ACETAZOLAMIDE

Anti-glaucoma and diuretic medicine. Reduces production of aqueous humour in the eye hence reducing intraocular pressure.
It is used as an adjunct to topical anti-glaucoma medicines

Dosage Forms

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Tablet

250 mg

Uses

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  • Open-angle glaucoma
  • Secondary glaucoma
  • Peri-operatively in angle-closure glaucoma

Dose and Duration

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Peri-operatively in angle-closure glaucoma
Adult: 0.25‒1 g daily in divided doses for as long as is required

Contraindications

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  • Chronic angle-closure glaucoma
  • Hypersensitivity to sulphonamides
  • Hyponatraemia
  • Hypokalaemia
  • Hyperchloraemic acidosis
  • Renal impairment
  • Severe hepatic impairment

Side Effects

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  • Stomach upset, taste disturbances, loss of appetite
  • Paraesthesia (tingling feeling in hands and feet)
  • Headache, dizziness
  • Thirst, increased frequency of urination
  • Reduced libido
  • Depression
  • Metabolic acidosis and electrolyte disturbances on long term therapy
  • Rash
  • Blood disorders

Interactions

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  • Carbamazepine (increased risk of hyponatraemia;
    increased concentration of carbamazepine)
  • Digoxin (hypokalaemia increases cardiac toxicity of digoxin)
  • Enalapril (enhanced hypotensive effect)
  • Lidocaine (hypokalaemia antagonises action of lidocaine)
  • Lithium (increased excretion of lithium)

Patient Instructions

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  • Do not drive or operate machinery while taking this medicine
  • Report any unusual skin rash especially when acetazolamide is used for long-term therapy

Pregnancy

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  • Do not use especially in the 1st trimester

Breastfeeding

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  • Can be used

⚠️ Caution

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  • May mask deterioration of angle-closure glaucoma
  • May cause metabolic acidosis in patients with renal impairment
  • Reduce dose in the elderly
  • Use with extreme caution in breast-feeding women
  • Monitor blood cell count and electrolyte levels periodically when used for long-term therapy