Pronunciation:

a-seet-a-ZOLE-a-mide

Brand Names:

• Diamox Sequels

Dosage Forms:

• Tablet
• Capsule, Extended Release

Classifications:

Therapeutic—

Cardiovascular Agent

Pharmacologic—

Carbonic Anhydrase Inhibitor

Chemical—

Sulfonamide

Uses of This Medicine:

Acetazolamide is used to treat edema (fluid retention) caused by heart failure or other medicines. This medicine is also used to treat seizures (eg, petit mal, unlocalized seizures). It is also used to treat open-angle glaucoma, secondary glaucoma, and acute angle-closure glaucoma before surgery to lower pressure inside the eye.

This medicine is also used to prevent or make the symptoms of mountain sickness better in climbers.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of acetazolamide in the pediatric population. Safety and efficacy have not been established.

Older adults—

No information is available on the relationship of age to the effects of acetazolamide in geriatric patients.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Methenamine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Amphetamine
• Arsenic Trioxide
• Aspirin
• Benzphetamine
• Carbamazepine
• Dextroamphetamine
• Digitalis
• Droperidol
• Levoketoconazole
• Levomethadyl
• Lisdexamfetamine
• Lithium
• Memantine
• Metformin
• Methamphetamine
• Methotrexate
• Porfimer
• Primidone
• Proscillaridin
• Quinidine
• Sotalol
• Topiramate

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Cyclosporine
• Fosphenytoin
• Licorice
• Phenytoin
• Salsalate

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Adrenal gland problem or
• Glaucoma, noncongestive angle-closure or
• Hypokalemia (low potassium levels in the blood) or
• Hyponatremia (low sodium levels in the blood) or
• Kidney disease or
• Liver disease (eg, cirrhosis) or
• Metabolic acidosis—Should not be used in patients with these conditions.

• Lung problems (eg, emphysema)—Use with caution. May make this condition worse.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For congestive heart failure:
    • Adults—At first, 250 to 375 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For edema caused by other medicines:
    • Adults—250 to 375 milligrams (mg) once a day for one or 2 days, with a rest day in between.
    • Children—Use and dose must be determined by your doctor.
  • For mountain sickness:
    • Adults—500 to 1000 milligrams (mg) in divided doses, taken 24 to 48 hours before climbing, then continue for 48 hours while on high altitude or as needed.
    • Children—Use and dose must be determined by your doctor.
  • For open-angle glaucoma:
    • Adults—At first, 250 milligrams (mg) per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1 gram (g) per day.
    • Children—Use and dose must be determined by your doctor.
  • For secondary and acute closed-angle glaucoma:
    • Adults—250 milligrams (mg) every 4 hours or 2 times a day. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For seizures (acetazolamide alone):
    • Adults—Dose is based on body weight and must be determined by your doctor. Usual dose is 8 to 30 milligrams (mg) per kilogram (kg) of body weight, taken in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1 gram (g) per day.
    • Children—Use and dose must be determined by your doctor.
  • For seizures (in combination with other anticonvulsants):
    • Adults—250 milligrams (mg) once a day. Your doctor may adjust your dose as needed.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may cause serious skin reactions (eg, Stevens-Johnson syndrome and toxic epidermal necrolysis). Check with your doctor if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, trouble breathing, or unusual tiredness or weakness.

Check with your doctor right away if you have blood in the urine, nausea and vomiting, pain in the groin or genitals, or sharp back pain just below the ribs. These may be symptoms of kidney stones.

Check with your doctor right away if you have chest pain or tightness, chills, cough or hoarseness, fever with or without chills, general feeling of tiredness or weakness, headache, lower back or side pain, painful or difficult urination, sore throat, sores, ulcers, or white spots in the mouth, swollen or painful glands, trouble breathing, unusual bleeding or bruising, or unusual tiredness or weakness. These maybe symptoms of serious blood problems (eg, agranulocytosis, aplastic anemia).

Taking this medicine together with aspirin may cause change or loss of consciousness, loss of appetite, rapid shallow breathing, trouble breathing, or weight loss. Talk with your doctor if you have any concerns about this.

Do not suddenly stop using this medicine without checking first with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

Black, tarry stools

blistering, peeling, or loosening of the skin

blood in the urine

bloody nose

change in consciousness

chest pain or tightness

chills

clay-colored stools

confusion

cough or hoarseness

dark urine

diarrhea

difficulty swallowing

dizziness

drowsiness

fever

frequent urination

headache

heavier menstrual periods

hives, itching, skin rash

increased volume of pale, dilute urine

itching

joint or muscle pain

loss of appetite

loss of consciousness

lower back or side pain

muscle tremors

nausea

no muscle tone or movement

painful or difficult urination

pinpoint red spots on the skin

puffiness or swelling of the eyelids or around the face, lips, or tongue

rash

red irritated eyes

red skin lesions, often with a purple center

restlessness

seizures

sore throat

sores, ulcers, or white spots in the mouth or on the lips

stomach pain or cramps

sudden decrease in amount of urine

sugar in the urine

swollen or painful glands

trouble breathing

unpleasant breath odor

unusual bleeding or bruising

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

unusual tiredness or weakness

vomiting of blood

weight loss

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

changes in vision

continuing ringing or buzzing or other unexplained noise in the ears

hearing loss

increased sensitivity of skin to sunlight

redness or other discoloration of the skin

severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.