CARBONIC ANHYDRASE INHIBITORS

Brand & Generic Names

Acetazolam
ACETAZOLAMIDE
Ak-Zol
Apo-Acetazolamide
Daranide
Dazamide
Diamox
DICHLORPHENAMIDE
METHAZOLAMIDE
Neptazane

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Carbonic anhydrase inhibitor

Uses

• Treatment of glaucoma.
• Treatment of epileptic seizures.
• Treatment of body-fluid retention.
• Treatment for shortness of breath, insomnia and fatigue in high altitudes.
• Treatment or prevention of altitude illness.

Dosage & Usage Information

How to take:
Sustained-release tablets--Swallow whole with liquid or food to lessen stomach irritation.
Extended-release capsules--Swallow whole with liquid.

When to take:
1 dose per day--At the same time each morning.
More than 1 dose per day--Take last dose several hours before bedtime.

If you forget a dose:
Take as soon as you remember. Continue regular schedule.

What drug does:
Inhibits action of carbonic anhydrase, an enzyme. This lowers the internal eye pressure by decreasing fluid formation in the eye.
Forces sodium and water excretion, reducing body fluid.

Time lapse before drug works:
2 hours.

Don't take with:
Non-prescription drugs without consulting doctor.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Drowsiness, confusion, excitement, nausea, vomiting, numbness in hands and feet, coma.

WHAT TO DO:

• Call your doctor or poison-control center for advice if you suspect overdose, even if not sure. Symptoms may not appear until damage has occurred.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Convulsions. Seek emergency treatment immediately.

Common:

None expected.

Infrequent:

• Back pain, sedation.
• Fatigue, weakness, tingling or burning in feet or hands.

Rare:

• Headache; mood changes; nervousness; clumsiness; trembling; confusion; hives, itch, rash; sores; ringing in ears; hoarseness; dry mouth; thirst; sore throat; fever; appetite change; nausea; vomiting; black, tarry stool; breathing difficulty; irregular or weak heartbeat; easy bleeding or bruising; muscle cramps; painful or frequent urination; blood in urine.
• Depression, loss of libido.

Warnings & Precautions

Don't take if:

• You are allergic to any carbonic anhydrase inhibitor.
• You have liver or kidney disease.
• You have Addison's disease (adrenal gland failure).
• You have diabetes.

Before you start, consult your doctor:

• If you have gout or lupus.
• If you are allergic to any sulfa drug.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Don't exceed recommended dose.
• If you take a digitalis preparation, eat foods high in potassium content or take a potassium supplement.

Pregnancy:
No proven harm to unborn child. Avoid if possible, especially first 3 months.

Breast-feeding:
Avoid drug or don't nurse your infant.

Infants & children:
Not recommended for children younger than 12.

Prolonged use:
May cause kidney stones, vision change, loss of taste and smell, jaundice or weight loss.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Avoid if you feel drowsy or dizzy. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without medical advice.

Others:
Medicine may increase sugar levels in blood and urine. Diabetics may need insulin adjustment.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Amphetamines*	Increased amphetamine effect.
Anticonvulsants*	Increased loss of bone minerals.
Antidepressants,	Increased anti-
tricyclic (TCA)*	depressant effect.
Antidiabetics*,	Increased potassium
oral	loss.
Aspirin	Decreased aspirin effect.
Ciprofloxacin	May cause kidney
	dysfunction.
Cortisone drugs*	Increased potassium loss.
Digitalis	Possible digitalis
preparations*	toxicity.
Diuretics*	Increased potassium loss.
Lithium	Decreased lithium effect.
Mecamylamine	Increased mecamylamine effect.
Methenamine	Decreased methenamine effect.
Mexiletene	May slow elimination of mexilitene
	and cause need to adjust dosage.
Quinidine	Increased quinidine effect.
Salicylates*	Salicylate toxicity.
Sympathomimetics*	Increased sympathomimetic effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	Avoid. Decreased carbonic anhydrase
	inhibitor effect.
Potassium-rich	Eat these to decrease
foods*.	potassium loss.
Marijuana:	Avoid. Increased carbonic anhydrase
	inhibitor effect.
Tobacco:	May decrease absorption of carbonic
	anhydrase inhibitors.