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

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