Diamox

Acetazolamide is a carbonic anhydrase inhibitor used for the following conditions:

• To remove extra fluid from the body in people with heart failure.
• Prevention and treatment of altitude sickness.
• Seizures.
• Glaucoma.

Side Effects of Diamox

Common side effects include:

• Paresthesias (tingling, numbness, burning, prickling)
• Ringing in the ears
• Hearing problems
• Loss of appetite
• Changes in taste
• Nausea
• Vomiting
• Diarrhea
• Frequent urination
• Drowsiness
• Confusion

Other less common side effects include:

• Transient myopia
• Sensitivity to light
• Glucose in the urine
• Blood in urine
• Hives
• Headache
• Fever
• Pain at injection site
• Flushing
• Anaphylaxis

Possible serious side effects include:

• Liver problems
• Flaccid paralysis
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis
• Agranulocytosis
• Aplastic anemia and other blood disorders
• Metabolic acidosis
• Electrolyte imbalance
• Growth retardation in children
• Seizures

Dosage for Diamox

For glaucoma: acetazolamide should be used as an adjunct to the usual therapy.

• The usual recommended dose for open-angle glaucoma ranges from 250 mg to 1 gram per day.
• The usual recommended dose for secondary glaucoma and preoperative treatment of closed-angle glaucoma is 250 mg every 4 hours.

For seizures:

• The manufacturer’s suggested total daily dose is 8-30 mg per kg.
• The optimum range appears to be from 375 to 1000 mg, however, some patients may respond to lower doses.
• When used with other anti-seizure medication, the starting dose should be 250 mg.
• To remove excess fluid in patients with congestive heart failure, the starting dose is usually 250 to 375 mg administered once a day in the morning.
• As tolerance may develop with use, this medication should be skipped for a day to allow the kidneys to recover in patients who stop responding to treatment.

For excess water retention caused by medication:

• The usual recommended dose is 250 to 375 mg once a day for one or two days, alternating with a day of rest.

For acute mountain sickness:

• The usual recommended dose is 500 mg to 1000 mg per day.
• 1000 mg is recommended in cases of rapid ascent.
• Treatment should be started 24-48 hours before ascent and continued for 48 hours while at high altitude, or longer as necessary to control symptoms.

Drug Interactions with Diamox

• Acetazolamide should not be used with other carbonic anhydrase inhibitors such as methazolamide (Neptazane).

Pregnancy and breastfeeding

• There are no adequate studies evaluating the use of acetazolamide during pregnancy. Evidence of birth defects was observed in animal studies.
• The use of acetazolamide during breastfeeding should be considered based on the importance of treatment to the mother.

Other Information about Diamox

Available Preparations

• Oral tablets: 125 and 250 mg
• Oral capsules extended release (12hr): 500 mg
• Powder for injection: 500 mg

Storage

• All oral preparations should be stored at room temperature.
• Injection acetazolamide should be stored at room temperature before mixing and in the refrigerator after mixing.

Mechanism of Action

• Carbonic anhydrase is an enzyme that regulates acidity and fluid balance in various organs.
• In the kidneys and eyes, carbonic anhydrase helps maintain fluid balance.
• Acetazolamide works as a diuretic and may be used to treat symptoms of acute mountain sickness and certain forms of seizures.

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Summary

Diamox and Diamox Sequels (acetazolamide) is a man-made drug prescribed for the treatment of glaucoma. Side effects include changes in taste, nausea, vomiting, diarrhea, frequent urination, drowsiness, and confusion.