‑line choice.
• Individuals with a family history of lithium responsiveness – Genetic factors can predict better outcomes with lithium therapy.
• Patients who have experienced recurrent depressive episodes despite antidepressant monotherapy – Adding lithium can improve remission rates.

Conversely, Eskalith may be unsuitable for:

• Pregnant or lactating women – Lithium crosses the placenta and can cause fetal cardiac anomalies; alternative agents are preferred.
• Patients with severe renal impairment (eGFR < 30 mL/min/1.73 m²) – Lithium is renally excreted; reduced clearance raises toxicity risk.
• Individuals with uncontrolled thyroid disease – Lithium can exacerbate hypothyroidism; thyroid function must be stable before initiation.

A thorough assessment by a psychiatrist, combined with baseline laboratory testing, is essential before starting therapy.

Risks, Side Effects, and Interactions

Common

• Tremor – Fine, postural tremor is the most frequently reported neurologic effect.
• Gastrointestinal upset – Nausea, diarrhoea, or mild abdominal discomfort may occur, especially during dose escalation.
• Increased thirst and polyuria – Resulting from lithium’s effect on renal concentrating ability.

Rare

• Weight gain – Modest increases in body mass index have been observed in long‑term users.
• Erythema or mild skin rash – Usually self‑limiting and not a cause for drug discontinuation unless severe.

Serious

• Lithium toxicity – Manifested by severe tremor, ataxia, confusion, seizures, or cardiac arrhythmias. Toxicity typically correlates with serum levels >1.5 mmol/L.
• Nephrogenic diabetes insipidus – Chronic lithium exposure can impair renal concentrating function, leading to persistent polyuria and risk of dehydration.
• Thyroid dysfunction – Lithium may induce hypothyroidism; regular thyroid‑stimulating hormone (TSH) monitoring is required.
• Neuroleptic malignant‑like syndrome – Rare but life‑threatening condition characterised by hyperthermia, rigidity, and autonomic instability.

Drug–Drug Interactions

• Non‑steroidal anti‑inflammatory drugs (NSAIDs) – Reduce renal clearance of lithium, raising serum concentrations.
• Angiotensin‑converting‑enzyme (ACE) inhibitors and angiotensin‑II receptor blockers (ARBs) – Similar effect on renal excretion, increasing toxicity risk.
• Thiazide diuretics – Decrease sodium reabsorption, leading to higher lithium reabsorption and serum levels.
• Selective serotonin reuptake inhibitors (SSRIs) – May augment serotonergic activity, slightly increasing the risk of serotonin syndrome when combined with high lithium levels.
• Antiepileptic mood stabilisers (e.g., valproate, carbamazepine) – May require dose adjustments due to additive effects on central nervous system depression.

Patients should disclose all concurrent medications, including over‑the‑counter products and herbal supplements, to their prescriber.

Practical Use: Dosing, Missed Dose, Overdose

• Initial dosing – For most adults, treatment begins with 300 mg of lithium carbonate once daily, usually taken in the evening to minimise daytime tremor.
• Titration – Serum lithium levels are checked after 5–7 days. The dose is typically increased by 300 mg increments every 1–2 weeks until a therapeutic window of .6–1.2 mmol/L (maintenance) is achieved. Some patients require twice‑daily dosing (e.g., 300 mg BID) to smooth plasma peaks.
• Maximum dose – Most guidelines advise not to exceed 180 mg per day, although individual tolerability and serum levels dictate the ceiling.

Missed dose – If a single dose is forgotten and the next scheduled dose is more than 6 hours away, take the missed dose as soon as remembered. If it is almost time for the next dose, skip the missed one; do not double‑dose.

Overdose – Lithium overdose is a medical emergency. Early signs include severe vomiting, diarrhoea, and marked tremor. Immediate actions:

• Contact emergency services (HK emergency number 999).
• If the patient is conscious, avoid inducing vomiting.
• Hospital treatment may involve intravenous hydration, hemodialysis, and continuous cardiac monitoring.

Practical precautions –

• Food – Lithium can be taken with or without food; consistency in timing relative to meals helps maintain stable levels.
• Alcohol – Excessive alcohol can potentiate lithium’s neurotoxic effects and exacerbate dehydration; moderation is advised.
• Hydration – Adequate fluid intake (≈2 L/day) is essential; sudden changes in fluid volume can cause rapid shifts in serum lithium.
• Comorbidities – Chronic kidney disease, heart failure, or electrolyte disturbances require dose adjustments and more frequent laboratory surveillance.

Regular blood tests (baseline, then every 5–7 days during titration, followed by every 3 months in stable phase) are mandatory to ensure safety.

Buying Eskalith from Our Online Pharmacy

Patients in Hong Kong seeking a reliable source of Eskalith can obtain the medication through our online pharmacy.

• Affordable pricing – We source Eskalith directly from licensed overseas manufacturers, allowing us to offer prices close to the international market rate, often lower than local retail pharmacies.
• Verified quality – Every batch is inspected for authenticity, complies with GMP standards, and is accompanied by a batch‑specific Certificate of Analysis.
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Our service operates as a pharmacy‑broker model, partnering with overseas licensed pharmacies that hold the necessary regulatory approvals. This arrangement enables us to respect patient confidentiality while adhering to all relevant import regulations for personal medication use in Hong Kong.

FAQ

• Is Eskalith available in both brand‑name and generic forms in Hong Kong?
  Yes. Eskalith is the brand‑name tablet, while generic lithium carbonate tablets—often marketed under names such as Lithobid or simply “Lithium Carbonate”—are also approved. Both contain the same active ingredient and are therapeutically equivalent when dosed appropriately.

• What is the typical appearance of an Eskalith tablet?
  Eskalith tablets are round, film‑coated, and usually white or off‑white. The imprint varies by manufacturer but often includes “Eskalith” and the dosage strength (e.g., “300 mg”).

• Does lithium carbonate require refrigeration?
  No. Eskalith should be stored at controlled room temperature, between 15 °C and 30 °C, protected from excess moisture and direct sunlight. Refrigeration is not necessary and may affect tablet integrity.

• Can Eskalith be safely imported for personal use in Hong Kong?
  Personal import of a 30‑day supply of prescribed medication is permitted under Hong Kong customs regulations, provided the importer holds a valid prescription and the product meets the Hong Kong Health Authority’s quality standards. Our online pharmacy assists customers in complying with these requirements.

• Are there special warnings for Asian populations taking lithium?
  Some studies suggest that individuals of East Asian descent may experience higher serum lithium levels at comparable doses, possibly due to lower average body weight and differing renal clearance. Consequently, clinicians often start with a lower initial dose and monitor levels closely.

• How does food affect the absorption of Eskalith?
  Food modestly slows lithium carbonate absorption but does not significantly alter the overall bioavailability. Consistency is key; patients are advised to take the medication at the same time each day relative to meals to maintain stable plasma concentrations.

• What are the differences between United‑States and European formulations of lithium carbonate?
  The active ingredient is identical, but excipients such as binders, coatings, or fillers may vary. These differences rarely impact efficacy but can affect tolerability in patients sensitive to certain inactive ingredients (e.g., lactose).

• Is lithium testing required before starting Eskalith?
  Baseline laboratory assessment—including serum creatinine, estimated glomerular filtration rate (eGFR), thyroid‑stimulating hormone (TSH), and a baseline lithium level (usually  mmol/L)—is recommended to ensure renal and thyroid function are adequate for safe initiation.

• Can I travel internationally with Eskalith?
  Yes, provided you carry the medication in its original packaging, include a copy of the prescription or a doctor’s letter, and adhere to the maximum quantity allowed by the destination country's customs (often a 30‑day supply). Always check the specific regulations of the country you will be visiting.

• What should I do if I experience a sudden increase in thirst while on Eskalith?
  Increased thirst may signal rising lithium levels or developing diabetes insipidus. Contact your healthcare provider promptly for serum lithium testing and possible dose adjustment. Maintaining adequate hydration and avoiding excessive sodium loss (e.g., from prolonged sweating) can help mitigate this symptom.

• Do lithium carbonate tablets contain any allergens?
  Most formulations are free of common allergens such as gluten, soy, and dairy. However, excipients differ among manufacturers; patients with known hypersensitivities should review the full ingredient list supplied by the pharmacy.

Glossary

Therapeutic Window

The serum concentration range in which a drug provides maximal clinical benefit with minimal toxicity. For lithium, this is typically .6–1.2 mmol/L.

Nephrogenic Diabetes Insipidus

A condition where the kidneys become insensitive to antidiuretic hormone, leading to excessive urine output; it can be induced by chronic lithium exposure.

GSK‑3β (Glycogen Synthase Kinase‑3 Beta)

An enzyme involved in intracellular signaling; lithium’s inhibition of GSK‑3β contributes to its neuroprotective and mood‑stabilising effects.

Serum Lithium Level

The concentration of lithium measured in blood; used to guide dosing and monitor for toxicity.

⚠️ Disclaimer

The information provided about Eskalith is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Eskalith for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.