Type of Drug:

Anticonvulsant; diuretic or “water pill”; antiglaucoma drug; carbonic anhydrase inhibitor.

How the Acetazolamide Product Works:

Anticonvulsant: Prevents or reduces seizures by slowing abnormal nerve impulses in the brain and central nervous system.

Diuretic: Reduces amount of fluid in the body by increasing urine formation.

Antiglaucoma: Reduces pressure in the eyes by decreasing the formation of fluid inside the eye.

Uses of The Acetazolamide:

To treat petit mal and un localized seizures.

To treat edema (excess fluid in tissues) which may accompany congestive heart failure, other circulatory system disorders, or other drug therapy.

Sustained-release capsules: To treat certain types of glaucoma. Usually used in combination with drugs applied directly to the eye.

To prevent or treat the effects of acute mountain sickness.

Precautions:

Blood disorder cancer while taking this medication. Patients should be routinely monitored to avoid this problem.

Potassium loss: By increasing urine formation, acetazolamide may cause loss of potassium from the body. Low potassium levels may be treated by eating foods and drinking fluids high in potassium, such as citrus (orange) juice, bananas, dates, raisins, melons, and tomatoes. If increasing potassium in the diet does not raise potassium levels to normal, a potassium supplement may be necessary to replace lost potassium.

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Acetazolamide may appear in breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children have not been established.

Lab Tests: Lab tests are required during treatment with acetazolamide. Tests may include blood counts, electrolytes (eg, potassium, sodium, chloride), and liver and kidney function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with acetazolamide. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs interact with acetazolamide.

• Cyclosporine (eg, sandimmune)
• Iithium (eg, eskalith)
• Primidone (eg, mysoline)
• Quinidine (eg, quinidex)
• Salicylates (eg, aspirin, Arthro pan, Doan’s Tusal)

Side Effects:

Every drug is capable of producing side effects. Many acetazolamide users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; loss of appetite; diarrhea.

Skin: Unusual bleeding or bruising; rash; red or purple spots under the skin; sensitivity to light.

Other: Fever; tingling or numbness in hands or feet; drowsiness; confusion; allergic reaction; taste alterations; ringing in the ears; hearing dysfunction; excessive urination; electrolyte imbalance; metabolic acidosis; crystals in urine; kidney stones; abnormal blood cell counts; transient nearsightedness; sore throat.

Guidelines for Use:

• Epilepsy - Suggested total daily dose is 8 to 30 mg/kg in divided doses. Optimum range appears to be from 375 to 1000 mg daily. When given in combination with other anticonvulsant’s, the starting dose should be 250 mg once daily in addition to existing medications.
• Tablets can be crushed and mixed with sweet foods to mask bitter taste.
• Capsules can be opened and contents sprinkled on food, if necessary.
• Sustained-release capsules - Do not crush or chew.
• Doses more than 1 g per 24 hours do not produce an increased effect.
• For use of acetazolamide in acute mountain sickness, congestive heart failure, drug-induced edema, and glaucoma, see the Diuretics­Carbonic Anhydrase Inhibitors monograph.
• May cause stomach upset. Take with food.
• May cause drowsiness. Use caution when driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• May cause loss of potassium from the body. Contact your doctor if signs of potassium loss (eg, weakness, muscle cramps, nausea, dizziness) occur.
• Notify your doctor if sore throat, fever, unusual bleeding or bruising, tingling or numbness in the hands or feet, flank or loin pain, or skin rash occurs.
• When using acetazolamide, urination may increase; if possible, take early in the day ..
• Temporary nearsightedness (change in vision) has occasionally occurred with this medicine. It subsides when the dose is reduced or the medicine is stopped.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun or other forms of ultraviolet (UV) light (eg, tanning beds). Use sun­screens and wear protective clothing until tolerance is determined.
• Store at room temperature (59 to 86°F).