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Drugs

Side Effects
Serious

Breathing difficulty, seizures, serious allergic reaction (hives, itching, swelling of eyes, lips, and throat).
Common

Unusual fatigue; diarrhea; increase in volume and frequency of urination; loss of appetite and weight; metallic taste in mouth; numbness, tingling, or prickling sensations in hands, feet, fingers, toes, lips, and elsewhere.
Less Common

Worsening nearsightedness, dark or bloody urine, painful urination, depression, lower back or flank pain, sudden decrease in urine output, unusual bruising or bleeding, bloody, black, pale, or tarry stools, confusion, clumsiness.
Acetazolamide


Drug Class:
Carbonic anhydrase inhibitor; anticonvulsant

Available OTC?: No

Available Generic?: Yes

Diamox 500 mg
(Storz)
Available In
Why Prescribed
How It Works
Range and Frequency
Onset of Effect
Duration of Action
Dietary Advice
Storage
Missed Dose
Stopping the Drug
Prolonged Use
Over 60
Driving and Hazardous Work
Alcohol
Pregnancy
Breast Feeding
Infants and Children
Special Concerns
Overdose Symptoms
What to Do
Drug Interactions
Food Interactions
Disease Interactions


Available In
Tablets, extended-release capsules, injection

Why Prescribed
To treat glaucoma, seizures, familial periodic paralysis; to prevent or treat mountain (altitude) sickness; to prevent one type of kidney stones.

How It Works
For glaucoma: Blocks the enzyme carbonic anhydrase, thus decreasing the normal secretion of fluid inside the eyeball. For seizures: Appears to reduce the firing of neurons in the brain. For paralysis: Stabilizes muscle membranes. For mountain sickness: Stimulates greater oxygen intake, improves blood flow to the brain, and improves release of oxygen from red blood cells. For kidney stones: Increases alkalinity of urine, which reduces stone formation.

Range and Frequency
Tablets-- For glaucoma: Adults: 250 mg, one to four times a day. Children: 4.5 to 6.8 mg per lb of body weight per day in divided doses. For seizures: 4.5 mg per lb daily in divided doses. For altitude sickness: 250 mg, two to four times a day. Extended-release capsules-- For glaucoma: 500 mg twice a day (morning and evening). For altitude sickness: 500 mg, one to two times a day. Injection-- For glaucoma: Adults: 500 mg once a day. Children: 2.3 to 4.5 mg per lb every six hours.

Onset of Effect
Tablets: Within 60 to 90 minutes. Extended release capsules: two hours. Injection: two minutes.

Duration of Action
Tablets: eight to 12 hours. Extended-release capsules: 18 to 24 hours. Injection: four to five hours.

Dietary Advice
Take oral acetazolamide with food or milk to avoid stomach upset. Tablets can be crushed and mixed with sweet foods to cover taste. (Do not crush extended-release capsules.) Eat foods high in potassium.

Storage
Store in a tightly sealed container away from heat, moisture, and direct light.

Missed Dose
Take it as soon as you remember. If it is near the time for the next dose, skip the missed dose and resume your regular dosage schedule. Do not double the next dose.

Stopping the Drug
The decision to stop taking the drug should be made by your doctor. Do not stop taking the drug abruptly.

Prolonged Use
Prolonged use of this drug may require increased potassium intake.

Over 60
Adverse reactions may be more likely and more severe in older patients.

Driving and Hazardous Work
Do not drive or engage in hazardous work until you determine how the medicine affects you.

Alcohol
Alcohol may interfere with seizure control.

Pregnancy
Adequate studies have not been done; discuss the relative risks and benefits with your doctor.

Breast Feeding
It may be necessary to switch medications or discontinue breast feeding.

Infants and Children
No problems are expected.

Special Concerns
May increase urine output, especially at first, as your body adapts to the drug. To keep this condition from disrupting sleep, take a single dose after breakfast if possible; if you take multiple daily doses, take the last one before 6 pm, unless your doctor instructs otherwise.

Overdose Symptoms
Drowsiness, numbness, nausea, thirst, vomiting, seizures, coma.

What to Do
Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions
Do not take acetazolamide with high doses of aspirin or amphetamines, as this may be toxic. Do not take it if you are allergic to sulfa-type drugs. Consult your doctor if you are taking mecamylamine, quinidine, lithium, methenamine, or oral hypoglycemia agents.

Food Interactions
Avoid black licorice. Include high-potassium foods such as bananas and citrus fruits in your diet.

Disease Interactions
Do not take acetazolamide if you have serious liver or kidney disease, Addison's disease, low blood levels of potassium or sodium, or diabetes mellitus. Consult your doctor if you have gout or a lung disease such as emphysema, or a history of kidney stones.

Date Published: 04/13/2005
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