Drug reference

Acetazolamide

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1266, 1267

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Reduction of intra-ocular pressure in open-angle glaucoma | Reduction of intra-ocular pressure in secondary glaucoma | Reduction of intra-ocular pressure perioperatively in angle-closure glaucoma ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES, OR BY INTRAVENOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Adult: 0.25–1 g daily in divided doses, intramuscular injection preferably avoided because of alkalinity Glaucoma ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 250–500 mg daily Epilepsy ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES, OR BY INTRAVENOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Adult: 0.25–1 g daily in divided doses, intramuscular injection preferably avoided because of alkalinity

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Contra Indications

Adrenocortical insufﬁciency. hyperchloraemic acidosis. hypokalaemia. hyponatraemia. long-term administration in chronic angle-closure glaucoma

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Cautions

Avoid extravasation at injection site (risk of necrosis). diabetes mellitus. elderly. impaired alveolar ventilation (risk of acidosis). long-term use. pulmonary obstruction (risk of acidosis). renal calculi

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Allergy And Cross Sensitivity

Contra-indicated if history of sulfonamide hypersensitivity.

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Safety

Interactions

→Appendix 1: acetazolamide

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Side Effects

GENERAL SIDE-EFFECTS ▶Common or very common Haemorrhage. metabolic acidosis . nephrolithiasis. sensation abnormal ▶Uncommon Bone marrow disorders. depression. dizziness . electrolyte imbalance. hearing impairment. hepatic disorders. leucopenia. nausea. renal colic. renal impairment. renal lesions. severe cutaneous adverse reactions (SCARs). skin reactions. thrombocytopenia. tinnitus. urinary tract discomfort. urine abnormalities. vomiting ▶Rare or very rare Anaphylactic reaction. appetite disorder . confusion. diarrhoea. fatigue. fever. ﬂushing. headache . irritability. libido decreased. paralysis. photosensitivity reaction. seizure ▶Frequency not known Agranulocytosis. drowsiness. myopia. polyuria. taste altered. thirst SPECIFIC SIDE-EFFECTS ▶Uncommon ▶With oral use Osteomalacia ▶Rare or very rare ▶With oral use Ataxia. hyperglycaemia. hypoglycaemia. renal tubular necrosis ▶Frequency not known ▶With oral use Agitation SIDE-EFFECTS, FURTHER INFORMATION Acetazolamide is a sulfonamide derivative; blood disorders, rashes, and other sulfonamide-related side-effects occur occasionally — patients should be told to report any unusual skin rash. If electrolyte disturbances and metabolic acidosis occur, these can be corrected by administering bicarbonate.

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Pregnancy

Manufacturer advises avoid, especially in ﬁrst trimester (toxicity in animal studies).

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Breast Feeding

Amount too small to be harmful.

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Hepatic Impairment

Manufacturer advises avoid.

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Renal Impairment

Avoid—risk of metabolic acidosis.

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Monitoring Requirements

Monitor blood count and plasma electrolyte concentrations with prolonged use.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet CAUTIONARY AND ADVISORY LABELS 3 ▶Acetazolamide (Non-proprietary) Acetazolamide 250 mg Acetazolamide 250mg tablets | 112 tablet P £75.36 DT = £8.36 Powder for solution for injection ▶Diamox (Advanz Pharma) Acetazolamide 500 mg Diamox Sodium Parenteral 500mg powder for solution for injection vials | 1 vial P £14.76 Modified-release capsule CAUTIONARY AND ADVISORY LABELS 3, 25 ▶Diamox SR (Advanz Pharma) Acetazolamide 250 mg Diamox SR 250mg capsules | 30 capsule P £16.66 DT = £16.66 ▶Eytazox (Teva UK Ltd) Acetazolamide 250 mg Eytazox 250mg modified-release capsules | 30 capsule P £16.60 DT = £16.66

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Dose text by age group

Adult

0.25–1 g daily in divided doses, intramuscular

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1266

Adult

250–500 mg daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1266

Adult

0.25–1 g daily in divided doses, intramuscular

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1267

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Acetazolamide

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1266, 1267

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 1266, 1267

Contra Indications

Adrenocortical insufﬁciency. hyperchloraemic acidosis. hypokalaemia. hyponatraemia. long-term administration in chronic angle-closure glaucoma

PDF page 1267

Cautions

PDF page 1267

Allergy And Cross Sensitivity

Contra-indicated if history of sulfonamide hypersensitivity.

PDF page 1267

Safety

Interactions

→Appendix 1: acetazolamide

PDF page 1267

Side Effects

PDF page 1267

Pregnancy

Manufacturer advises avoid, especially in ﬁrst trimester (toxicity in animal studies).

PDF page 1267

Breast Feeding

Amount too small to be harmful.

PDF page 1267

Hepatic Impairment

Manufacturer advises avoid.

PDF page 1267

Renal Impairment

Avoid—risk of metabolic acidosis.

PDF page 1267

Monitoring Requirements

Monitor blood count and plasma electrolyte concentrations with prolonged use.

PDF page 1267

Dose and formulations

Medicinal Forms

PDF page 1267

Dose text by age group

Adult

0.25–1 g daily in divided doses, intramuscular

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1266

Adult

250–500 mg daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1266

Adult

0.25–1 g daily in divided doses, intramuscular

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1267

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.