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Active Ingredient: Acetazolamide
Brand(s): Diamox

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What is Acetazolamide?

Acetazolamide is a carbonic anhydrase inhibitor. It’s chemically associated with the sulphonamides but has no bacteriostatic activity. The effect in glaucoma comes from blocking the enzyme carbonic anhydrase in the ciliary body of the eye, which makes the eye make less fluid. The decreased provision of intraocular fluid results in a drop in intraocular stress. Period of motion after oral administration: 8–12 hours

Acetazolamide Drug Recommendation

An ophthalmologist must perform glaucoma treatment. In open-chamber glaucoma, therapy consists of native drug therapy and/or laser therapy. If this treatment doesn’t help enough to relieve the pressure on the eyeballs, surgery may be needed. Eye drops containing a prostaglandin analogue are the primary alternative to drug remedies. If the impact of or intolerance to a prostaglandin analogue is inadequate, a beta-blocker is really useful as monotherapy. In addition to the above monotherapies, you can also use a 2-agonist or a carbonic anhydrase inhibitor in the same area. When a single treatment doesn’t work well enough, medicines with different ways of working are mixed. Most people with narrow-angle glaucoma are treated with a combination of drugs and laser therapy or surgery.

Acetazolamide is best used for acute narrow-angle glaucoma, when eye stress needs to go down quickly and significantly. It is no longer used for open-angle glaucoma.

When not to use?

  • Being pregnant
    • Teratogenesis: A restricted variety of human knowledge doesn’t point out an elevated threat of congenital anomalies. In  100 pregnancies with first trimester publicity (case stories and case sequences, particularly with intracranial hypertension), there isn’t clear proof of an elevated threat of congenital anomalies, but the numbers are too low to make an announcement in regards to the threat. In animals at supratherapeutic doses, there may be proof of harm (limb abnormalities). There are over 1000 pregnancies with publicity within the 2 orwereharmbuthypertension) sequences of 3 trimesters (knowledge primarily from one previous, not well documented publication); the variety of abnormalities was not elevated.
    • A couple of instances of metabolic acidosis within the new child have been reported after maternal use of acetazolamide shortly after starting. Acetazolamide is a spinoff of the sulphonamides. Sulfonamides could cause hyperbilirubinemia (with kernicterus) within the neonate when used over the past few months of being pregnant.
    • On account of inadequate or restricted expertise, use solely on very strict indications.

  • Lactation
    • Transition in breast milk: Sure, to a minor extent (roughly 2% of the maternal dose).
    • Based on the producer, this low concentration in breast milk is unlikely to trigger antagonistic results in the toddler.
    • can, in all probability, be used safely.

Acetazolamide Dosage

  • persistent non-congestive closed-chamber glaucoma;
  • sodium and potassium depletion.
  • hypochloremic acidosis;
  • extreme renal impairment;
  • hepatic illness or extreme hepatic impairment;
  • Addison;
  • cor pulmonale;
  • hypersensitivity to sulphonamides.

Diamox Indications

  1. Glaucoma:
    • as an adjuvant.
    • Secondary glaucoma
    • preoperatively in acute narrow-angle glaucoma.
  2. Oedema:
    • Together with different diuretics within the therapy of oedema, if an impact on the completely different elements of the nephron is desired (Diamox tablets/injection),
    • Premenstrual oedema (acetazolamide tablets).
    • Prophylaxis of pulmonary oedema at very excessive altitude (registered indication of acetazolamide tablets).
    • prophylaxis and therapy of altitude illness.
  3. Different:
    • as an adjuvant or monotherapy (Diamox tablets).

Acetazolamide Drug Interactions

Acetazolamide and other sulfonamides might make folic acid antagonists, blood sugar-lowering agents, and oral anticoagulants work better.

Don’t use it at the same time as acetylsalicylic acid, because salicylates and acetazolamide make each other more toxic. Free acetazolamide improves the focus of free acetazolamide within the plasma by displacement from the protein binding site and by inhibition of renal excretion, thus increasing the danger of (extreme) metabolic acidosis (even with regular renal function) and central nervous system toxicity (equivalent to lethargy, somnolence, confusion, tinnitus, and anorexia).

Because of how acetazolamide affects potassium levels, the dose may need to be changed when it is taken with cardiac glycosides like digoxin or blood pressure medications. When mixed with other diuretics, like thiazides, the effect of the diuretic and the risk of hypokalemia may get worse.

Acetazolamide might raise phenytoin levels in the blood, and there have been reports of lower primidone levels and higher carbamazepine levels in the blood. Extreme osteomalacia has additionally been reported in conjunction with different antiepileptic medicines. Because of how acetazolamide affects blood glucose levels, it is important to keep an eye on them even more when using blood glucose-lowering agents.

Acetazolamide makes the pH of the tubular urine alkaline. This is likely to change the way weak acids and bases like ephedrine and methadone leave the body (excretion is sped up) and how quickly bases leave the body (excretion is slowed down). For instance, acetazolamide decreases the urinary excretion of amphetamine and quinidine. Acetazolamide will increase the excretion of lithium, thereby lowering the impact of lithium.

Ciclosporin levels in the blood might improve, so monitor these sufferers intently. They should not be used concurrently with other carbonic anhydrase inhibitors due to additive effects. The plasma half-life of procaine could also be extended when acetazolamide is used concomitantly. There’s an elevated threat of kidney stones with the concomitant use of sodium hydrogen carbonate.

Acetazolamide Dosage

Check blood dependencies before and during treatment; if these changes are not made, discontinue use. The 250-mg pill has a double break mark, permitting it to be dosed in 62.5-mg increments. For youngsters, oral suspension (drink) can be utilised.

  1. Persistent open-chamber glaucoma: as an adjuvant to standard remedy
    • Adults: Oral: 250 mg 1-4 /day Doses above 1000 mg/day often don’t produce a larger therapeutic impact.

  2. Secondary glaucoma and pre-operative acute narrow-angle glaucoma
    • Adults
      • Oral: 250 mg every 4 hours; or 250 mg twice a day for short-term remedy.
      • Oral, intravenous: 500 mg without delay, followed by 125-250 mg every 4 hours, based on scientific image.
  3. Remedy for oedema, together with different diuretics
    • Adults: Oral, intravenous: 250-375 mg 12/day in the morning for 2 days, followed by sooner or later of relaxation; then repeat schedule. Or administer acetazolamide every 2 days. Overdosage or too frequent dosing often results in therapy failure and will trigger elevated uncomfortable side effects.
    • Kids > 1 month: Oral: 5 mg/kg physique weight 1/day (max. 375 mg/day) in the morning for 2 days, followed by sooner or later of relaxation; then repeat schedule. Or administer acetazolamide every 2 days.

  4. Premenstrual oedema
    • Adults: Oral: 250 or 375 mg 5-10 days earlier than the beginning of menstruation and 2-3/week as wanted.

  5. Excessive-altitude pulmonary oedema prophylaxis
    • Adults: Oral: 250-375 mg sooner or later, earlier than reaching altitude, then 2-3/week for long-term stays.

  6. Offlabel: prophylaxis of altitude illness
    • Adults and kids  40 kg: Oral: 125 mg twice a day; begin 24 hours earlier than reaching an altitude of 3000 metres and proceed till two days after reaching the utmost altitude (or shorter if descending earlier).
    • Kids  40 kg: Oral: 2.5 mg/kg physique weight, 2/day; begin 24 hours earlier than reaching an altitude of 3000 metres and proceed till two days after reaching the utmost altitude (or shorter if descending earlier).
    • Basic: Take into account prophylaxis if there’s an excessive threat of altitude illness. The prophylaxis could also be interrupted if the ascent can be interrupted by a stay of > 2 days at roughly the identical altitude. Then restart prophylaxis while climbing once more.

  7. Off-label: therapy of altitude illness
    • Adults and kids  40 kg: oral: 250 mg twice/day for 3 days, or shorter if descending earlier.
    • Kids  40 kg: Oral: 2.5 mg/kg physique weight, 2/day for 3 days, or shorter if descending earlier.
    • The traveller ought to begin taking the drug on the first signs of headache, even when the signs are mild and the affected person later climbs higher. If there isn’t an additional ascent, you possibly can wait if you have gentle signs. If signs happen once more throughout additional climbing, take the treatment once more for 3 days. When staying at an altitude of > 4000 m, prescribe tablets for six days.

  8. as an adjuvant to anticonvulsants
    • Adults: Oral: beginning dose of 250 mg without delay; improving based on scientific image; standard dose is 375-1000 mg day by day.
    • Kids > 1 month:
      • Oral: 8-30 mg/kg physique weight per day in divided doses.
      • Oral: 8-30 mg/kg/day in 2-3 doses, max. 1500 mg/day.
      • Intravenous: in emergency instances solely: 8-30 mg/kg/day in 2-3 doses, max 1500 mg/day.

It is not advised for patients with severe renal impairment (creatinine clearance less than 30 ml/min).

Use in the case of liver illness or extreme hepatic impairment is contraindicated.

Signs of Overdose

  • drowsiness
  • confusion
  • Paraesthesia

Acetazolamide Precautions

Because of the risk of blood count abnormalities (acute haemolytic anaemia, agranulocytosis, aplastic anaemia, thrombocytopenia, and eosinophilia), blood dependencies should be checked earlier and more frequently during therapy. If there’s a change within the blood, discontinue use. Use with care if you have liver disease or severe liver damage, especially cirrhosis, because you are more likely to get hepatic encephalopathy.

There have been rare reports of Stevens-Johnson syndrome, poisonous epidermal necrolysis, and fulminant hepatic necrosis like reactions to sulphonamides and acetazolamide. These reactions are usually fatal. Hypersensitivity reactions could happen again if a sulphonamide or a derivative of it is used again, no matter how it is given. A generalised rash with fever and pustules at the beginning of treatment could also be a sign of acute generalised exanthematous pustulosis (AGEP). Patients should report any unusual skin rashes. If hypersensitivity or other serious reactions happen, treatment should be stopped right away.

Long-term use is not recommended in patients with persistent non-congestive closed-angle glaucoma. It is possible that the chamber angle will close on its own, but glaucoma will not get worse because the intraocular pressure will be lower.

Verify serum electrolytes often. Acetazolamide can cause problems with the balance of electrolytes, such as low sodium, low potassium, and metabolic acidosis. Caution should be used in patients who have conditions that are associated with, or predispose them to, electrolyte or acid-base imbalances, such as renal dysfunction or patients who have impaired alveolar air flow (pulmonary obstruction, emphysema). Hypokalemia is similar to primary hyperaldosteronism and Cushing’s syndrome, so you should be careful if you think you might have it.

Increasing the dose doesn’t make people pee more, and it will cause more unpleasant side effects like drowsiness and tingling. Each of the improved and reduced glucose ranges has been reported. Warning needs to be exercised in instances of impaired glucose tolerance or diabetes mellitus.

When doing mountain sports, altitude sickness can happen if you go from sea level to above 3,000 m in less than 24 hours and stay there for a long time. Above 3,000 m, climb at least 500 m per evening. Spend at least two nights at the same altitude after any ascent of more than 500 metres. Based on the LCR’s travel advice about altitude sickness, if there is a high risk of it, you might want to take acetazolamide to prevent it:

  • After experiencing altitude illness at the same (or lower) altitude,
  • When ascending > 600 m/day above 3000 m,
  • when rising from sea level to > 3500 m, sooner or later.

Cirpo Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do, they may require medical attention. Check with your doctor immediately if any of the following side effects occur:

  • Bone marrow melancholy, aplastic anaemia, agranulocytosis, leukopenia, thrombocytopenia, thrombocytopenic purpura, pancytopenia.
  • Listening to impairment and tinnitus
  • Melena
  • Irregular liver function
  • pores and skin rash, urticaria, erythema multiforme
  • Stevens-Johnson syndrome, poisonous epidermal necrolysis
  • Crystalluria, renal and ureteral colic, haematuria, glucosuria, renal failure
  • Metabolic acidosis, transient hypokalaemia, hyponatraemia, hyperglycaemia, hypoglycaemia, osteomalacia.
  • convulsions, weak point, indicators of paralysis
  • Hepatitis, cholestatic icterus, fulminant hepatic necrosis
  • Itching, photosensitisation

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


The information about psychotic disorders included in the Acetazolamide review is solely for educational purposes and should not be regarded as a substitute for licenced healthcare or a referral from the well-being treatment distributor.


⚠Disclaimer of liability

This website isn\’t connected with any brands. They own all the brand, logos, and images. This website\’s content is for informational purposes only and not intended as medical advice, diagnosis, or treatment. If you have questions about a medical issue, consult a doctor. Do not reject medical advice or delay in getting it because of this website.

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Frequently Asked Questions

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  1. What is Acetazolamide Diamox?

    This medication helps reduce symptoms such as headaches, tiredness, nausea, dizziness, and shortness of breath that can occur when ascending to high altitudes rapidly (generally above 3,048 metres or 10,000 feet). Acetazolamide is an effective medication for both preventing and treating the symptoms of altitude sickness.

  2. What to do if you miss a dose?

    If you realise that you have missed taking your dose of acetazolamide, take it as soon as you remember. If it is almost time for the next dose you are supposed to take, however, you should skip the dose you missed and go back to your regular dosing schedule. Do not increase the dosage by two.

  3. What if u take too much Diamox?

    In the event of an overdose, contact your primary care physician or the emergency room of the hospital closest to you. It’s possible that you need to seek emergency medical attention right away. You could also try getting in touch with the hospital’s poison management team in your area.

  4. How to store Acetazolamide?

    Keep your medications out of the reach of light and moisture at a temperature between 68 and 77 degrees Fahrenheit (20 and 25 degrees Celsius), which is room temperature.

  5. What Should I Avoid While Taking Acetazolamide?

    When you are taking Diamox, you should refrain from drinking alcohol and using any illegal medications. They might make the treatment less effective (for example, by making your confusion even worse) while simultaneously making its adverse effects (such as sedation) more severe.

  6. What are the side effects of Acetazolamide Diamox?

    Dizziness, lightheadedness, an increase in the amount of urine, blurred vision, dry mouth, drowsiness, headaches, and other symptoms are among the most common adverse reactions to this medication.

  7. What are the Contraindication?

    Patients who are known to have an allergic reaction to any of the components of the tablet, as well as pregnant women and children, are advised to avoid taking this medication.

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