Acetazolamide oral modified release
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Modified release capsules of acetazolamide.
Drugs List
Therapeutic Indications
Uses
Glaucoma
Dosage
Adults
250mg once or twice daily.
Children
Children aged 12 to 18 years (unlicensed):
250mg once or twice daily.
Patients with Renal Impairment
Caution should be exercised in mild renal impairment due to the increased risk of electrolyte and acid/base balance disorders, including metabolic acidosis.
Caution is advised when treating patients with a past history of renal calculi. The benefit of treatment should be weighed against the risks of precipitating further calculi.
In patients with moderate to severe renal impairment, increase dosage interval to every 12 hours or use 250mg as maximum daily dose.
Contraindications
Children under 18 years
Adrenal insufficiency
Hepatic cirrhosis
Hyperchloraemic acidosis
Hypokalaemia
Hyponatraemia
Long term use in chronic non-congestive narrow angle glaucoma
Pregnancy
Severe hepatic impairment
Severe renal impairment
Precautions and Warnings
Elderly
Impaired glucose tolerance
Breastfeeding
Diabetes mellitus
Disorder of acid-base balance
Electrolyte imbalance
Hepatic impairment
History of nephrolithiasis
Mechanical obstruction of urinary tract
Obstructive pulmonary disease
Pulmonary emphysema
Renal impairment
Reduce dose in patients with moderate renal impairment
Advise ability to drive/operate machinery may be affected by side effects
Diuresis is not dose-related
Contains sunset yellow (E110) - may cause allergic reaction
Blood counts should be performed before and periodically during treatment
Monitor serum electrolytes before and during treatment
Consider AGEP if feverish generalised erythema occurs
Monitor fluid balance
Advise patients to report any unusual rash to the prescriber
Advise patients/carers to seek medical advice if suicidal intent develops
May affect results of some laboratory tests
Discontinue if hypersensitivity reactions occur
Discontinue immediately if any severe fall in blood counts occur
Discontinue permanently if AGEP is diagnosed
Pregnancy and Lactation
Pregnancy
Acetazolamide is contraindicated during pregnancy.
The manufacturer does not recommend using acetazolamide during pregnancy. Animal studies have shown teratogenic effects at doses in excess of ten times those recommended in humans. Human data is limited and as such a potential risk cannot be ruled out.
Lactation
Use acetazolamide with caution during breastfeeding.
The manufacturer advises caution if acetazolamide is used when breastfeeding. Acetazolamide is present in human breast milk, the quantity is not considered to be sufficient to cause adverse effects in breastfed infants. Effects on exposed infants are unknown.
Side Effects
Abnormal liver function
Acute generalised exanthematous pustulosis
Agranulocytosis
Anaphylaxis
Aplastic anaemia
Ataxia
Bone marrow depression
Cholestatic jaundice
Confusion
Convulsions
Crystalluria
Decreased appetite
Depression
Diarrhoea
Dizziness
Drowsiness
Electrolyte disturbances
Erythema multiforme
Excitement
Fatigue
Fever
Flaccid paralysis
Flushing
Fulminant hepatic necrosis
Glycosuria
Haematuria
Headache
Hearing disturbances
Hepatitis
Hyperglycaemia
Hypoglycaemia
Hypokalaemia
Hyponatraemia
Irritability
Leukopenia
Melaena
Metabolic acidosis
Myopia
Nausea
Nephrolithiasis
Osteomalacia
Pancytopenia
Paraesthesia
Photosensitivity
Polyuria
Rash
Reduced libido
Renal colic
Renal failure
Renal injury
Renal lesions
Renal tubular necrosis
Sensory disturbances
Stevens-Johnson syndrome
Taste disturbances
Thirst
Thrombocytopenia
Thrombocytopenic purpura
Tingling in extremities
Tinnitus
Toxic epidermal necrolysis
Ureteral colic
Ureteral pain
Urticaria
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: October 2021
Reference Sources
Summary of Product Characteristics: Diamox SR 250mg capsules. Amdipharm Mercury Company Limited. Revised August 2019 .
NICE Evidence Services
Available at: www.nice.org.uk
Last accessed: 06 October 2021
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