Acetazolamide (Diamox, Dazamide)

Category:

• Miscellaneous

Description:

• Diruretic, anticonvulsant, antiglaucoma agent, mountain sickness

Indications:

• Open angle glaucoma, narrow angle glaucoma (preoperatively)

• Epilepsy (petit mal, grand mal, mixed)

• Edema in CHF

• Drug induced edema

• Acute mountain sickness (prevention and treatment)

Contraindications:

• Hypersensitivity to sulfonamides; severe renal disease; severe hepatic disease; COPD

• Electrolyte imbalances; Addison’s disease; hyperchloremic acidosis; long-term use in narrow angle glaucoma

Precautions:

• Pregnancy Category D; premature deliveries and abnormalities in humans

• Causes carbonated beverages to taste flat

• Salicyclates increase serum levels of acetazolamide – CNS TOXICITY

Adverse Reactions (Side Effects):

• CNS: anxiety, confusion, depression, dizziness, drowsiness, fatigue seizures, headache, paresthesia, sedation, stimulation

• EENT: myopia, tinnitus

• GI: anorexia, constipation, diarrhea, hepatic insufficiency, melena, nausea, taste alterations, vomiting, weight loss

• GU: crystalluria, glucosuria, hypokalemia, polyuria, renal calculi, uremia

• HEME: agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, pancytopenia, purpura, thrombocytopenia

• SKIN: fever, photosensitivity, pruritis, rash, Stevens-Johnson syndrome

• METAB: hyperglycemia

Dosage:

Administered orally (tablets, sequels) and intravenously

Adult: 

• Narrow-angle glaucoma:  

  • PO/IV 250mg every 4 hours or 250mg twice daily, to be used as short-term therapy

• Open-angle glaucoma: 

  • PO/IV 250-1000mg daily in divided doses for amounts over 250mg

• Edema: 

  • IV 250-375mg daily in the morning

• Seizures: 

  • PO/IV 8-30 mg/kg daily; usual range 375-1000mg per day

• Mountain sickness:  

  • Treatment: PO 250mg every 8-12 hours

  • Prophylaxis: PO 125mg twice daily

  • Periodic breathing at altitude: PO 62.5-125mg with dinner or at bedtime  

Child:           

• Edema:  

  • IV 5 mg/kg daily in the morning

• Seizures:  

  • PO/IV 8-30 mg/kg daily in divided doses three or four times daily, 

  • or 300-900 mg/meter square/day, not to exceed 1.5 grams daily