Acetazolamide

Generic name: Acetazolamide
Brand names: Diamox

Why is Acetazolamide prescribed?

Diamox controls fluid secretion. It is used in the treatment of glaucoma (excessive pressure in the eyes), epilepsy (for both brief and unlocalized seizures), and fluid retention due to congestive heart failure or drugs. It is also used to prevent or relieve the symptoms of acute mountain sickness in climbers attempting a rapid climb and those who feel sick even though they are making a gradual climb.

Most important fact about Acetazolamide

This drug is considered to be a sulfa drug because of its chemical properties. Although rare, severe reactions have been reported with sulfa drugs. If you develop a rash, bruises, sore throat, or fever contact your doctor immediately.

How should you take Acetazolamide?

Take Acetazolamide exactly as prescribed by your doctor.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Diamox.

More common side effects may include:
Change in taste, diarrhea, increase in amount or frequency of urination, loss of appetite, nausea, ringing in the ears, tingling or pins and needles in hands or feet, vomiting

Why should Acetazolamide not be prescribed?

Your doctor will not prescribe Acetazolamide for you if your sodium or potassium levels are low, or if you have kidney or liver disease, including cirrhosis.

Diamox should not be used as a long-term treatment for the type of glaucoma called chronic noncongestive angle-closure glaucoma.

Special warnings about Acetazolamide

Be very careful about taking high doses of aspirin if you are also taking Diamox. Effects of this combination can range from loss of appetite, sluggishness, and rapid breathing to unresponsiveness; the combination can be fatal.

If you have emphysema or other breathing disorders, use Acetazolamide with caution.

If you are taking Diamox to help in rapid ascent of a mountain, you must still come down promptly if you show signs of severe mountain sickness.

Possible food and drug interactions when taking Acetazolamide

If Diamox is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Diamox with the following:

Amitriptyline (Elavil)
Amphetamines such as Dexedrine
Aspirin
Cyclosporine (Sandimmune)
Lithium (Lithonate)
Methenamine (Urex)
Oral diabetes drugs such as Micronase
Quinidine (Quinidex)

Special information if you are pregnant or breastfeeding

The effects of Diamox during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Diamox may appear in breast milk and could affect a nursing infant. If Acetazolamide is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Diamox is finished.

Recommended dosage

ADULTS

This medication is available in both oral and injectable form. Dosages are for the oral form only.

Glaucoma

This medication is used as an addition to regular glaucoma treatment. Dosages for open-angle glaucoma range from 250 milligrams to 1 gram per 24 hours in 2 or more smaller doses. Your doctor will supervise your dosage and watch the effect of Acetazolamide carefully if you are using it for glaucoma. In secondary glaucoma and before surgery in acute congestive (closed-angle) glaucoma, the usual dosage is 250 milligrams every 4 hours or, in some cases, 250 milligrams twice a day. Some people may take 500 milligrams to start, and then 125 or 250 milligrams every 4 hours. The injectable form of Acetazolamide is occasionally used in acute cases.

The usual dosage of Diamox Sequels (sustained-release capsules) is 1 capsule (500 milligrams) twice a day, usually in the morning and evening.

Your doctor may adjust the dosage, as needed.

Epilepsy

The daily dosage is 8 to 30 milligrams per 2.2 pounds of body weight in 2 or more doses. Typical dosage may range from 375 to 1,000 milligrams per day. Your doctor will adjust the dosage to suit your needs; Diamox can be used with other anticonvulsant medication.

Congestive Heart Failure

The usual starting dosage to reduce fluid retention in people with congestive heart failure is 250 milligrams to 375 milligrams per day or 5 milligrams per 2.2 pounds of body weight, taken in the morning. Diamox works best when it is taken every other day--or 2 days on, 1 day off--for this condition.

Edema Due to Medication

The usual dose is 250 milligrams to 375 milligrams daily for 1 or 2 days, alternating with a day of rest.

Acute Mountain Sickness

The usual dose is 500 milligrams to 1,000 milligrams a day in 2 or more doses, using either tablets or sustained-release capsules. Doses of Acetazolamide are often begun 1 or 2 days before attempting to reach high altitudes.

CHILDREN

The safety and effectiveness of Diamox in children have not been established. However, doses of 8 milligrams to 30 milligrams per 2.2 pounds of body weight have been used in children with various forms of epilepsy.

Overdosage

There is no specific information available on Diamox overdose, but any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.