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Acetazolamide
July 16, 2009 | Leave a Comment
Generic Name
Acetazolamide (uh-sete-uh-ZOLE-uh-mide) [6j
Type of Drug
Carbonic-anhydrase inhibitor.
Prescribed For
Glaucoma and prevention or treatment of mountain sickness; also prescribed for epilepsy and treatment of drug-induced swelling or swelling due to congestive heart failure.
General Information
By blocking an enzyme in the body called carbonic anhydrase, acetazolamide produces a weak diuretic effect that helps to treat glaucoma by reducing pressure inside the eye. Acetazolamide’s antiseizure properties are also produced by its effect on carbonic anhydrase, though exactly how acetazolamide prevents seizure is not well understood.
Cautions and Warnings
Do not take acetazolamide if you are allergic or sensitive to any of its ingredients or to sulfa drugs.
Do not take acetazolamide if you have low blood sodium or potassium, diabetes, or serious kidney, liver, or Addison’s disease.
Possible Side Effects
Side effects of short-term therapy are usually minimal.
✓ Most common: nausea or vomiting; tingling feeling in the arms, legs, lips, mouth, or anus; appetite and weight loss; a metallic taste; increased frequency in urination; diarrhea; not feeling well; occasional drowsiness; and weakness. You may also experience rash, drug crystals in the urine, painful urination, low back pain, urinary difficulty, and low urine volume.
♦ Rare: Rare side effects can affect the liver, mental state, blood sugar, muscles, and senses. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Avoid over-the-counter drug products that contain stimulants or anticholinergics, which tend to aggravate glaucoma and cardiac disease.
• Acetazolamide may increase blood concentrations of cyclosporine (used to prevent the rejection of transplanted organs).
• Acetazolamide may block or delay the absorption of primidone (prescribed for seizure).
• Avoid aspirin because it may enhance acetazolamide side effects.
• Combining diflunisal and acetazolamide can result in an excessive lowering of eye pressure.
Food Interactions
Acetazolamide may be taken with food if it upsets your stomach. Because acetazolamide can increase potassium loss, take this drug with potassium-rich foods such as bananas, citrus fruits, melons, and tomatoes.
Usual Dose
Glaucoma
Adult: 250-1000 mg a day.
Child: 4.5-6.75 mg per lb. a day in divided doses.
Diuresis in congestive heart failure or drug-induced swelling Adult: 250-375 mg a day.
Child: 2.25 mg per lb., once daily in the morning.
Epilepsy: 375-1000 mg a day in divided doses.
Mountain Sickness: 500-1000 mg a day. If possible begin medication 24-48 hours before ascent.
Overdosage
Symptoms of overdose include drowsiness, loss of appetite, nausea, vomiting, dizziness, tingling in the hands or feet, weakness, tremors, or ringing or buzzing in the ears. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy—and take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acetazolamide may cause minor drowsiness and confusion, particularly during the first 2 weeks of therapy. Be careful when driving or doing any task that requires concentration.
Call your doctor if you develop sore throat, fever, unusual bleeding or bruises, tingling in the hands or feet, rash, or unusual pains.
Acetazolamide can increase sensitivity to the sun. Avoid prolonged sun exposure and protect your eyes while taking this drug.
Be sure to drink plenty of water or fluids while taking acetazolamide.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: High doses of this drug may cause birth defects or interfere with fetal development. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Small amounts of acetazolamide may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more sensitive to this drug’s side effects.