acetazolamide (Rx)

Brand and Other Names:Diamox Sequels (DSC)
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 125mg
  • 250mg

powder for injection

  • 500mg

capsule, extended-release

  • 500mg

Glaucoma

Closed-angle (acute congestive) glaucoma

  • 500 mg PO/IV, followed by 125-250 mg PO q4hr
  • Sustained-release: 500 mg PO q12hr

Open-angle (chronic simple) glaucoma

  • 250 mg-1 g PO/IV qDay or divided q6-12hr
  • Sustained-release: 500 mg PO q12hr

Secondary glaucoma

  • 500 mg PO/IV, followed by 125-250 mg PO q4hr
  • Sustained-release: 500 mg PO q12hr

Acute Altitude Sickness

Immediate release: 500-1000 mg/day PO divided q8-12hr

Extended release: 500-1000 mg PO q12-24hr

Dosing considerations

  • Start 24-48 hours before ascent and continue for 48 hours at high altitude or longer, to control symptoms if necessary

Congestive Heart Failure

CHF-associated edema

250-375 mg (5 mg/kg) PO qAM  

Seizure

8-30 mg/kg/day PO qDay or divided q12hr  

Drug-induced Edema

250-375 mg PO/IV qDay

Dosing considerations

  • Do not increase dose if edema fails to decrease following an initial response; allow instead kidney recovery by skipping medication for a day; best results obtained when given on alternate days or for 2 days followed by a day of rest

Epilepsy

Tablet: 8-30 mg/kg/day PO qDay, OR divided q6-12 hr; not to exceed 30 mg/kg/day or 1 g/day  

Extended-release capsule: Not recommended

Dosing Modifications

Renal impairment

  • CrCl 10-50 mL/min: Administer no more frequently than q12hr
  • CrCl <10 mL/min: Ineffective (avoid use)
  • Hemodialysis: 20-50% dialyzable
  • Peritoneal dialysis: Dose adjustment not necessary

Dosage Forms & Strengths

tablet

  • 125mg
  • 250mg

powder for injection

  • 500mg

capsule, extended-release

  • 500mg

Epilepsy

<12 years

  • Safety and efficacy not established

>12 years

  • Tablet: 8-30 mg/kg/day PO qDay or divided q6-12 hr; not to exceed 30 mg/kg/day or 1 g/day  
  • Extended-release capsule: Not recommended

Acute Altitude Sickness

<12 years

  • Safety and efficacy not established

>12 years

  • Immediate release: 500-1000 mg/day PO divided q8-12hr
  • Extended release: 500-1000 mg PO q12-24hr

Dosing considerations

  • Start 24-48 hr before ascent and continue for 48 hr at high altitude to control symptoms, if necessary

250 mg PO qDay or q12hr; use lowest effective dose possible

Next:

Interactions

Interaction Checker

and acetazolamide

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (2)

              • lonafarnib

                acetazolamide will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              • methenamine

                acetazolamide, methenamine. Other (see comment). Contraindicated. Comment: This combination may form an insoluble precipitate in the urine, decreasing the effects of both agents.

              Monitor Closely (49)

              • amantadine

                acetazolamide will decrease the level or effect of amantadine by Other (see comment). Modify Therapy/Monitor Closely. Excretion rate of amantadine increases rapidly when urine is acidic, administration of urine acidifying drugs may increase elimination of amantadine from the body. Monitor for efficacy of amantadine.

              • aspirin

                acetazolamide, aspirin. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, aspirin. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • aspirin rectal

                acetazolamide, aspirin rectal. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, aspirin rectal. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • aspirin/citric acid/sodium bicarbonate

                acetazolamide, aspirin/citric acid/sodium bicarbonate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • atogepant

                acetazolamide will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • avanafil

                avanafil increases effects of acetazolamide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • avapritinib

                acetazolamide will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                acetazolamide increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • balsalazide

                acetazolamide, balsalazide. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, balsalazide. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • bearberry

                acetazolamide will increase the level or effect of bearberry by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • benzphetamine

                acetazolamide will increase the level or effect of benzphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • carbamazepine

                acetazolamide will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantly

              • choline magnesium trisalicylate

                acetazolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • deutetrabenazine

                acetazolamide and deutetrabenazine both increase sedation. Use Caution/Monitor.

              • dextroamphetamine

                acetazolamide will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • dichlorphenamide

                dichlorphenamide and acetazolamide both decrease serum potassium. Use Caution/Monitor.

                dichlorphenamide, acetazolamide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

              • diflunisal

                acetazolamide, diflunisal. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, diflunisal. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • ephedrine

                acetazolamide will increase the level or effect of ephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, acetazolamide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

              • finerenone

                acetazolamide will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • flecainide

                acetazolamide will increase the level or effect of flecainide by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • flibanserin

                acetazolamide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • isavuconazonium sulfate

                acetazolamide will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ivacaftor

                acetazolamide increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

              • lemborexant

                acetazolamide will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • lisdexamfetamine

                acetazolamide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • lomitapide

                acetazolamide increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

              • lurasidone

                lurasidone increases effects of acetazolamide by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • memantine

                acetazolamide will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • mesalamine

                acetazolamide, mesalamine. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, mesalamine. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • metformin

                acetazolamide increases toxicity of metformin by Other (see comment). Use Caution/Monitor. Comment: Decreases serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis.

              • mexiletine

                acetazolamide will increase the level or effect of mexiletine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • midazolam intranasal

                acetazolamide will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

              • nitazoxanide

                nitazoxanide, acetazolamide. Either increases levels of the other by Mechanism: plasma protein binding competition. Use Caution/Monitor.

              • nitroglycerin rectal

                nitroglycerin rectal, acetazolamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

              • orlistat

                orlistat decreases levels of acetazolamide by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.

              • ospemifene

                acetazolamide, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

              • pseudoephedrine

                acetazolamide will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • quinidine

                acetazolamide will increase the level or effect of quinidine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

              • salicylates (non-asa)

                acetazolamide, salicylates (non-asa). Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, salicylates (non-asa). Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • salsalate

                acetazolamide, salsalate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, salsalate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • sevelamer

                sevelamer decreases levels of acetazolamide by increasing elimination. Use Caution/Monitor.

              • sulfasalazine

                acetazolamide, sulfasalazine. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, sulfasalazine. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              • tadalafil

                tadalafil increases effects of acetazolamide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • tazemetostat

                acetazolamide will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tinidazole

                acetazolamide will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • topiramate

                topiramate, acetazolamide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of kidney stone formation.

              • trientine

                acetazolamide decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.

              • willow bark

                acetazolamide, willow bark. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

                acetazolamide, willow bark. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

              Minor (30)

              • acetaminophen

                acetazolamide decreases levels of acetaminophen by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen IV

                acetazolamide decreases levels of acetaminophen IV by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen rectal

                acetazolamide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • amobarbital

                acetazolamide, amobarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • atracurium

                acetazolamide decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • biotin

                acetazolamide decreases levels of biotin by unspecified interaction mechanism. Minor/Significance Unknown. Biotin supplementation may be necessary.

              • butabarbital

                acetazolamide, butabarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • butalbital

                acetazolamide, butalbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • cisatracurium

                acetazolamide decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • cyanocobalamin

                acetazolamide decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dexmethylphenidate

                dexmethylphenidate increases effects of acetazolamide by decreasing metabolism. Minor/Significance Unknown.

              • dextroamphetamine

                acetazolamide increases levels of dextroamphetamine by passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown.

              • ethotoin

                acetazolamide, ethotoin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • fosphenytoin

                acetazolamide, fosphenytoin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • incobotulinumtoxinA

                acetazolamide decreases effects of incobotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.

              • levocarnitine

                acetazolamide decreases levels of levocarnitine by unspecified interaction mechanism. Minor/Significance Unknown.

              • onabotulinumtoxinA

                acetazolamide decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.

              • pancuronium

                acetazolamide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • pentobarbital

                acetazolamide, pentobarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • phenobarbital

                acetazolamide, phenobarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • phenytoin

                acetazolamide, phenytoin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • primidone

                acetazolamide decreases levels of primidone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                acetazolamide, primidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • rapacuronium

                acetazolamide decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rimabotulinumtoxinB

                acetazolamide decreases effects of rimabotulinumtoxinB by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rocuronium

                acetazolamide decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • ruxolitinib

                acetazolamide will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • sage

                sage decreases effects of acetazolamide by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction; some species of sage may cause convulsions.

              • secobarbital

                acetazolamide, secobarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.

              • succinylcholine

                acetazolamide decreases effects of succinylcholine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • vecuronium

                acetazolamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              Previous
              Next:

              Adverse Effects

              Frequency Not Defined

              Confusion

              Convulsions

              Drowsiness

              Flaccid paralysis

              Malaise

              Paresthesias

              Photosensitivity

              Urticaria

              Anorexia

              Diarrhea

              Metallic taste

              Nausea

              Vomiting

              Hepatic disease

              Aplastic anemia

              Agranulocytosis

              Leukopenia

              Thrombocytopenia

              Thrombocytopenic purpura

              Melena

              Acidosis

              Electrolyte imbalance

              Muscle weakness

              Hematuria

              Polyuria

              Glycosuria

              Hearing dysfunction or tinnitus

              Sulfonamide type reactions

              Previous
              Next:

              Warnings

              Contraindications

              Hypokalemia

              Hyponatremia

              Hyperchloremic acidosis

              Hypersensitivity to acetazolamide or sulfa

              Liver disease

              Severe renal disease or dysfunction

              Long term use in noncongestive angle-closure glaucoma

              Cirrhosis

              Long-term administration in patients with chronic, noncongestive angle-closure glaucoma

              Cautions

              Use caution in COPD, emphysema, and concomitant high-dose aspirin

              Use caution in diabetes, respiratory acidosis, and hepatic impairment

              Adverse drug reactions common to sulfonamide derivatives; Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN) may occur

              May impair alertness and/or physical coordination

              FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur

              May impair alertness and/or physical coordination

              Severe adverse effects including tachypnea, anorexia, coma, lethargy, and death reported with high-dose aspirin; use caution or avoid administration

              Increasing dose does not increase diuresis; may instead increase the incidence of paresthesia and/or drowsiness

              IM administration not recommended due to alkaline pH, which may cause pain

              Previous
              Next:

              Pregnancy & Lactation

              Pregnancy category: C

              Lactation: Enters breast milk; not recommended

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Carbonic anhydrase inhibitor that decreases rate of aqueous humor formation, in that way decreasing intraocular pressure

              Inhibits H+ ion excretion in renal tubule, increasing sodium, potassium, bicarbonate, and water excretion and producing alkaline diuresis

              Inhibits carbonic anhydrase in CNS, which in turn decreases abnormal and excessive discharge from the CNS neurons

              Absorption

              Bioavailability: Rapidly absorbed orally

              Tablet

              • Onset: 1-1.5 hr
              • Duration: 8-12 hr
              • Peak plasma time: 1-4 hr

              Sustained-release

              • Onset: 2 hr
              • Duration: 18-24 hr
              • Peak plasma time: 8-18 hr

              IV

              • Onset: 5-10 min
              • Duration: 4-5 hr
              • Peak plasma time: 15 min

              Distribution

              Protein bound: 70-90%

              Vd: 0.2 L/kg

              Metabolism

              Metabolism: None

              Elimination

              Half-life: 2-4 hr (tablet)

              Dialyzable: Yes (hemodialysis)

              Excretion: Urine 90%

              Previous
              Next:

              Administration

              IV Incompatibilities

              Additive: Multivitamins

              Y-site: Diltiazem(?), multivitamins

              IV Compatibilities

              Solution: Compatible with most common solvents

              Additive: Cimetidine, ranitidine

              IV Preparation

              Standard diluent: 500 mg/50 mL D5W

              Minimum volume: 50 mL D5W

              IV Administration

              IV push: 100-500 mg/min

              Infusion: 4-8 hr

              Storage

              Store intact vials at room temperature

              May store reconstituted solution in refrigerator for 3 days or at room temperature for 12 hr

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              125 mg tablet
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              125 mg tablet
              acetazolamide oral
              -
              250 mg tablet
              acetazolamide oral
              -
              125 mg tablet
              acetazolamide oral
              -
              125 mg tablet
              acetazolamide oral
              -
              500 mg capsule
              acetazolamide oral
              -
              500 mg capsule

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Patient Education
              acetazolamide oral

              ACETAZOLAMIDE - ORAL

              (a-SEET-a-ZOLE-a-mide)

              COMMON BRAND NAME(S): Diamox

              USES: Acetazolamide is used to prevent and reduce the symptoms of altitude sickness. This medication can decrease headache, tiredness, nausea, dizziness, and shortness of breath that can occur when you climb quickly to high altitudes (generally above 10,000 feet/3,048 meters). It is particularly useful in situations when you cannot make a slow ascent. The best ways to prevent altitude sickness are climbing slowly, stopping for 24 hours during the climb to allow the body to adjust to the new height, and taking it easy the first 1 to 2 days.This medication is also used with other medications to treat high pressure inside the eye due to certain types of glaucoma. Acetazolamide belongs to a class of drugs known as carbonic anhydrase inhibitors. It works by decreasing the production of fluid inside the eye. It is also used to decrease a buildup of body fluids (edema) caused by heart failure or certain medications. Acetazolamide can work less well over time, so it is usually used only for a short period.It has also been used with other medications to treat certain types of seizures (petit mal and unlocalized seizures).

              HOW TO USE: If you are taking the tablets, take this medication by mouth as directed by your doctor, usually 1 to 4 times daily. If you are taking the long-acting capsules, take this medication by mouth as directed by your doctor, usually 1 or 2 times daily. Swallow the long-acting capsules whole. Do not open, break, or chew the capsules. Doing so can destroy the long action of the drug and may increase side effects.Acetazolamide may be taken with or without food. Drink plenty of fluids unless otherwise directed by your doctor. The dosage is based on your medical condition and response to treatment.To prevent altitude sickness, start taking acetazolamide 1 to 2 days before you start to climb. Continue taking it while you are climbing and for at least 48 hours after you have reached your final altitude. You may need to continue taking this medication while staying at the high altitude to control your symptoms. If you develop severe altitude sickness, it is important that you climb down as quickly as possible. Acetazolamide will not protect you from the serious effects of severe altitude sickness. (See also Precautions.)If you are taking this drug for another condition (such as glaucoma, seizures), use this medication regularly as directed to get the most benefit from it. To help you remember, take it at the same time(s) each day. Taking your last dose in the early evening will help prevent you from having to get up in the middle of the night to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.When used for an extended period, this medication may not work as well and may require different dosing. Your doctor will be monitoring your condition. Tell your doctor if your condition does not improve or if it worsens (for example, you have more frequent seizures).This drug may reduce the potassium levels in your blood. Your doctor may recommend that you eat foods rich in potassium (such as bananas or orange juice) while you are taking this medication. Your doctor may also prescribe a potassium supplement for you to take during treatment. Consult your doctor for more information.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Dizziness, lightheadedness, or increased urination may occur, especially during the first few days as your body adjusts to the medication. Blurred vision, dry mouth, drowsiness, loss of appetite, nausea, vomiting, diarrhea, or changes in taste may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: tingling of the hands/feet, hearing loss, ringing in the ears, unusual tiredness, easy bleeding/bruising, fast/irregular heartbeat, muscle cramps/pain, new or worsening eye pain, decrease in vision, mental/mood changes (such as confusion, difficulty concentrating), signs of liver disease (such as nausea/vomiting that doesn't stop, stomach/abdominal pain, yellowing eyes/skin, dark urine), signs of kidney problems (such as painful urination, pink/bloody urine, change in the amount of urine), signs of infection (such as sore throat that doesn't go away, fever, chills).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking acetazolamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: adrenal gland problems (such as Addison's disease), untreated mineral imbalance (such as low sodium/potassium, hyperchloremic acidosis), dehydration, kidney disease, liver disease, breathing problems (such as chronic obstructive pulmonary disease-COPD, emphysema, lung infection), diabetes, gout, narrow-angle glaucoma, overactive thyroid (hyperthyroidism).While this medication can help you get used to high altitudes and help you tolerate quick climbs, it cannot completely prevent serious altitude sickness. Symptoms of serious altitude sickness may include: severe shortness of breath, mental/mood changes (such as confusion, difficulty concentrating), lack of coordination/staggering walk, extreme tiredness, severe headache.If you develop any of these symptoms, it is very important that you descend to a lower altitude as quickly as possible to prevent serious, possibly fatal problems.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This drug may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination.If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. This medication may also lower your blood sugar. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or by drinking a glass of orange juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to its effects, especially dizziness and lightheadedness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: cisapride, lithium, memantine, methenamine, orlistat, certain drugs used to treat seizures (topiramate, zonisamide).Check the labels on all your medicines because they may contain aspirin or aspirin-like drugs (salicylates), which can cause serious side effects if taken in large doses with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.Some products have ingredients that could worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially NSAIDs such as ibuprofen/naproxen).This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not change brands or dosage forms of this medication without consulting your doctor or pharmacist. Not all forms of this medication work the same way.Do not share this medication with others.Lab and/or medical tests (such as complete blood count, potassium and sodium levels in the blood, liver function tests) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time for your next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.