Acetazolamide

Fitas Staff
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Acetazolamide is a drug to treat glaucoma, epilepsy, or altitude sickness. This drug can also be used to treat fluid buildup (edema) in people with heart failure.

Acetazolamide works by inhibiting the enzyme carbonic anhydrase. This enzyme can be found in the kidneys, eyes, brain, and in the blood. Therefore, this drug can cause more than one effect.

The effects that can occur when consuming acetazolamide are increased excretion of body fluids, reduced production of fluid (aqueous humor) and pressure in the eye, and decreased excessive electrical activity in the brain.

Acetazolamide brand names: Cendo Glaucon, Glauseta

What is Acetazolamide

GroupPrescription drugs
CategoryDiuretic
BenefitTreating glaucoma, edema, epilepsy , and altitude sickness
Consumed byAdults and children over 12 years of age
Acetazolamide for pregnant and lactating mothersCategory C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women. The drug should only be used if the potential benefit outweighs the potential risk to the fetus. Acetazolamide passes into breast milk. If you are pregnant or breast-feeding, do not use this medication without first consulting your doctor.
Drug formTablet

Warnings Before Taking Acetazolamide

Acetazolamide should only be used according to a doctor’s prescription. Pay attention to the following things before taking acetazolamide:

  • Do not use acetazolamide if you are allergic to it or any sulfa drugs . Tell your doctor about any allergies you may have.
  • Tell your doctor if you have kidney disease, electrolyte disturbances, adrenal gland disorders, or liver disease, especially cirrhosis. Acetazolamide should not be used by patients with these conditions.
  • Tell your doctor if you have or have ever had difficulty urinating, hyperthyroidism, dehydration, kidney stones, gout, diabetes , chronic obstructive pulmonary disease (COPD), lung infection, Addison’s disease, or angle-closure glaucoma.
  • Do not drive or perform activities that require alertness after taking acetazolamide, as this medication may cause dizziness or drowsiness.
  • Avoid prolonged exposure to direct sunlight while undergoing treatment with acetazolamide, because this drug can cause the skin to become more susceptible to sunburn.
  • Tell your doctor if you are pregnant, breastfeeding, or planning to become pregnant.
  • Tell your doctor if you are taking any medications, supplements, or herbal products, to anticipate possible drug interactions.
  • Seek medical attention immediately if you experience serious side effects or drug allergies after taking acetazolamide.

Acetazolamide Dosage and Usage Rules

The following are the general doses for Acetazolamide based on the patient’s age and condition:

Condition: Glaucoma

  • Adults: 250–000 mg per day. Consumption of the drug needs to be divided into several consumption schedules if the daily dose is above 250 mg.

Condition: Epilepsy

  • Adults: 250–1,000 mg per day, divided into several consumption schedules.
  • Children : 8–30 mg/kgBW per day, divided into several consumption schedules. Maximum dose 750 mg per day.

Condition: Prevention of altitude sickness

  • Adults: 500–1,000 mg per day, divided into several schedules. The drug is consumed 1–2 days before climbing until 2 days after climbing. If symptoms persist, drug consumption can be continued for more than 2 days after climbing.

Condition: Edema due to heart failure or side effects of other medications

  • Adults: 250-375 mg, once daily.

Condition: Complaints of swelling in women before menstruation

  • Adults: 125–375 mg daily.

How to Take Acetazolamide Correctly

Follow your doctor’s instructions and read the information on the medicine packaging before taking acetazolamide.

Acetazolamide should be taken with food or immediately after a meal. Swallow acetazolamide tablets whole with water. Drink enough water while taking this medication. Consult your doctor about your daily fluid needs that are appropriate for your condition.

If you are taking this medication for glaucoma, epilepsy, or heart failure, follow the schedule given by your doctor while taking acetazolamide. Your doctor may recommend periodic laboratory tests to monitor your condition.

While taking acetazolamide, try to take it at the same time every day. If you forget to take acetazolamide, take it as soon as possible if it is not too close to the next scheduled dose. If it is close, skip the missed dose and do not double the next dose.

Store acetazolamide in a closed container, at room temperature, in a dry place away from sunlight, and out of reach of children.

Acetazolamide Interactions with Other Drugs

The following are interactions that can occur if you use acetazolamide with other drugs:

  • Increases the risk of acidosis and fatal side effects on the central nervous system if used with high doses of aspirin.

  • Increases the risk of side effects from anticonvulsant drugs, such as phenytoin or carbamazepine.

  • Increases the risk of arrhythmias if used with cardiac glycosides, such as digoxin.

  • Increases the risk of low blood pressure (hypotension) if used with antihypertensive drugs, such as captopril.

  • Increases the risk of hypoglycemia side effects if used with antidiabetic drugs, such as glimepiride or insulin.

  • Increases the risk of bleeding when used together with oral anticoagulant drugs, such as warfarin.

  • Decreases the effectiveness of lithium and primidone.

  • Increases the risk of side effects from amphetamines or quinidine.

  • Inhibits the antibiotic effect of methenamine

  • Increases the risk of kidney stones if taken with sodium bicarbonate.

  • Increases the risk of side effects from ciclosporin

Acetazolamide Side Effects and Dangers

The following are some side effects that can arise after taking acetazolamide:

  • Dizzy

  • Feeling like I’m going to faint

  • Frequent urination

  • Blurred vision

  • Dry mouth

  • Drowsiness

  • Loss of appetite

  • Nauseous

  • Vomit

  • Diarrhea

  • Disorders of the sense of taste

See a doctor if the side effects do not improve or get worse. See a doctor immediately if you experience an allergic reaction to the drug or serious side effects such as:

  • Tingling in the hands or feet

  • Decreased hearing ability

  • Ringing in the ears

  • The body feels very tired

  • Easy bruising or bleeding

  • Faster or irregular heartbeat

  • Muscle pain or cramps

  • There is pain or the pain in the eye gets worse

  • Visual impairment

  • Difficulty concentrating or confusion

  • Liver disease, which can be characterized by nausea, vomiting, abdominal pain, dark urine, yellowing of the eyes or skin

  • Kidney disease, which can be characterized by pain when urinating, bloody urine, decreased or increased urine volume

  • Symptoms of infection, such as sore throat, fever, or chills

Reference

Greiner, R.C., et al. (2022). Revisiting Acidosis in Acetazolamide Treatment of Severe Glaucoma: A Case Report. American Journal of Ophthalmology Case Reports, 27, pp. 1–3.
Cao, Z., et al. The Combined Use of Acetazolamide and Rhodiola in the Prevention and Treatment of Altitude Sickness. Annals of Translational Medicine, 10(10), pp. 541.
Indonesian Food and Drug Supervisory Agency (2022). Check BPOM Products. Acetazolamide.
Mayo Clinic (2022). Drugs and Supplements. Carbonic Anhydrase Inhibitor (Oral Route, Parenteral Route).
Electronic Media Compendium (2019). Acetazolamide 250mg Tablets.
Medscape (2021). (2018). Acetazolamide (Rx).
MIMS Indonesia (2018). Acetazolamide.
Multum, C. Drugs (2021). Acetazolamide.
Stewart, M. Patient Info (2020). Acetazolamide for Glaucoma.
WebMD. Acetazolamide.

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