Acetazolamide 500mg Inj, 1 Vial

Acetazolamide is a potent carbonic anhydrase inhibitor. It acts on the renal tubule, specifically the proximal convoluted tubule, to inhibit carbonic anhydrase, leading to decreased reabsorption of bicarbonate, sodium, and water. This results in increased excretion of bicarbonate, sodium, potassium, and water, causing diuresis and alkalinization of the urine. In the eye, it reduces the formation of aqueous humor by inhibiting carbonic anhydrase in the ciliary body, thereby lowering intraocular pressure. In the central nervous system, it may inhibit carbonic anhydrase in the brain, which can reduce abnormal neuronal discharge in epilepsy and facilitate acclimatization to high altitudes by increasing ventilation.

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 immediately or seek emergency medical attention:

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.
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, pale 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 minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects, contact your doctor if they bother you or persist:

Diarrhea, nausea, or vomiting.
Changes in taste.
Decreased appetite.
Blurred vision.
Dizziness, sleepiness, tiredness, or weakness.
Headache.
Flushing.
Nervousness or excitability.
Pain at the injection site.

This is not an exhaustive list of possible 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 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.

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

Regularly undergo blood tests and other laboratory examinations as directed by your doctor to monitor your condition.

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 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 growth in 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 taking this medication to ensure the well-being of both you and your baby.

• Salicylates (high-dose): Concurrent use can lead to severe metabolic acidosis and CNS toxicity due to displacement of acetazolamide from protein binding sites and inhibition of renal clearance.
• Methenamine: Acetazolamide alkalinizes urine, which can prevent methenamine from being converted to formaldehyde, rendering it ineffective as a urinary antiseptic.

• Cyclosporine: Acetazolamide may increase cyclosporine levels, increasing risk of nephrotoxicity and neurotoxicity.
• Lithium: Acetazolamide increases renal excretion of lithium, potentially leading to decreased lithium levels and loss of therapeutic effect.
• Other diuretics (e.g., loop, thiazide): Additive diuretic and potassium-wasting effects, increasing risk of hypokalemia and metabolic acidosis.
• Corticosteroids: Increased risk of hypokalemia.
• Amphotericin B: Increased risk of hypokalemia.
• Quinidine: Acetazolamide alkalinizes urine, which can decrease renal excretion of quinidine, leading to increased quinidine levels and toxicity.

• Anticonvulsants (e.g., phenytoin, carbamazepine): May alter levels of either drug; monitor closely.
• Oral hypoglycemics: May alter blood glucose control; monitor glucose levels.
• Sodium bicarbonate: Increased risk of metabolic alkalosis.
• Topiramate: Increased risk of metabolic acidosis and kidney stone formation.

• Not available

• Paresthesias (tingling sensation in extremities, common but usually benign)
• Fatigue, lethargy, confusion (signs of metabolic acidosis or electrolyte imbalance)
• Nausea, vomiting, abdominal pain
• Rash, fever, sore throat (signs of hypersensitivity or blood dyscrasias)
• Flank pain, hematuria (signs of kidney stones)
• Muscle weakness, cramps (signs of hypokalemia)
• Signs of hepatic encephalopathy (in patients with liver impairment)

Category C. Use only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects (limb defects) at high doses. There are no adequate and well-controlled studies in pregnant women.

L3 (Moderately Safe). Acetazolamide is excreted into breast milk in small amounts. While adverse effects in breastfed infants are generally not expected, monitor the infant for signs of metabolic acidosis (e.g., poor feeding, lethargy) or growth retardation, especially with prolonged use or high doses.

Dosing is established for specific indications (glaucoma, epilepsy, edema). Use with caution, especially in neonates and infants, due to potential for metabolic acidosis and electrolyte imbalances. Close monitoring of electrolytes and acid-base status is crucial.

Increased susceptibility to adverse effects, particularly electrolyte imbalances (hypokalemia, hyponatremia), metabolic acidosis, and renal impairment. Start with lower doses and titrate slowly. Monitor renal function and electrolytes frequently. Increased risk of falls due to diuretic effect.

• Acetazolamide is a sulfonamide derivative; caution should be exercised in patients with a history of sulfonamide allergy, although cross-reactivity is not absolute.
• Paresthesias (tingling of fingers, toes, or around the mouth) are a very common side effect, often benign and dose-related, and usually do not require discontinuation.
• Can cause metabolic acidosis, especially with prolonged use or in patients with renal impairment. Monitor serum bicarbonate levels.
• May increase the risk of kidney stone formation due to decreased urinary citrate and increased urinary pH.
• Ensure adequate hydration to prevent kidney stone formation, unless contraindicated for fluid restriction.
• The IV formulation is preferred for acute situations (e.g., acute angle-closure glaucoma) due to rapid onset of action.

• For glaucoma: Topical beta-blockers (e.g., timolol), prostaglandin analogs (e.g., latanoprost), alpha-2 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, levetiracetam, lamotrigine).
• For altitude sickness: Dexamethasone (for severe symptoms), gradual ascent.

If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe use, never share your prescription medications with others, and do not take medications that have been prescribed to someone else.

Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Proper disposal of unused or expired medications is crucial. Unless instructed otherwise by a healthcare professional or pharmacist, do not dispose of medications by flushing them down the toilet or pouring them down the drain. Instead, consult with your pharmacist to determine the best method for disposal, as some communities may have designated drug take-back programs.

Additionally, some medications may come with a separate patient information leaflet, which can be obtained by consulting with your pharmacist. If you have any questions or concerns about your medication, it is recommended that you discuss them with your doctor, nurse, pharmacist, or other healthcare provider.

In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, including the dosage and timing of the incident, to facilitate prompt and effective treatment.