Acetazolamide: indications, contraindications, use

In the case of prolonged use, it is possible to develop metabolic acidosis or electrolyte imbalance. This is usually corrected by assigning sodium bicarbonate.

In addition, there have been cases of transient myopia occurring after the withdrawal of this drug.

Gastrointestinal tract - diarrhea, nausea and vomiting can occur.

The use of acetazolamide can also cause fever, leukopenia, agranulocytosis, thrombolytic purpura, thrombocytopenia, aplastic anemia, rash, pancytopenia, urolithiasis, anaphylactic reactions, renal colic, crystalluria, urolithiasis, kidney damage, and bone marrow suppression. Much less marked was the onset of fulminant necrosis of the liver.

Possible casuistic side effects:

• urticaria rash,
• hematuria,
• melene,
• glucosuria,
• tinnitus and other hearing impairment,
• hepatic dysfunction,
• flaccid paralysis,
• kidney damage,
• convulsions.

Route of administration and dose

To be taken orally, only with glaucoma, to select the dose individually strictly depending on the obtained parameters of intraocular pressure.

In case of epilepsy:

• , adults are recommended to be administered once a day for 250-500 mg for 3 days, and for the fourth - a break;
• for children - depending on body weight, in two divided doses;
• with the combined use of acetazolamide with various anticonvulsants, the first dose is only 250 mg once a day( increase only if necessary);
• children are not recommended to use doses of more than 750 mg / day;
• for swelling - a day for 250-375 mg;

The maximum diuretic effect can be achieved in the case of reception every other day. When mountain sickness is recommended to take a dose of 250 mg three times a day.

Special instructions

During the treatment of this drug, especially the elderly, a special diet is recommended, very rich in potassium: beets, peas, beans, potatoes, carrots, beans, prunes, dried apricots, peanuts, oranges, bananas, peaches, raisins, oatmeal.

Contraindications

Drug Acetazolamide is absolutely contraindicated to the following patients:

• with hypersensitivity to sulfonamides,
• with decreasing potassium or sodium level in blood,
• for dysfunction or kidney and liver diseases, adrenal gland,
• for hyperchloremic acidosis.

Also not recommended for patients with liver cirrhosis, because all this can significantly increase the risk of hepatic encephalopathy.

Precautions

With increased sensitivity to various sulfonamides, severe side effects may develop:

• fever,
• anaphylaxis,
• rash( toxic epidermal necrolysis),
• bone marrow suppression,
• crystalluria,
• hemolytic anemia,
• formation of kidney stones,
• thrombocytopenic purpura,
• leukopenia,
• hemolytic anemia,
• pancytopenia,
• agranulocytosis.

If suddenly there are any skin changes or changes in the blood picture, the medicine used should be urgently canceled.

With prolonged use, it is mandatory to monitor the serum level of electrolytes, and also control the picture of peripheral blood.

Preparation Acetazolamide, which is used in doses, is more than recommended, is not able to increase diuresis, and often only reduces it, however, at the same time, it increases drowsiness or paresthesia. In some circumstances, it is used in especially large doses together with other diuretics to ensure the most reliable diuresis in refractory heart failure.

In addition to this, doctors do not recommend the use of this drug during the work of drivers of vehicles, as well as people whose profession is necessarily associated with increased attention.

Interaction with other drugs

In the case of simultaneous use of acetazolamide with any anticholinesterase drugs in patients with myasthenia, muscle weakness is greatly enhanced.

In case of simultaneous use, the risk of various toxic effects of ephedrine, salicylates, carbamazepine, digitalis preparations and nondepolarizing muscle relaxants increases.

In the case of simultaneous administration of the drug with diuretics, theophylline potentiates some diuretic action.

Simultaneous use of acetazolamide with lithium preparations increases the excretion of lithium in urine. In addition, a case of lithium intoxication after therapy with Acetazolamide has been described not later than 1 month.

Joint use with ammonium chloride causes acidosis, and also weakens the effect of the action of acetazolamide( doctors do not recommend to apply at one time).

Co-administration with acetazolamide significantly increases the clinical efficacy of the insulin substance and, of course, oral hypoglycemic agents.

Simultaneous use of this drug with primidone is a risk of reducing the concentration of primidone in the blood serum and a reduction in the entire anticonvulsant action and marked osteomalacia.

In addition to all of the above, there are also reports that with simultaneous use, the total concentration of cyclosporin substance that is capable of accompanying the kidneys with harmful toxic effects increases significantly and rapidly in blood plasma.

Storage conditions

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The drug Acetazolamide should be stored up to 5 years after manufacturing, in rooms at a temperature of 8-30 degrees Celsius. Immediately after opening the vial, it should be stored for 28 days and no more.

The average cost of the drug in Russia and Ukraine

The average cost of the drug Acetazolamide in Russia is 240 rubles, and in Ukraine the average price is 43 hryvnia.

Analogues

Excellent analogs of this drug are the following drugs:

• Diakarb - the average price in Russia is 255 rubles.
• Diacarba( tablets) - the average price in Russia is 320 rubles.

Reviews

Basically, reviews about this drug are positive. Practically all the patients who used them were satisfied. Detailed reviews can be read at the end of the article.