acetazolamide

CIMS Class : ( Diuretics ) , ( Anticonvulsants ) , ( Antiglaucoma Preparations )

acetazolamide

P - Contraindicated in pregnancy
L - Contraindicated in lactation
Lab ¤ - Lab interference

related acetazolamide information

Indication & Oral

Dosage Diuresis
Adult: 250-375 mg once daily or on alternate days.
Intermittent treatment is needed for continued efficacy.
Oral
Preoperative management of angle-closure glaucoma
Adult: 250-1000 mg daily in divided doses.
Child: 1 mth-12 yr: 10-20 mg/kg daily. Max: 750 mg daily, in
2-4 divided doses.
Oral
Adjunct in open-angle glaucoma
Adult: 250-1000 mg daily in divided doses.
Child: 1 mth-12 yr: 10-20 mg/kg daily. Max: 750 mg daily, in
2-4 divided doses.
Oral
Epilepsy
Adult: Either alone or with other antiepileptics: 250-1000 mg
daily in divided doses.
Child: Neonates and up to 12 yr: Initially, 2.5 mg/kg bid-tid;
maintenance: 5-7 mg/kg bid-tid. Max: 750 mg daily.
Oral
Prophylaxis of high-altitude disorders
Adult: 500-1000 mg daily in divided doses. Prompt descent
is still advised if severe symptoms such as cerebral
or pulmonary oedema occur.
Intravenous
Chronic open-angle glaucoma
Adult: As an adjunct, 0.25-1 g every 24 hr, usually in divided
doses. Adjust dose according to symptomatology and
 or pulmonary oedema occur.
Intravenous
Chronic open-angle glaucoma
Adult: As an adjunct, 0.25-1 g every 24 hr, usually in divided
doses. Adjust dose according to symptomatology and
ocular tension.
Intravenous
Acute closed angle glaucoma
Adult: 250-500 mg. may repeat 2-4 hr later if needed. Max: 1
g daily.
Intravenous
Epilepsy
Adult: 8-30 mg/kg daily in divided doses. Optimum dose:
375-1000 mg daily. When used with other anticonvulsants,
initiate at 250 mg once daily in addition to existing
medications and adjust accordingly.

Reconstitution: Reconstitute with at least 5 ml of sterile

water for inj to produce a solution containing = 100 mg/ml.
Further dilute with 5% dextrose solution or normal saline for
IV infusion.
Incompatibility: Admixture incompatibility: Multivitamins.
Administration Should be taken with food.
Overdosage Symptoms may include electrolyte imbalance, acidotic state
and central nervous effects. Monitor serum electrolyte levels
(particularly potassium) and blood pH levels. Supportive
measures are required to restore electrolyte and pH balance.
Acidotic state can usually be corrected by the admin of
bicarbonate.
Contraindications Hypersensitivity to sulphonamides; sodium or potassium
depletion, hepatic insufficiency; hepatic cirrhosis;
hyperchloraemic acidosis; severe renal impairment; severe
pulmonary obstruction; chronic noncongestive angle-closure
glaucoma; adrenocortical insufficiency. Pregnancy, lactation.
Special Potassium supplements may be required. Impaired hepatic
Precautions or renal function; diabetes. Monitor plasma electrolytes and
blood count regularly. IM route is not recommended. Caution
when driving or operating machinery. Elderly.
Adverse Drug Drowsiness, paraesthesia, ataxia, dizziness, thirst, anorexia,
Reactions headache; confusion, malaise, depression; GI distress,
metabolic acidosis, polyuria, hyperuricaemia, renal calculi,
nephrotoxicity, hepatic dysfunction.
Potentially Fatal: Rarely, skin reactions or blood dyscrasias.
Drug Interactions Aids penetration of weakly acidic substances like
sulphonamides across blood and CSF barrier. May inhibit
renal excretion of basic drugs (e.g. quinidine, ephedrine,
amphetamines) and promotes excretion of acidic drugs. May
increase salicylate toxicity (acidosis). Hypokalaemia with
corticosteroids and potassium-wasting diuretics. May
 sulphonamides across blood and CSF barrier. May inhibit
renal excretion of basic drugs (e.g. quinidine, ephedrine,
amphetamines) and promotes excretion of acidic drugs. May
increase salicylate toxicity (acidosis). Hypokalaemia with
corticosteroids and potassium-wasting diuretics. May
increase excretion of lithium and primidone. May cause
osteomalacia with anticonvulsants.
Potentially Fatal: May potentiate effect of folic acid
antagonists, oral hypoglycaemic agents, oral anticoagulants
and severe reactions to sulphonamides.
Lab Interference May cause false positive results for urinary protein. Interferes
with HPLC theophylline assay and serum uric acid levels.
Pregnancy
Category (US
FDA) Category C: Either studies in animals have revealed
adverse effects on the foetus (teratogenic or embryocidal or
other) and there are no controlled studies in women or
studies in women and animals are not available. Drugs
should be given only if the potential benefit justifies the
potential risk to the foetus.
Storage Intravenous: Store between 15-30°C (59-86°F).
Reconstituted solution may be stored at for 3 days at 2-8°C
(36-46°C) or 12 hr at 15-30°C (59-86°F). Oral: Store at
15-30°C.
Mechanism of Acetazolamide specifically inhibits the enzyme carbonic
Action anhydrase which catalyses the reversible reaction involving
the hydration of CO2 and dehydration of carbonic acid. It
increases the excretion of HCO3 ions and as well as Na and
K leading to alkaline diuresis. Carbonic anhydrase is also
inhibited in the CNS to retard abnormal and excessive
discharge from neurons.
Onset: 60-90 minutes (oral); 2 minutes (IV).
Duration: 8-12 hr (oral); 4-5 hr (IV).
Absorption: Moderately rapid absorption from the GI tract;
peak plasma concentrations after 2 hr (oral).
Distribution: Concentrates in the red blood cells and renal
cortex; enters the breast milk. Protein-binding: High.
Excretion: Urine (as unchanged drug); 3-6 hr (elimination
half-life).
CIMS Class Diuretics / Anticonvulsants / Antiglaucoma Preparations
ATC S01EC01 - acetazolamide; Belongs to the class of carbonic
Classification anhydrase inhibitors used in the treatment of glaucoma and
miosis.
*acetazolamide information:
Note that there are some more drugs interacting with acetazolamide
acetazolamide
acetazolamide brands available in India
Always prescribe with Generic Name : acetazolamide, formulation, and dose
 Always prescribe with Generic Name : acetazolamide, formulation, and dose
(along with brand name if required)
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Brands : ACETAMIDE tab ACETAMIN tab , ACETARIV tab , AVVA SR-cap ,

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