Acetazolamide 250mg 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 formation of bicarbonate and hydrogen ions. In the kidney, this leads to increased excretion of bicarbonate, sodium, potassium, and water, resulting in diuresis. In the eye, it reduces the formation of aqueous humor, thereby lowering intraocular pressure. In the CNS, it may affect neuronal excitability by altering CO2 and bicarbonate levels.

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 immediate medical attention:

Signs of an allergic reaction, such as:
+ 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
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of acidosis (too much acid in the blood), such as:
+ Confusion
+ Rapid breathing
+ Rapid heartbeat
+ Abnormal heartbeat
+ Severe stomach pain, nausea, or vomiting
+ Excessive sleepiness
+ Shortness of breath
+ Feeling extremely tired or weak
Signs of electrolyte problems, such as:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Balance changes
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe nausea or vomiting
Signs of high or low blood sugar, such as:
+ Fruity-smelling breath
+ Dizziness
+ Rapid breathing
+ Rapid heartbeat
+ Confusion
+ Sleepiness
+ Weakness
+ Flushing
+ Headache
+ Unusual thirst or hunger
+ Frequent urination
+ Shaking
+ 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 changes
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
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, such as:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Nausea or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or 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 minor 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
Sleepiness
Fatigue
Weakness
Headache
Flushing
* Nervousness or excitability

Reporting Side Effects

If you have questions or concerns about side effects, 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 you experienced, including any symptoms that occurred.
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.

Additionally, provide your doctor and pharmacist with a comprehensive list of all your medications, including:
Prescription and over-the-counter (OTC) drugs
Natural products
* Vitamins

This will help ensure that it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before engaging in activities that require alertness or clear vision, such as driving, wait until you understand how this drug affects you.

Regular blood tests and other laboratory evaluations should be conducted as directed 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 sunlight, 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 combining high doses of aspirin with this medication has led to 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 side effects. In some cases, this drug may affect growth in children and teenagers, necessitating regular growth assessments. Discuss this with your doctor.

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

• High-dose salicylates (risk of severe metabolic acidosis and CNS toxicity)
• Methenamine (risk of crystalluria and decreased efficacy of methenamine)

• Cyclosporine (increased cyclosporine levels)
• Lithium (increased lithium excretion, decreased lithium levels)
• Quinidine (decreased quinidine excretion, increased quinidine levels)
• Other carbonic anhydrase inhibitors (additive toxicity)
• Topiramate, Zonisamide (increased risk of metabolic acidosis)

• Corticosteroids (increased risk of hypokalemia)
• Digoxin (increased risk of digoxin toxicity due to hypokalemia)
• Amphetamines, tricyclic antidepressants (decreased excretion, increased effects)
• Oral anticoagulants (potential for altered anticoagulant effect, monitor INR)
• Diuretics (additive diuretic and potassium-wasting effects)
• Folic acid antagonists (e.g., methotrexate, pyrimethamine) (potential for increased toxicity)

• Sodium bicarbonate (may reduce acetazolamide efficacy)

• Paresthesias (tingling/numbness in extremities, common but usually benign)
• Fatigue, malaise, drowsiness
• Nausea, vomiting, diarrhea, anorexia
• Polyuria (increased urination)
• Signs of metabolic acidosis (e.g., hyperventilation, confusion, lethargy)
• Signs of electrolyte imbalance (e.g., muscle weakness, cramps, irregular heartbeat)
• Signs of blood dyscrasias (e.g., fever, sore throat, unusual bleeding/bruising, pallor)
• Skin rash, Stevens-Johnson syndrome (rare but serious)
• Vision changes (e.g., transient myopia)
• Flank pain, hematuria (signs of renal calculi)

Acetazolamide is classified as Pregnancy Category D. This means there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Animal studies have shown teratogenic effects (e.g., limb defects, growth retardation). Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus.

Acetazolamide is excreted into 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, diarrhea, or rash. The risk to the infant is generally considered low, but caution is advised, especially in premature infants or those with underlying conditions.

Used in pediatric patients for glaucoma, epilepsy, and hydrocephalus. Dosing is weight-based. Children may be more susceptible to metabolic acidosis and electrolyte imbalances. Close monitoring of electrolytes and acid-base status is crucial.

Elderly patients may be more susceptible to adverse effects, particularly electrolyte imbalances (hypokalemia, metabolic acidosis), dehydration, and central nervous system effects (drowsiness, confusion). Renal function often declines with age, necessitating careful dose adjustment and monitoring. Start with lower doses and titrate slowly.

• Paresthesias (tingling sensation) are a very common and usually benign side effect, often occurring in the extremities. Patients should be counseled about this.
• Acetazolamide is a sulfonamide derivative; therefore, patients with a history of sulfonamide allergy should be monitored closely for hypersensitivity reactions, although cross-reactivity is not absolute.
• Long-term use can lead to metabolic acidosis, which may require bicarbonate supplementation or discontinuation of the drug.
• Patients should be advised to maintain adequate fluid intake to prevent the formation of renal calculi (kidney stones), a known side effect.
• The diuretic effect of acetazolamide tends to diminish with prolonged use due to the development of metabolic acidosis.
• For acute mountain sickness, acetazolamide helps with acclimatization by increasing bicarbonate excretion, which acidifies the blood and stimulates respiration.

• 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).
• For Edema: Loop diuretics (e.g., furosemide), thiazide diuretics (e.g., hydrochlorothiazide), potassium-sparing diuretics (e.g., spironolactone).
• For Epilepsy: Various other anticonvulsants (e.g., valproic acid, carbamazepine, lamotrigine, levetiracetam).
• For Altitude Sickness: Dexamethasone (for severe symptoms), gradual ascent.

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 your 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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.