NSAIDs and Lithium: Risks, Interactions, and What You Need to Know

When you take NSAIDs, nonsteroidal anti-inflammatory drugs used for pain, swelling, and fever. Also known as non-opioid pain relievers, they include common meds like ibuprofen, naproxen, and celecoxib. and lithium, a mood-stabilizing drug used primarily for bipolar disorder. Also known as lithium carbonate, it helps balance brain chemicals but has a very narrow safety window. together, you’re playing with fire. NSAIDs can cause your body to hold onto lithium like a sponge, pushing levels into the toxic range—even if you’ve been taking the same dose for years. This isn’t theoretical. Studies show NSAIDs can raise lithium blood levels by 25% or more, turning a safe treatment into a medical emergency.

Why does this happen? Your kidneys handle both drugs. Lithium gets filtered out slowly, and NSAIDs mess with that process by reducing blood flow to the kidneys. Less flow means less lithium gets flushed. The result? Lithium builds up. You might not feel anything at first. But then comes the warning signs: shaky hands, confusion, nausea, frequent urination, or even seizures. These aren’t side effects you can ignore. They’re red flags that your lithium level is dangerously high. People on long-term lithium therapy are especially at risk because their bodies have adapted to steady levels. A single extra dose of ibuprofen for a headache can throw that balance off.

This interaction doesn’t just affect one type of NSAID. It’s true for over-the-counter painkillers and prescription ones alike. Even topical NSAIDs like gels or patches can contribute, though the risk is lower. The same goes for aspirin—some people think it’s safe because it’s old and well-known, but it still interferes. And it’s not just about pain. If you’re on lithium for bipolar disorder, you might also be dealing with joint pain, migraines, or arthritis. That’s why so many patients end up combining these drugs without realizing the danger. Your doctor might not bring it up unless you ask. You need to be the one to flag it.

What should you do? First, never start or stop an NSAID without telling your prescriber. Second, keep a list of every medication and supplement you take—including herbal stuff like turmeric or ginger, which can also affect kidney function. Third, get your lithium levels checked more often when you start or stop an NSAID. Blood tests aren’t optional here—they’re lifesavers. If you need pain relief, talk to your doctor about safer options like acetaminophen (Tylenol), which doesn’t interfere with lithium the same way. But even that’s not risk-free if you’re taking high doses or have kidney issues.

Below, you’ll find real-world guides that break down exactly how these drugs behave in your body, what symptoms to watch for, and how to avoid dangerous mix-ups. You’ll see how other patients managed their pain while staying safe on lithium, what alternatives actually work, and why timing matters more than you think. This isn’t just about avoiding side effects—it’s about keeping your treatment effective and your life stable.