Acetazolamide

(a set a zole' a mide)

PCI - Contraindicated in pregnancy

LCI - Contraindicated in lactation

Molecule Info

 | See TERMINOLOGY & ABBREVIATIONS |

Indication & Dosage

Oral route 

Diuresis  Adult: 250-375 mg once daily or on alternate days.  Intermittent treatment is needed for continued efficacy.  Oral  Preoperative management of angle-closure glaucoma  Adult: 250-1000 mg daily in divided doses.  Child: 1 mth-12 yr: 10-20 mg/kg daily.  Max: 750 mg daily, in 2-4 divided doses. Oral  Adjunct in open-angle glaucoma  Adult: 250-1000 mg daily in divided doses.  Child: 1 mth-12 yr: 10-20 mg/kg daily.  Max: 750 mg daily, in 2-4 divided doses. Oral  Epilepsy  Adult: Either alone or with other antiepileptics: 250-1000 mg daily in divided doses.  Child: Neonates and up to 12 yr: Initially, 2. 5 mg/kg bid-tid; maintenance: 5-7 mg/kg bid-tid.  Max: 750 mg daily.  Oral  Prophylaxis of high-altitude disorders  Adult: 500-1000 mg daily in divided doses.  Prompt descent is still advised if severe symptoms such as cerebral or pulmonary oedema occur.

Intravenous  route 

Chronic open-angle glaucoma  Adult: As an adjunct, 0. 25-1 g every 24 hr, usually in divided doses.  Adjust dose according to symptomatology and ocular tension.  Intravenous  Acute closed angle glaucoma  Adult: 250-500 mg.  may repeat 2-4 hr later if needed.  Max: 1 g daily.  Intravenous  Epilepsy  Adult: 8-30 mg/kg daily in divided doses.  Optimum dose: 375-1000 mg daily.  When used with other anticonvulsants, initiate at 250 mg once daily in addition to existing medications and adjust accordingly. Reconstitution: Reconstitute with at least 5 ml of sterile water for inj to produce a solution containing 100 mg/ml.  Further dilute with 5% dextrose solution or normal saline for IV infusion.  

Incompatibility: Admixture incompatibility: Multivitamins.

Administration

Should be taken with food.

Overdosage

Symptoms may include electrolyte imbalance, acidotic state and central nervous effects.  Monitor serum electrolyte levels and blood pH levels.  Supportive measures are required to restore electrolyte and pH balance.  Acidotic state can usually be corrected by the admin of bicarbonate.

Contraindications

Hypersensitivity to sulphonamides; sodium or potassium depletion, hepatic insufficiency; hepatic cirrhosis; hyperchloraemic acidosis; severe renal impairment; severe pulmonary obstruction; chronic noncongestive angle-closure glaucoma; adrenocortical insufficiency.  Pregnancy, lactation.

Special Precautions

Potassium supplements may be required.  Impaired hepatic or renal function; diabetes.  Monitor plasma electrolytes and blood count regularly.  IM route is not recommended.  Caution when driving or operating machinery.  Elderly.

Adverse Drug Reactions

Drowsiness, paraesthesia, ataxia, dizziness, thirst, anorexia, headache; confusion, malaise, depression; GI distress, metabolic acidosis, polyuria, hyperuricaemia, renal calculi, nephrotoxicity, hepatic dysfunction. Potentially Fatal: Rarely, skin reactions or blood dyscrasias.

Drug Interactions

Aids penetration of weakly acidic substances like sulphonamides across blood and CSF barrier.  May inhibit renal excretion of basic drugs and promotes excretion of acidic drugs.  May increase salicylate toxicity.  Hypokalaemia with corticosteroids and potassium-wasting diuretics.  May increase excretion of lithium andprimidone.  May cause osteomalacia with anticonvulsants. Potentially Fatal: May potentiate effect of folic acid antagonists, Oral   hypoglycaemic agents, Oral   anticoagulants and severe reactions to sulphonamides.

Lab Interference

May cause false positive results for urinary protein.  Interferes with HPLC theophylline assay and serum uric acid levels.

Pregnancy Category (US FDA)

Category C: Either studies in animals have revealed adverse effects on the foetus and there are no controlled studies in women or studies in women and animals are not available.  Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Storage

Intravenous  : Store between 15-30°C.  Reconstituted solution may be stored at for 3 days at 2-8°C or 12 hr at 15-30°C.  Oral: Store at 15-30°C.

Mechanism of Action

Acetazolamide specifically inhibits the enzyme carbonic anhydrase which catalyses the reversible reaction involving the hydration of CO2 and dehydration of carbonic acid.  It increases the excretion of HCO3 ions and as well as Na and K leading to alkaline diuresis.  Carbonic anhydrase is also inhibited in the CNS to retard abnormal and excessive discharge from neurons. Onset: 60-90 minutes; 2 minutes. Duration: 8-12 hr; 4-5 hr.  Absorption: Moderately rapid absorption from the GI tract; peak plasma concentrations after 2 hr.  Distribution: Concentrates in the red blood cells and renal cortex; enters the breast milk.  Protein-binding: High.  Excretion: Urine; 3-6 hr.

mph Class

Diuretics / Anticonvulsants / Antiglaucoma Preparations

ATC Classification

S01EC01 - acetazolamide; Belongs to the class of carbonic anhydrase inhibitors.  Used in the treatment of glaucoma.

 

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Brand/Product Info


Total Products : 2  
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
ACEMOX The Acme Laboratories Ltd. Acetazolamide 250mg Tablet 100's: 150.00 MRP
REMOX Reman Drug Laboratories Ltd. Acetazolamide 250mg Tablet 100's: 131.00 MRP

Gen. MedInfo

Why is this medication prescribed?

Acetazolamide is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision.  Acetazolamide decreases the pressure in the eye.  Acetazolamide is also used to reduce the severity and duration of symptoms of altitude sickness.  Acetazolamide is used with other medicines to reduce edema and to help control seizures in certain types of epilepsy.

This medication is sometimes prescribed for other uses; ask your Doctor for more information.

How should this medicine be used?

Acetazolamide comes as a tablet and capsule to take by mouth.  Follow the directions on your prescription label carefully, and ask your Doctor to explain any part you do not understand.  Take acetazolamide exactly as directed.  Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking the extended-release form of acetazolamide, do not crush or chew the capsules.

What Special Precautions should I follow?
Before taking acetazolamide,
  • tell your Doctor if you are allergic to acetazolamide, sulfa drugs, diuretics, or any other drugs.
  • tell your Doctor what prescription and nonprescription medications you are taking, especially amphetamines, aspirin, cyclosporine, medications for depression or irregular heartbeat, diflunisal, digoxin, diuretics, lithium, phenobarbital, primidone, and vitamins.
  • tell your doctor if you have or have ever had heart, liver, or kidney disease; or diabetes.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.  If you become pregnant while taking acetazolamide, consult your doctor immediately.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking acetazolamide.
  • you should know that this drug may make you drowsy.  Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen.  Acetazolamide may make your skin sensitive to sunlight.
What should I do if I forget a dose?

Take the missed dose as soon as you remember it.  However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.  Do not take a double dose to make up for the missed one.

What side effects can this medication cause?

Acetazolamide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • upset stomach
  • vomiting
  • loss of appetite
  • numbness and tingling
  • increased thirst and urination
  • drowsiness
  • headache
  • confusion
  • fever
  • rash
  • blood in urine
  • painful urination
  • yellowing of the skin or eyes
  • seizures
  • sore throat
  • unusual bleeding or bruising
If you experience any of the following symptoms, consult your doctor immediately:

If you experience a serious side effect, you or your doctor may send a report to the Office of Directorate General, Drugs Administration.

What Storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children.  Store it at room temperature and away from excess heat and moisture.Throw away any medication that is outdated or no longer needed.  Talk to your Doctor about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, consult your Doctor.  If the victim has collapsed or is not breathing, consult local medical emergency services.

Before Calling Emergency

Determine the following information:

  • Patient's age, weight and condition
  • Name of the product/medicine (ingredients and strengths, if possible)
  • Time it was swallowed/taken
  • Amount swallowed/taken

 What to Expect at the Emergency Room

 The Health Care Provider/ Emergency Doctor will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate and blood pressure. Symptoms will be treated as appropriate. The patient may receive:

  • Antidote, gastric lavage, activated charcoal or other drugs/procedures as required
  • Blood tests to determine body chemical levels and blood acid/base balance
  • EKG/ECG test
  • Medicines to correct fluid and electrolyte imbalances

Do not let anyone else take your medicine.  

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals or other dietary supplements.  You should bring this list with you each time you visit a doctor or if you are admitted into a hospital.  It is also important information to carry with you in case of emergencies.


 This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.