Trade Names:Acetazolamide- Tablets 250 mg- Powder for injection, lyophilized 500 mg
Trade Names:Diamox Sequels- Capsules, sustained-release 500 mgAPO-Acetazolamide (Canada)
Inhibits carbonic anhydrase enzyme, reducing rate of aqueous humor formation and thus lowering IOP; produces diuretic effect; retards neuronal conduction in brain.
Sustained release (SR) T max is 3 to 6 h. Immediate release (IR) T max is 1 to 4 h.
SR is 2 h; IR is 1 to 1.5 h; IV is 2 min.
SR is 3 to 6 h; IR is 1 to 4 h; IV is 15 min.
SR is 18 to 24 h; IR is 8 to 12 h; IV is 4 to 5 h.
Prevention or lessening of symptoms associated with acute mountain sickness (tablet only); adjunctive treatment of chronic simple (open-angle) glaucoma and secondary glaucoma; preoperative treatment of acute congestive (closed-angle) glaucoma; adjunctive treatment of 1) edema caused by CHF or drug-induced edema and 2) centrencephalic epilepsies (eg, petit mal, generalized seizures).
Hypersensitivity to other sulfonamides; depressed sodium and/or potassium serum levels; marked kidney and liver disease or dysfunction; suprarenal gland failure; hyperchloremic acidosis; adrenocortical insufficiency; severe pulmonary obstruction with increased risk of acidosis; cirrhosis; long-term use in chronic noncongestive angle-closure glaucoma. Sustained release dosage form is not recommended for use as anticonvulsant or for treatment of edema caused by CHF or drug-induced edema.
PO 500 to 1,000 mg per day in divided doses.Chronic Simple (Open-Angle) GlaucomaAdults
PO 250 mg to 1 g per day, usually in divided doses for amounts above 250 mg.Diuresis in CHFAdults
PO/IV Initially 250 to 375 mg (5 mg/kg) every morning; then give on alternate days or for 2 days alternating with 1 day of rest.Drug-Induced EdemaAdults
PO/IV 250 to 375 mg daily for 1 to 2 days, alternating with a day of rest.EpilepsyAdults
PO/IV 8 to 30 mg/kg per day in divided doses; optimum range 375 to 1,000 mg/day. When drug is given in combination with other anticonvulsants, initial dosage is 250 mg daily.Secondary Glaucoma/Preoperative Treatment of Closed-Angle GlaucomaAdults (short-term care)
PO 250 mg every 4 h or 250 mg twice daily.Acute care
PO Initially 500 mg; then 125 to 250 mg every 4 h. IV therapy may be used for rapid relief of increased IOP. Direct IV administration is preferred because IM route is painful.
Store sustained-release capsules at controlled room temperature (68° to 77°F). Store tablets and powder for injection at ambient room temperature (59° to 86°F). Store reconstituted injectable solution in refrigerator (36° to 46°F) for up to 3 days or use within 12 h of reconstitution if stored at room temperature (59° to 86°F).
May cause significant decrease in IOP.Primidone
Primidone concentrations may be altered.Quinidine
Quinidine serum levels may be increased.Salicylates
May cause acetazolamide accumulation and toxicity, including CNS depression and metabolic acidosis.
False-positive urinary protein results may occur because of alkalinization of urine.
Drowsiness; confusion; sensory disturbances, including paresthesia and loss of appetite; convulsions.
Skin rash; urticaria.
Transient myopia; hearing disturbances; sore throat; tinnitus.
Nausea; vomiting; diarrhea; melena; taste alterations.
Polyuria; hematuria; glycosuria.
Blood dyscrasias, including agranulocytosis and aplastic anemia; unusual bleeding or bruising.
Hepatic insufficiency; fulminant hepatic necrosis.
Metabolic acidosis; electrolyte imbalance.
Flaccid paralysis; fever; flank or loin pain; severe adverse reactions associated with sulfonamides, including Stevens-Johnson syndrome and toxic epidermal necrolysis; photosensitivity.
Withhold drug and notify health care provider immediately if any of the following symptoms occur: sore throat, fever, pallor, purpura, hematuria, unusual bleeding or bruising.IOP measurements
Ensure that for patient being treated for glaucoma that IOPs are measured and documented in the patient's record before starting therapy and periodically during therapy.
Category C .
Safety and efficacy not established.
Increasing dose does not augment diuresis but may increase drowsiness and paresthesias.
Use in pulmonary obstruction and emphysema may aggravate or precipitate acidosis.
Electrolyte imbalance, acidosis, CNS effects.
Copyright © 2009 Wolters Kluwer Health.