dehydration
3 interactions related to dehydration
alcohol + lithium
Lithium has a narrow therapeutic window and is cleared almost entirely by the kidneys. Alcohol promotes urination and dehydration, which can reduce renal lithium clearance and push serum lithium levels higher — toward the toxic range (tremor, confusion, unsteadiness, vomiting). Alcohol also independently destabilizes mood in bipolar disorder, and its early intoxication signs can mask the early warning signs of lithium toxicity.
lithium + sodium
Lithium and sodium are handled by the same transporters in the kidney and compete for reabsorption. Eating much less sodium than usual causes the kidneys to hold on to both sodium and lithium, which can push lithium levels up toward toxicity; a sudden large increase in sodium can flush lithium out and drop it below the level needed to control mood. The amount of sodium matters less than keeping it steady.
alcohol + hydrochlorothiazide
Hydrochlorothiazide and alcohol both lower blood pressure and increase fluid loss, so taking them together can cause additive dizziness, lightheadedness on standing, and fainting. Both can also worsen loss of potassium and magnesium. The interaction is usually manageable at light drinking levels but becomes more significant in older adults, in hot weather, and during illness.