Presentation and Status in Health Basket
30 X 250 mg
For oral administration.
Congestive Heart Failure: For diuresis in congestive heart failure, the starting dose is usually 250 to 375 mg once daily in the morning. If, after an initial response, the patient fails to continue to lose edema fluid, do not increase the dose but allow for kidney recovery by skipping medication for a day. Acetazolamide tablets yield best diuretic results when given on alternate days, or for two days alternating with a day of rest. Failures in therapy may be due to overdosage or too frequent dosage. The use of acetazolamide does not eliminate the need for other therapy such as digitalis, bed rest and salt restriction.
Drug Induced Edema: Recommended dosage is 250 to 375 mg of acetazolamide once a day for one or two days, alternating with a day of rest.
Glaucoma: Acetazolamide should be used as an adjunct to the usual therapy. The dosage employed in the treatment of chronic simple (open-angle) glaucoma ranges from 250 mg to 1 g of acetazolamide per 24 hours, usually in divided doses for amounts over 250 mg. It has usually been found that a dosage in excess of 1 g per 24 hours does not produce an increased effect. In all cases the dosage should be adjusted with careful individual attention both to symptomatology and ocular tension. Continuous supervision by a physician is advisable. In treatment of secondary glaucoma and in the postoperative treatment of some cases of acute congestive (close-angle) glaucoma, the preferred dosage is 250 mg every four hours, although some cases have responded to 250 mg twice daily on short-term therapy. In some acute cases, it may be more satisfactory to administer an initial dose of 500 mg followed by 125 or 250 mg every four hours depending on the individual case. A complementary effect has been noted when acetazolamide has been used in conjunction with miotics or mydriatics as the case demanded.
Acute Mountain Sickness: Dosage is 500 mg to 1,000 mg daily, in divided doses. In circumstances of rapid ascent such as in rescue or military operations, the higher dose level of 1,000 mg is recommended. It is preferable to initiate dosing 24 to 48 hours before ascent and to continue for 48 hours while at high altitude, or longer as necessary to control symptoms. The change from other medication to Acetazolamide should be gradual.
Elderly: Acetazolamide should only be used with particular caution in elderly patients or those with potential obstruction in the urinary tract or with disorders rendering their electrolyte balance precarious or with liver dysfunction.
Acetazolamide is an enzyme inhibitor which acts specifically on carbonic anhydrase. It is indicated for: Adjunctive treatment of drug induced edema and edema due to congestive heart failure.
Chronic simple (open angle) glaucoma, secondary glaucoma and pre operatively in acute angle closure glaucoma where delay of surgery is desired in order to lower intraocular pressure. Acute mountain sickness.
Acetazolamide is contra-indicated in situations in which sodium and/or potassium blood levels are depressed, in cases of marked kidney and liver disease or dysfunction, suprarenal gland failure, and hyperchloremic acidosis. Acetazolamide should not be used in patients with hepatic cirrhosis as this may increase the risk of hepatic encephalopathy. Long-term administration of Acetazolamide is contra-indicated in patients with chronic non-congestive angle-closure glaucoma since it may permit organic closure of the angle to occur while the worsening glaucoma is masked by lowered intraocular pressure. Acetazolamide should not be used in patients hypersensitive to sulphonamides.
Increasing the dose does not increase the diuresis and may increase the incidence of drowsiness and/or paraesthesia. Increasing the dose often results in a decrease in diuresis. Under certain circumstances, however, very large doses have been given in conjunction with other diuretics in order to secure diuresis in complete refractory failure. When Acetazolamide is prescribed for long-term therapy, special precautions are advisable. The patient should be cautioned to report any unusual skin rash. Periodic blood cell counts and electrolyte levels are recommended. Fatalities have occurred, although rarely, due to severe reactions to sulphonamides. A precipitous drop in formed blood cell elements or the appearance of toxic skin manifestations should call for immediate cessation of Acetazolamide therapy. In patients with pulmonary obstruction or emphysema where alveolar ventilation may be impaired, Acetazolamide may aggravate acidosis and should be used with caution. In patients with a past history of renal calculi, benefit should be balanced against the risks of precipitating further calculi.
Paraesthesia, particularly a “tingling” feeling in the extremities; some loss of appetite; taste disturbance, polyuria, flushing, thirst, headache, dizziness, fatigue, irritability, depression, reduced libido and occasional instances of drowsiness and confusion.
See prescribing information for full details.
Acetazolamide is a sulphonamide derivative. Sulphonamides may potentiate the effects of folic acid antagonists. Possible potentiation of the effects of folic acid antagonists, hypoglycaemics and oral anti-coagulants may occur. Concurrent administration of acetazolamide and aspirin may result in severe acidosis and increase central nervous system toxicity. Adjustment of dose may be required when Acetazolamide is given with cardiac glycosides or hypertensive agents. When given concomitantly, acetazolamide modifies the metabolism of phenytoin, leading to increased serum levels of phenytoin. Severe osteomalacia has been noted in a few patients taking acetazolamide in combination with other anticonvulsants. There have been isolated reports of reduced primidone and increased carbamazepine serum levels with concurrent administration of acetazolamide. Because of possible additive effects, concomitant use with other carbonic anhydrase inhibitors is not advisable. By increasing the pH of renal tubular urine, acetazolamide reduces the urinary excretion of amphetamine and quinidine and so may enhance the magnitude and the duration of effect of amphetamines and enhance the effect of quinidine. Ciclosporin: Acetazolamide may elevate ciclosporin levels.
Methenamine: Acetazolamide may prevent the urinary antiseptic effect of methenamine. Lithium: Acetazolamide increases lithium excretion and the blood lithium levels may be decreased. Sodium bicarbonate: Acetazolamide and sodium bicarbonate used concurrently increases the risk of renal calculus formation.
Pregnancy and Lactation
Pregnancy: There are no adequate and well-controlled studies in pregnant women.
See prescribing information for full details.
Lactation: Acetazolamide has been detected in low levels in the milk of lactating women who have taken Acetazolamide. Although it is unlikely that this will lead to any harmful effects in the infant, extreme caution should be exercised when Acetazolamide is administered to lactating women.
No specific antidote. Supportive measures with correction of electrolyte and fluid balance. Force fluids.
Lactose: Contains lactose.
Storage: Store below 25°C.
Before/after meal: Must be administrated with or after meal.