Acetazolamide 125mg Tablets

Acetazolamide is a potent carbonic anhydrase inhibitor. Carbonic anhydrase is an enzyme found in various tissues, including the renal tubules, ciliary body of the eye, and central nervous system. By inhibiting this enzyme, acetazolamide decreases the reabsorption of bicarbonate, sodium, and water in the proximal renal tubule, leading to increased excretion of these ions and diuresis. In the eye, it reduces the formation of aqueous humor, thereby lowering intraocular pressure. In the CNS, it may inhibit carbonic anhydrase in the brain, which can reduce abnormal neuronal discharge in epilepsy and facilitate bicarbonate excretion at high altitudes, aiding acclimatization.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of acidosis (too much acid in the blood): confusion, rapid breathing, rapid heartbeat, irregular heartbeat, severe stomach pain, nausea, vomiting, excessive sleepiness, shortness of breath, or feeling extremely tired or weak.
Signs of electrolyte problems: mood changes, confusion, muscle pain, cramps, or spasms, weakness, shakiness, balance disturbances, abnormal heartbeat, seizures, loss of appetite, or severe nausea and vomiting.
Signs of high or low blood sugar: fruity breath odor, dizziness, rapid breathing, rapid heartbeat, confusion, sleepiness, weakness, flushing, headache, unusual thirst or hunger, frequent urination, shaking, or sweating.
Changes in vision, eye pain, or severe eye irritation.
Changes in hearing.
Ringing in the ears.
Abnormal burning, numbness, or tingling sensations.
Painful urination or blood in the urine.
Difficulty urinating or changes in urine output.
Muscle weakness.
Balance disturbances.
Mobility problems.
Depression.
Confusion.
Seizures.

Rare but Serious Side Effects

In rare cases, sulfa drugs can cause severe and potentially life-threatening effects, including liver problems, blood disorders, and severe skin reactions (Stevens-Johnson syndrome/toxic epidermal necrolysis). If you experience any of the following symptoms, contact your doctor immediately:

Rash or red, swollen, blistered, or peeling skin.
Red or irritated eyes.
Sores in the mouth, throat, nose, or eyes.
Fever, chills, or sore throat.
New or worsening cough.
Extreme fatigue or weakness.
Bruising or bleeding.
Signs of liver problems: dark urine, fatigue, decreased appetite, nausea, stomach pain, light-colored stools, vomiting, or yellow skin and eyes.

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects, contact your doctor or seek medical attention if they bother you or persist:

Diarrhea, nausea, or vomiting.
Changes in taste.
Decreased appetite.
Blurred vision.
Dizziness, drowsiness, fatigue, or weakness.
Headache.
Flushing.
Feeling nervous or excitable.

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
A known sulfa allergy.
Certain health conditions, including:
+ Acidic blood problems
+ Kidney disease
+ Liver disease
+ Low potassium levels (hypokalemia)
+ Low sodium levels (hyponatremia)
+ Poor adrenal function
If you are currently taking methazolamide.

This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing treatments and health conditions.

Remember, do not start, stop, or change the dose of any medication without first consulting your doctor to ensure your safety.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Until you understand how this drug affects you, avoid operating a vehicle or engaging in any activities that require alertness and clear vision.

Regularly monitor your blood work and other laboratory tests as instructed by your doctor.

If you have diabetes (high blood sugar), it is crucial to closely monitor your blood sugar levels, as this medication may impact them. Additionally, notify all your healthcare providers and laboratory personnel that you are taking this drug, as it may influence the results of certain lab tests.

Be cautious when exposed to the sun, as this medication may increase your susceptibility to sunburn. If you experience easy sunburning while taking this drug, inform your doctor.

If you are also taking aspirin, consult with your doctor, as high doses of aspirin combined with this medication have been associated with severe side effects, including loss of appetite, rapid breathing, lethargy, coma, and even death.

If you are 65 years or older, exercise caution when using this medication, as you may be more prone to experiencing side effects.

In some cases, this drug may affect the growth of children and teenagers. Regular growth checks may be necessary, so discuss this with your doctor.

If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to weigh the benefits and risks of this medication to both you and your baby.

• Methenamine (risk of crystalluria and reduced efficacy of methenamine)
• Severe renal impairment (CrCl <10 mL/min)
• Severe hepatic dysfunction (risk of hepatic coma)
• Adrenal insufficiency
• Hyperchloremic acidosis

• High-dose salicylates (increased risk of metabolic acidosis and CNS toxicity, including anorexia, tachypnea, lethargy, coma, and death)
• Cyclosporine (increased cyclosporine levels, leading to nephrotoxicity and neurotoxicity)
• Lithium (increased lithium excretion, leading to decreased lithium levels)
• Other carbonic anhydrase inhibitors (additive toxicity)
• Topiramate, Zonisamide (increased risk of metabolic acidosis and kidney stones)

• Amphetamines, Quinidine, Procainamide (decreased excretion due to alkaline urine, leading to increased levels and toxicity)
• Antidiabetics (may alter blood glucose levels)
• Diuretics (additive diuretic and potassium-wasting effects)
• Corticosteroids (increased risk of hypokalemia)
• Folic acid antagonists (e.g., methotrexate, pyrimethamine) (may potentiate toxicity due to altered pH)

• Sodium bicarbonate (may increase risk of kidney stones)

• Paresthesias (tingling sensation in extremities, common)
• Fatigue, lethargy, malaise
• Nausea, vomiting, diarrhea, anorexia
• Polyuria, polydipsia
• Signs of metabolic acidosis (e.g., hyperventilation, confusion, stupor)
• Signs of electrolyte imbalance (e.g., muscle weakness, cramps, irregular heartbeat)
• Skin rash, fever, sore throat (signs of hypersensitivity or hematologic reaction)
• Flank pain, hematuria (signs of kidney stones)
• Vision changes (rare, but possible with severe acidosis or idiosyncratic reaction)

Acetazolamide is Pregnancy Category C. Animal studies have shown teratogenic effects (limb defects) at doses higher than human therapeutic doses. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Acetazolamide is excreted in breast milk in small amounts. The American Academy of Pediatrics considers it compatible with breastfeeding. However, monitor the infant for potential adverse effects such as metabolic acidosis, growth inhibition, or rash. Use with caution, especially in premature or jaundiced infants.

Dosing is weight-based for most indications. Use with caution in infants and young children due to increased risk of metabolic acidosis. Long-term use may affect growth. Monitor electrolytes and acid-base status closely.

Elderly patients may be more susceptible to adverse effects, particularly electrolyte imbalances (hypokalemia, metabolic acidosis) and renal impairment. Start with lower doses and titrate slowly. Monitor renal function and electrolytes closely.

• Acetazolamide is a sulfonamide derivative; inquire about sulfa allergies before administration. Cross-reactivity with non-antibiotic sulfonamides is low but possible.
• Paresthesias (tingling of extremities) are a very common and usually benign side effect, often dose-related. Patients should be counseled about this.
• Administer in the morning for diuretic effect to avoid nocturia.
• Ensure adequate hydration to minimize the risk of kidney stone formation.
• Long-term use requires regular monitoring of serum electrolytes (especially potassium and bicarbonate) and renal function.
• Can cause metabolic acidosis, which may be symptomatic (e.g., hyperventilation, fatigue, confusion).
• Not effective in patients with severe renal impairment (CrCl <10 mL/min) and is contraindicated due to accumulation risk.

• For Glaucoma: Beta-blockers (e.g., timolol), prostaglandin analogs (e.g., latanoprost), alpha-adrenergic agonists (e.g., brimonidine), miotics (e.g., pilocarpine), other carbonic anhydrase inhibitors (e.g., dorzolamide, brinzolamide - topical).
• For Edema: Loop diuretics (e.g., furosemide), thiazide diuretics (e.g., hydrochlorothiazide), potassium-sparing diuretics (e.g., spironolactone).
• For Epilepsy: Other anticonvulsants (e.g., valproic acid, carbamazepine, lamotrigine, levetiracetam).
• For Acute Mountain Sickness: Dexamethasone (for treatment), gradual ascent (for prevention).

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.