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Acetazolamide: Uses, Dosage, Side Effects & Interactions Explained
Summary of Key Points
Acetazolamide is a prescription medication used to manage a variety of conditions, including glaucoma, altitude sickness, epilepsy, and more. It works by reducing fluid buildup in the body and altering certain chemical levels in the blood. Acetazolamide is available in different forms and strengths. Always consult your healthcare provider before starting or adjusting your dose. You can also speak to one of our telemedicine providers for personalized advice.
Names of Medication
Generic Name: Acetazolamide
US Brand Name: Diamox
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.
Pharmacologic Category
Carbonic Anhydrase Inhibitors
Acetazolamide Dosage
Acetazolamide is prescribed for a range of conditions, and the dosage and frequency will vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can schedule a telemedicine appointment with one of our providers for further guidance.
Acetazolamide for Glaucoma
Dosage: 250 mg to 1,000 mg per day, divided into multiple doses
Frequency: Typically taken 2 to 4 times a day
Length of Treatment: Long-term, depending on response and condition
Acetazolamide for Altitude Sickness
Dosage: 125 mg to 250 mg twice daily
Frequency: Twice a day, starting 1 to 2 days before ascent
Length of Treatment: Continue for 48 hours after reaching altitude or until symptoms resolve
Acetazolamide for Epilepsy
Dosage: 250 mg to 1,000 mg per day, divided into multiple doses
Frequency: Typically taken 1 to 4 times daily
Length of Treatment: Long-term, as directed by your healthcare provider
Acetazolamide for Metabolic Alkalosis
Dosage: 250 mg to 375 mg once or twice daily
Frequency: Once or twice a day
Length of Treatment: As directed by your healthcare provider
Acetazolamide for Heart Failure
Dosage: 250 mg to 375 mg once daily
Frequency: Once daily
Length of Treatment: As directed by your healthcare provider
Acetazolamide for Pseudotumor Cerebri
Dosage: 250 mg to 1,000 mg per day, divided into multiple doses
Frequency: Typically taken 2 to 4 times daily
Length of Treatment: Long-term, depending on response
Acetazolamide for Kidney Stones
Dosage: 250 mg to 375 mg once daily
Frequency: Once daily
Length of Treatment: As directed by your healthcare provider
Acetazolamide for Respiratory Acidosis
Dosage: 250 mg to 375 mg once daily
Frequency: Once daily
Length of Treatment: As directed by your healthcare provider
Acetazolamide for Cystic Fibrosis
Dosage: 250 mg to 1,000 mg per day, divided into multiple doses
Frequency: Typically taken 2 to 4 times daily
Length of Treatment: Long-term, depending on response
Acetazolamide for Periodic Paralysis
Dosage: 250 mg to 1,000 mg per day, divided into multiple doses
Frequency: Typically taken 2 to 4 times daily
Length of Treatment: Long-term, depending on response
Dosage Forms and Strengths of Acetazolamide
Tablets: 125 mg, 250 mg
Extended-Release Capsules: 500 mg
Injection (IV): 500 mg per vial
Contraindications for Acetazolamide
A contraindication is a specific condition where a medication should not be used because it may cause harm. If you have any of the following conditions, it may not be safe for you to take Acetazolamide. Always consult with your healthcare provider before starting or stopping any medication.
Severe Kidney Disease: Acetazolamide is processed through the kidneys. If your kidneys are not functioning well, the medication can accumulate, leading to harmful side effects.
Severe Liver Disease: Acetazolamide can affect electrolyte balance, potentially worsening liver problems and increasing the risk of hepatic encephalopathy (a decline in brain function due to liver disease).
Adrenal Gland Insufficiency (Addison’s Disease): Acetazolamide can interfere with hormone regulation, which can be dangerous for individuals with adrenal gland issues.
Low Sodium or Potassium Levels: Acetazolamide can further reduce sodium and potassium, essential electrolytes for normal body function. Low levels can lead to serious complications, such as heart rhythm problems.
Allergy to Sulfa Drugs: Acetazolamide is a sulfonamide derivative, so individuals allergic to sulfa drugs may also be allergic to Acetazolamide.
Drug-to-Drug Interactions
Acetazolamide can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It’s essential to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Acetazolamide:
- Aspirin (acetylsalicylic acid): High doses of aspirin can increase the risk of Acetazolamide toxicity.
- Digoxin (Lanoxin): Acetazolamide may lower potassium levels, which could heighten the risk of digoxin toxicity.
- Phenytoin (Dilantin): Acetazolamide may reduce the effectiveness of phenytoin, a medication used to control seizures.
- Topiramate (Topamax): Both Acetazolamide and Topiramate can raise the risk of metabolic acidosis (a buildup of acid in the body), especially when taken together.
- Diuretics (e.g., Furosemide/Lasix): Combining Acetazolamide with other diuretics may increase the risk of dehydration and electrolyte imbalances.
Acetazolamide in Pregnancy
Is it safe to take Acetazolamide during pregnancy?
Acetazolamide is classified as a Pregnancy Category C drug by the FDA, meaning there are no well-controlled studies in pregnant women, but animal studies have shown some risk to the fetus. Acetazolamide should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, discuss this with your healthcare provider to determine the best course of action.
Acetazolamide While Breastfeeding
Is it safe to take Acetazolamide while breastfeeding?
Acetazolamide passes into breast milk, but its effects on a nursing infant are not well studied. If you are breastfeeding, it’s important to weigh the benefits of taking Acetazolamide against any potential risks to your baby. Consult your healthcare provider to discuss your options.
Estimated Cost of Acetazolamide Medication
The estimated cost of a 30-day supply of Acetazolamide (250 mg tablets) without insurance ranges from $15 to $30 when using a GoodRx coupon. Prices may vary depending on the pharmacy and location. Be sure to check for discounts or coupons that may help lower the cost of your Acetazolamide prescription.
Possible Alternatives to Acetazolamide
If Acetazolamide is not suitable for you, or if you are seeking alternative treatments, other options are available depending on the condition being treated. Always discuss any changes to your treatment plan with your healthcare provider. You can also consult one of our providers through telemedicine for personalized advice.
- Glaucoma: Alternatives include beta-blockers (e.g., Timolol), prostaglandin analogs (e.g., Latanoprost), or laser surgery.
- Altitude Sickness: Gradual ascent, proper hydration, and medications like Dexamethasone or Nifedipine may be alternatives.
- Epilepsy: Other anticonvulsants like Lamotrigine or Valproate may be used. Lifestyle changes, such as ensuring adequate sleep and managing stress, can also help reduce seizures.
- Metabolic Alkalosis: Treating the underlying cause, adjusting electrolyte levels, or using medications like potassium chloride may be considered.
- Heart Failure: Alternatives include diuretics like Furosemide, ACE inhibitors, or lifestyle changes such as reducing salt intake and engaging in regular exercise.
- Pseudotumor Cerebri: Weight loss, lumbar puncture, or medications like Topiramate may be considered.
- Kidney Stones: Increasing water intake, making dietary changes, or using medications like potassium citrate may help prevent kidney stones.
- Respiratory Acidosis: Treating the underlying lung condition or using oxygen therapy may be alternatives.
- Cystic Fibrosis: Alternatives include medications like Dornase alfa (Pulmozyme) or chest physiotherapy.
- Periodic Paralysis: Lifestyle changes, such as avoiding triggers (e.g., high-carb meals), and medications like potassium supplements may be alternatives.
Recent Updates on Acetazolamide Research
Recent studies have explored Acetazolamide’s potential in treating conditions beyond its traditional uses. For example, ongoing research is investigating its role in treating sleep apnea and improving outcomes in patients with chronic obstructive pulmonary disease (COPD). There is also growing interest in its use for managing certain types of migraines. However, more research is needed to confirm these findings. Always consult your healthcare provider before considering new treatments. You can also schedule a telemedicine appointment with one of our providers to discuss the latest research and how it may apply to your care.
