Adult Dosing
Simple Glaucoma
- Extended Release CAPS: 500 mg PO bid
- TABS: 250 mg-1 g PO daily, dose over 250 mg to be given in divided doses
Secondary glaucoma/ preoperatively in acute congestive (closed-angle) glaucoma
- Extended Release CAPS: 500 mg PO bid
- TABS: 250 mg PO q4 hrs or bid
- Alt: 500 mg PO x 1, followed by 125-250 mg PO q4 hrs
Epilepsy
- TABS: 8-30 mg/kg or 375-1000 mg PO in divided doses; Max: 1 g/day
- In combination with other anticonvulsants: 250 mg PO Daily
Edema due to Congestive Heart Failure
- TABS: 250-375 mg PO qam
- For best diuretic results: 250-375 mg PO qod or for two days alternating
Drug-Induced Edema
- TABS: 250-375 mg x 1-2 days; alternating with a day of rest
Acute Mountain Sickness
- Extended Release CAPS, TABS: 500-1000 mg PO in divided doses, may use higher dose 1000 mg in case of rapid ascent
- Note: Start 24-48 hrs before ascent and continue for 48 hrs while at high altitude or longer as necessary to control symptoms
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 10-50 mL/min: Reduce dose to 250 mg bid
- <10 mL/min: Contraindicated
Hepatic Dose Adjustment
- Marked liver diseases/cirrhosis: Contraindicated
Geriatric Dosing
- For Glaucoma, reduce dose to 125 mg QID or 500 mg Extended Release CAPS daily
See Supplemental Patient Information
- Fatalities like Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias have occurred due to severe reactions to sulfonamides, discontinue the drug if such serious reactions occurs
- Anorexia, tachypnea, lethargy, coma and death have been reported with concomitant use of high-dose aspirin and acetazolamide, use cautiously in these patients
- Large dose results in a decrease in diuresis and can increase the incidence of drowsiness and/or paresthesia, give large doses in conjunction with other diuretics in order to secure diuresis in complete refractory failure
- Monitor CBC and platelet count at baseline prior to initiating acetazolamide therapy and at regular intervals during therapy, discontinue the treatment and institute appropriate therapy if significant changes occur
- Use cautiously in patients with pulmonary obstruction or emphysema where alveolar ventilation may be impaired, as acetazolamid therapy precipitate or aggravate acidosis
- Acetazolamide causes both increase and decrease in blood glucose, use cautiously in patients with impaired glucose tolerance or diabetes mellitus
- Monitor serum electrolytes periodically as acetazolamide causes electrolyte imbalances, including hyponatremia and hypokalemia, as well as metabolic acidosis
Cautions: Use cautiously in
- Renal diseases
- Concomitant high dose of aspirin
- Pulmonary obstruction or emphysema
- Diabetes mellitus
- Gout
Supplemental Patient Information
- Advise patients to avoid driving, operating machinery, or performing other hazardous activities as acetazolamide therapy may cause dizziness or drowsiness
Pregnancy Category:C
Breastfeeding: As per limited data low levels of acetazolamide is excreted in milk, following the maternal dosage of 1000 mg/day and would not be expected to cause any adverse effects in breastfed infants. This information is based upon LactMed database. (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 February 2011). As per manufacturer's data, because of the potential for serious adverse reaction in nursing infants from acetazolamide, a decision should be made whether to discontinue nursing or to discontinue the drug taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- AcetaZOLAMIDE 125 MG TABS [Bottle] (TARO)
90 mg = $45.99
180 mg = $83.97 - Diamox Sequels 500 MG CP12 [Bottle] (TEVA/WOMENS HEALTH)
60 mg = $359.9
180 mg = $1043.75
Warning: 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.
