INDICATIONS: 1. Diuretic (particularly in the presence of metabolic alkalosis) 2. Correction of severe metabolic alkalosis
DOSAGE: For diuresis, the dose is usually 250-375 mg stat. If, after an initial response, the patient fails to continue to diurese, do not increase the dose but allow for kidney recovery by skipping medication for a day. Acetazolamide yields best diuretic results when given on alternate days, or for 2 days alternating with a day of rest.Increasing the dose does not increase the diuresis and may increase the incidence of drowsiness and/or paraesthesia. Increasing the dose often results in a decrease in diuresis.
Evidence to support use in patients below the age of 12 years have not been established.
Acetazolamide is contraindicated in the presence of metabolic acidosis. This drug is not indicated in patients on renal replacement therapy.
Acetazolamide is an enzyme inhibitor that acts on carbonic anhydrase, the enzyme that catalyzes the reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid.
CONTRAINDICATIONS 1. Hypersensitivity to acetazolamide or other sulphonamides 2. Metabolic acidosis 3. Cirrhosis (risk of development of hepatic encephalopathy)
Acetazolamide and sodium bicarbonate used concurrently increases the risk of renal calculus formation.
METABOLIC SIDE EFFECTS
Metabolic acidosis, electrolyte imbalance, including hypokalaemia, hyponatraemia, loss of appetite, taste alteration, hyper/hypoglycaemia.
The Lay Medical Man 