How does it work?

Acetazolamide belongs to a group of medicines called carbonic anhydrase inhibitors. Carbonic anhydrase is a chemical in the body that is responsible for the production and breakdown of carbonic acid. Part of this reaction results in the production of bicarbonate. Acetazolamide acts to inhibit the action of carbonic anhydrase and thereby decrease the production of bicarbonate Bicarbonate is required for the production of the fluid that fills the back of the eye (aqueous humour). By decreasing the production of bicarbonate, acetazolamide decreases the amount of aqueous humour produced in the eye. This helps reduce the pressure caused by the fluid within the eye in conditions such as glaucoma. In the kidneys, acetazolamide acts to increase the amount of bicarbonate lost from the body. Bicarbonate draws water with it from the kidneys. This results in a small increase in the amount of water being lost from the body. Therefore acetazolamide has some activity as a diuretic. As acetazolamide causes only minor water loss, it is called a weak diuretic. Acetazolamide may also be used in conjunction with other anti-epileptic medicines in the treatment of epilepsy. It is not fully understood how it works in this condition. It is thought to stabilise the activity of nerves. Chemicals must pass through openings on nerve cells for electrical signals to be generated. By decreasing the amount of bicarbonate produced in the body, acetazolamide alters the balance of chemicals in the blood. This may alter the amounts of some chemicals that can pass through the openings on nerve cells. This in turn, may help prevent excessively rapid and repetitive firing of electrical signals. Thereby electrical nerve activity in the brain may be stabilised, leading to prevention of fits and maintenance of normal brain function.

What is it used for?

Epilepsy

Excess fluid retention (oedema) due to heart failure

Excess fluid retention (oedema) due to other medicines

Excess fluid retention (oedema) due to the pre-menstrual syndrome

Glaucoma caused by another disease of the eye

Open angle glaucoma

Prior to surgery for suddenly severe closed angle glaucoma

Warning!

This medicine may cause skin rashes and you should consult your doctor if you develop a rash, skin peeling, itching, or other unexplained skin reaction while taking this medicine.

Individuals taking this medicine are advised to monitor blood cell counts regularly.

Use with caution in

Blockage of the airways (pulmonary obstruction)

Decreased liver function

Elderly people

Emphysema

History of kidney stones

Potential blockage of the urinary tract

Unstable balance of salts in the body

Not to be used in

Allergy to medicines from the sulphonamide group, eg the antibiotic sulphamethoxazole

Chronic non-congestive glaucoma

Failure of the adrenal glands

High levels of chloride in the blood, resulting in high acid levels in the blood (hyperchloraemic acidosis)

Low blood potassium levels (hypokalaemia)

Low blood sodium levels (hyponatraemia)

Severe kidney disease

Severe liver disease

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy. Seek medical advice from your doctor.

This medicine may pass into breast milk in small amounts. It should only be used during breastfeeding if the benefit to the mother outweighs any potential risk to the nursing infant. Seek medical advice from your doctor.

Label warnings

This medication may cause drowsiness. If affected do not drive or operate machinery.

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