Acetazolamide
Description
Acetazolamide is a medication that is used to treat glaucoma (a condition caused by increased pressure within your eyes), oedema (abnormal buildup of fluids in the body) epilepsy (fits or convulsions) and to prevent or reduce the symptoms of mountain sickness. This medicine works by blocking the action of an enzyme called carbonic anhydrase in your body. This leads to a decrease in the production of fluid inside your eyes thereby reducing pressure within your eye. It also reduces the fluid buildup in your body, thereby reducing oedema.
Acetazolamide shows common side effects like dizziness, increased urination, light-headedness, dry mouth, loss of appetite, etc. These effects are usually temporary and may resolve on their own, but if any of these side effects are severe and long-lasting, inform your doctor immediately. This medicine might cause drowsiness so avoid any activity which requires concentration like driving or operating heavy machines. Also, if you experience symptoms like blood in urine, loss of movement in any part of your body, or seizure, seek medical attention right away.
Acetazolamide can be taken with or without food in a dose and duration prescribed by your doctor. Take it at the same time every day to get the most benefit from this medicine. Do not take Acetazolamide without consulting your doctor if you have had surgery, or have any kidney or liver conditions. Acetazolamide is not recommended during pregnancy and breastfeeding unless prescribed by your doctor.
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Side effects
Major & minor side effects for Acetazolamide
- Diarrhoea
- Vomiting
- Loss of appetite
- Numbness, tingling in arms or legs
- Increased thirst
- Increased urination frequency
- Drowsiness
- Headache
- Confusion
- Fever and cough
- Blood in urine
- Yellowing of skin and eyes
- Sore throat
- Unusual bleeding or bruising
- Ringing or buzzing in the ears
- Altered blood glucose levels
- Abdominal pain
- Severe skin rash and hives
- Change in taste/ Metallic taste
- Decrease in sexual drive
Uses of Acetazolamide
What is it prescribed for?
- Oedema
- Acute mountain sickness
- Glaucoma
- Seizure disorder
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Concerns
Commonly asked questions
- Onset of actionAcetazolamide starts to act within 2 to 4 hours of oral administration.
- Duration of effectThe duration of action of Acetazolamide lasts for approximately 8 to 12 hours. This medicine may remain in your body for 18 hours.
- Safe with alcohol?Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
- Is it habit forming?No habit-forming tendencies were reported for Acetazolamide.
- Usage in pregnancy?Acetazolamide is not recommended during pregnancy unless prescribed by your doctor. This is medicine is prescribed during pregnancy only if the benefits outweigh the risk. Hence, before initiating the treatment, inform your doctor if you are pregnant or planning pregnancy. All the risks and benefits should be discussed with your doctor before starting this medicine.
- Usage while breast-feeding?Acetazolamide is not recommended for use in breastfeeding women. It is only acceptable for use if there are no alternatives available and upon your doctor's recommendation. All the risks and benefits should be discussed with your doctor before starting this medicine.
Allergy
Avoid taking Acetazolamide if you have a known allergy to it. Seek immediate medical attention if you notice any symptoms such as oedema (swelling of the hands, feet, ankles, face, lips), difficulty in swallowing or breathing, severe rashes (hives), redness, and itching.
Severe liver impairment
Acetazolamide is not recommended for use if you have severe liver damage as it increases the risk of hepatic encephalopathy. This is a condition in which the liver fails to work properly resulting in the build-up of toxins in the blood that travels to the brain and affects brain function.
Severe kidney impairment
Acetazolamide is filtered by the kidney and moved out of the body through urine. People with kidney problems need to be careful while taking this medicine due to the increased risk of kidney damage. Inform your doctor if you have pre-existing kidney problems. Your doctor will select an appropriate dose based on your clinical condition.
Chronic non-congestive angle-closure glaucoma
Angle-closure glaucoma is a condition that occurs when the iris (coloured tissue at the front of your eye with pupil in the centre) narrows or blocks the drainage angle (area of the eye which allows the fluid to drain from the eye). Hence, fluid cannot circulate through the eyes and lead to an increase in pressure. Acetazolamide is not recommended for use if you have chronic non-congestive angle-closure glaucoma as it may worsen your condition.
Addison's disease
Addison's disease is a condition of the adrenal glands which results in adrenal insufficiency (a condition in which your adrenal glands do not produce enough hormones). Avoid taking Acetazolamide in this condition as it results in severe side effects such as increased urinary pH, bicarbonate levels and a decrease in blood potassium levels.
Altered levels of sodium/potassium
Acetazolamide may increase the excretion of potassium and sodium from your body. Therefore, this medicine is not recommended if you have low blood levels of sodium and/or potassium as it may worsen the condition.
Warnings for special population
Pregnancy
Acetazolamide is not recommended during pregnancy unless prescribed by your doctor. This is medicine is prescribed during pregnancy only if the benefits outweigh the risk. Hence, before initiating the treatment, inform your doctor if you are pregnant or planning pregnancy. All the risks and benefits should be discussed with your doctor before starting this medicine.
Breast-feeding
Acetazolamide is not recommended for use in breastfeeding women. It is only acceptable for use if there are no alternatives available and upon your doctor's recommendation. All the risks and benefits should be discussed with your doctor before starting this medicine.
General warnings
Other medicines
Acetazolamide is reported to interact with many medicines. This may cause serious side effects. Hence, if you are prescribed acetazolamide, it is better to notify your doctor of all the medications taken by you currently.
Use in children
Acetazolamide is not recommended to patients below 12 years of age as the safety and efficacy for this age group is not clinically established.
Use in elderly
Acetazolamide should be used in the elderly with extreme caution as long-term therapy with acetazolamide is reported to cause side effects on kidneys and the liver. Hence, close monitoring of liver and kidney functions is advised during therapy with Acetazolamide in the elderly.
Liver diseases
Acetazolamide is primarily broken down in the liver. People with liver problems need special dose consideration while taking this medicine due to the increased risk of liver damage. Your doctor will adjust the dose based on your clinical condition.
Kidney diseases
Acetazolamide is filtered by the kidney and moved out of the body through urine. People with kidney problems need special dose consideration while taking this medicine due to the increased risk of kidney damage and side effects. Inform your doctor if you have pre-existing kidney problems.
Respiratory diseases
Acetazolamide should be used with extreme caution in people with a history of respiratory diseases such as COPD, respiratory acidosis, etc. since it may worsen your condition. Close monitoring of lung function tests, appropriate dose adjustments, or replacement with a suitable alternative may be necessary based on the condition.
Driving or operating machines
Therapy with Acetazolamide may cause dizziness, confusion, or disorientation. Hence, do not perform activities that require mental alertness such as driving vehicles or operating machines after taking this medicine.
Missed Dose
Take the missed dose of Acetazolamide as soon as you remember. If it is almost the time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Overdose
Seek emergency medical help in case of an overdose with Acetazolamide.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol
Description
Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Instructions
Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine
Dexamethasone
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Insulin
Insulin
Formoterol
Formoterol
Alprazolam
Alprazolam
Choline salicylate
Choline salicylate
Carbamazepine
Carbamazepine
Amiodarone
Amiodarone
Cisapride
Cisapride
Hydrocortisone
Hydrocortisone
Zonisamide
Zonisamide
Metformin
Metformin
Aspirin
Aspirin
Sodium biphosphate
Sodium biphosphate
Magnesium salicylate
Magnesium salicylate
Disease interactions
Bone Marrow Depression/Blood Dyscrasias
Long-term therapy with Acetazolamide is reported to caused bone marrow depression in rare cases. This may result in a decrease in various types of cells in the blood. Hence, blood cell count should be monitored at regular intervals during therapy with acetazolamide.
Respiratory acidosis
Respiratory acidosis is a condition that occurs when your lungs are not able to remove the carbon dioxide produced in the body. Acetazolamide should be used with caution if you have respiratory acidosis or a history of lung problems as it can worsen your condition. Your doctor will closely monitor your lung function, suggest appropriate dose adjustments, or replace this medicine with a suitable alternative as may be necessary.
Diabetes Mellitus
Long-term therapy with Acetazolamide in people with diabetes is reported to alter the blood sugar levels. If you are diabetic, monitor your blood sugar levels regularly while using this medicine.
Gout
Acetazolamide is reported to decrease the excretion of uric acid. Thus, the rise in blood levels of uric acid can worsen the symptoms of gout.
Metabolic acidosis
Acetazolamide may decrease the bicarbonate levels and increase the chloride levels in your blood. During long-term treatment, it may cause metabolic acidosis (a condition in which there is excessive acid in the body fluids). Hence, Acetazolamide should be used with caution if you have metabolic acidosis, hyperchloremic acidosis, or conditions that may contribute to acidosis such as kidney problems, severe respiratory problems, diarrhoea, etc. Close monitoring of your clinical condition, appropriate dose adjustments, or replacement with a suitable alternative may be necessary.
Bone Marrow Depression/Blood Dyscrasias
Long-term therapy with Acetazolamide is reported to caused bone marrow depression in rare cases. This may result in a decrease in various types of cells in the blood. Hence, blood cell count should be monitored at regular intervals during therapy with acetazolamide.
Respiratory acidosis
Respiratory acidosis is a condition that occurs when your lungs are not able to remove the carbon dioxide produced in the body. Acetazolamide should be used with caution if you have respiratory acidosis or a history of lung problems as it can worsen your condition. Your doctor will closely monitor your lung function, suggest appropriate dose adjustments, or replace this medicine with a suitable alternative as may be necessary.
Diabetes Mellitus
Long-term therapy with Acetazolamide in people with diabetes is reported to alter the blood sugar levels. If you are diabetic, monitor your blood sugar levels regularly while using this medicine.
Gout
Acetazolamide is reported to decrease the excretion of uric acid. Thus, the rise in blood levels of uric acid can worsen the symptoms of gout.
Metabolic acidosis
Acetazolamide may decrease the bicarbonate levels and increase the chloride levels in your blood. During long-term treatment, it may cause metabolic acidosis (a condition in which there is excessive acid in the body fluids). Hence, Acetazolamide should be used with caution if you have metabolic acidosis, hyperchloremic acidosis, or conditions that may contribute to acidosis such as kidney problems, severe respiratory problems, diarrhoea, etc. Close monitoring of your clinical condition, appropriate dose adjustments, or replacement with a suitable alternative may be necessary.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Acetazolamide with or without food exactly as prescribed by your doctor. Avoid taking a higher dose or for a longer duration than that advised by your doctor.
Ensure that the course of treatment is completed. Do not stop the use of Acetazolamide without consulting your doctor.
This medicine may increase the frequency of urination. Hence, take the last dose for the day in the early evening to prevent frequent urination at night.
This medicine may decrease the potassium level in your body. Take potassium-rich food such as bananas or orange juice while taking Acetazolamide.
Miscelleneous
How it works
Acetazolamide blocks the actions of an enzyme in your body. This helps to lower the pressure within your eyes. It also decreases the accumulation of fluid in your body. This mechanism also helps to control seizures. Acetazolamide also increases the excretion of sodium, potassium, bicarbonate, and water from the body and helps in relieving the symptoms of altitude/mountain sickness.
Legal Status
Classification
Category
Carbonic anhydrase inhibitor anticonvulsants, Carbonic anhydrase inhibitors
Schedule
Schedule H
Pubchem.ncbi.nlm.nih.gov. 2021. Acetazolamide. [online] Available at: < [Accessed 17 August 2021].
Medicines.org.uk. 2021. [online] Available at: < [Accessed 17 August 2021].
Dailymed.nlm.nih.gov. 2021. DailyMed - ACETAZOLAMIDE capsule, extended release. [online] Available at: < [Accessed 17 August 2021].
Drugs, H., 2021. Acetazolamide: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 17 August 2021].
Dailymed.nlm.nih.gov. 2021. DailyMed - ACETAZOLAMIDE tablet. [online] Available at: < [Accessed 17 August 2021].
Information on this page was last updated on 21 Sep 2021
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