• Basic Info
• Top Questions
• Clinical Info
• Interactions

What is acetazolamide?
Acetazolamide is a carbonic anhydrase inhibitor. Carbonic anhydrase is a protein in your body. Acetazolamide reduces the activity of this protein. Acetazolamide is used to treat glaucoma and to treat and to prevent acute mountain sickness (altitude sickness). It is also used as a part of some treatment plans for congestive heart failure and seizure disorders. Acetazolamide may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of acetazolamide?

If you experience any of the following serious side effects, stop taking acetazolamide and seek emergency medical attention:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• a sore throat or a fever;

• unusual bleeding or bruising;

• side or groin pain;

• tingling or tremors in your hands or feet; or

• a rash.

Other, less serious side effects may be more likely to occur. Continue to take acetazolamide and talk to your doctor if you experience

• decreased appetite, nausea, vomiting, constipation, diarrhea, or changes in taste;

• drowsiness, dizziness, fatigue, or weakness;

• nervousness or mild tremor;

• headache or confusion;

• increased sensitivity of the skin to sunlight;

• worsening gout;

• loss of blood sugar control (if you are diabetic);

• ringing in your ears or hearing problems; or

• changes in your vision.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take acetazolamide?
Take acetazolamide exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Take acetazolamide with food if it upsets your stomach. Store acetazolamide at room temperature away from moisture and heat.

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What is the most important information I should know about acetazolamide?
Call your doctor immediately if you experience a sore throat, fever, unusual bleeding or bruising, tingling or tremors in your hands or feet, pain in your side or groin, or a rash. These symptoms could be early signs of a serious side effect. Use caution when driving, operating machinery, or performing other hazardous activities. Acetazolamide may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Avoid prolonged exposure to sunlight. Acetazolamide may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

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What other drugs will affect acetazolamide?
Before taking this medication, tell your doctor if you are taking any of the following medicines: cyclosporine (Sandimmune). Cyclosporine may have more side effects if it is taken with acetazolamide. primidone (Mysoline). Primidone may not be as effective if it is taken with acetazolamide, and seizure control may be reduced. diflunisal (Dolobid). Diflunisal may increase both the activity and the side effects of acetazolamide. aspirin, salsalate (Disalcid, Salflex, Salsitab, others), choline salicylate (Arthropan), magnesium salicylate (Doan's, Magan, Mobidin), and other aspirin-like products (salicylates). These medicines may also interact with acetazolamide, and special monitoring of your therapy may be necessary.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Acetazolamide has been assigned to pregnancy category C. Animal studies have shown it to be teratogenic (limb defects, axial skeletal and genitourinary malformations). There are no controlled data from human pregnancy. Acetazolamide should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Despite widespread usage, there is no evidence of a direct association between acetazolamide and birth defects during human pregnancy. Two cases are noteworthy. In one, a woman who used acetazolamide 750 mg/day for glaucoma during the first and second trimesters gave birth to an infant with sacrococcygeal teratoma. In a second case, a woman who used acetazolamide 500 mg/day for glaucoma throughout pregnancy gave birth to an infant who demonstrated metabolic complications postpartum. These problems included metabolic acidosis, hyperbilirubinemia, hypocalcemia, and hypomagnesemia. The neonate was successfully treated, and was only observed to have mild hypertonicity of the lower limbs at up to eight months of age. Retrospective studies, such as the Collaborative Perinatal Project (CCP), reveal no evidence of a relationship between major or minor categories of defects to the use of acetazolamide. The CPP found 12 of 50,282 monitored mother-child pairs had been exposed to the drug during the first or second trimester. A total of 1,024 pairs were exposed to the drug during pregnancy. None of the 12 and 18 of the 1,024 were observed to have anomalies. The incidence of expected anomalies was 18.06 in the 1,024. Therefore, there is no evidence of teratogenicity associated with the use of acetazolamide from this retrospective study. Physicians are encouraged to register patients before fetal outcome is known (e.g., ultrasound, results of amniocentesis, etc) into the Antiepileptic Drug (AED) Pregnancy Registry at 1-888-233-2334 or 1-888-AED-AED4. This is an ongoing study at the Massachusetts General Hospital/Harvard Medical School. This study is designed to monitor the outcomes of pregnant women exposed to antiepileptic drugs in order to determine which therapies are associated with increased risk.

Acetazolamide is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. Acetazolamide is considered compatible with breast-feeding by the American Academy of Pediatrics.

Limited data are available. A single case of a woman who breast-fed while taking acetazolamide SR 1000 mg/day for glaucoma has been reported. Milk acetazolamide levels after 5 days between 1 and 9 hours after a dose ranged from 1.3 to 2.1 mcg/mL, which represented approximately 25% of the maternal serum drug levels. Plasma levels in the nursing infant ranged from 0.2 to 0.6 mcg/mL. No side effects in the nursing infant were observed. In short, limited data suggest that nursing infants are likely to receive only miniscule amounts of acetazolamide, amounts unlikely to result in side effects.

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Who should NOT use this medication?

• Marked impairment of hepatic function. Cirrhosis. (See Hepatic Impairment under Cautions.)
• Depressed serum concentrations of sodium and/or potassium.
• Adrenocortical insufficiency.
• Hyperchloremic acidosis.
• Marked impairment of renal function.
• Long-term treatment of angle-closure glaucoma; further closure of the angle may occur while worsening of glaucoma is masked by lower IOP.
• Hypersensitivity to acetazolamide or any ingredients in the formulation.

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What does my medication look like?
Acetazolamide is available with a prescription generically and under the brand name Diamox . Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Diamox 125 mg--round, white, scored tablets Diamox 250 mg--round, white, scored tablets Diamox Sequels 500 mg (Sustained Release)--orange capsules

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What happens if I overdose?
Seek emergency medical attention. Symptoms of an acetazolamide overdose are not well known, but the following symptoms might be expected: drowsiness, decreased appetite, nausea, vomiting, dizziness, numbness or tingling, shaking, and ringing in the ears.

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Who should not take acetazolamide?
Tell your doctor if you have ever had an allergic reaction to a sulfa-based drug such as sulfamethoxazole (e.g., Bactrim, Septra, Gantanol). Acetazolamide is also a sulfa-based drug, and you may have a similar reaction to it. Before taking acetazolamide, tell your doctor if you are on aspirin therapy, have liver disease, have kidney disease, have heart disease, have lung disease, or have a hormonal disease. You may not be able to take acetazolamide, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

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Can I stop taking the medication if I feel better?
Even though you may feel better you should not stop taking your high blood pressure medication without first checking with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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