ACETAZOLAMIDE:
It is a diuretic drug which is used to treat the patients with Epilepsy and fluid overload.
What is Acetazolamide used for?
- Epilepsy
- Altitude sickness
- Swelling caused by fluid buildup
- High eye pressure (glaucoma)
- Idiopathic intracranial hypertension (high pressure in the brain)
How is acetazolamide available?
- Immediate release tablet.
- Extended-release capsule.
- Injection.
How does acetazolamide act (mechanism of action)?
It temporarily blocks the enzyme (carbonic anhydrase), leading to increased urine output, reduced eye fluid production, and a calming effect on overactive brain activity.
However, it may take several days or weeks to notice improvements in seizure control, depending on dosage, frequency, and individual response.
How much time does acetazolamide take to act?
Acetazolamide typically begins to take effect within 1 to 2 hours after oral administration. However, the full therapeutic effect may take several hours to become noticeable, depending on the condition being treated.
Why is Acetazolamide important for you/your child’s treatment?
It is important that your child takes Acetazolamide regularly so that you/your child doesn’t suffer from Seizures or have fewer seizures episodes and other diseases.
Acetazolamide controls seizures but doesn’t cure epilepsy and works only while you keep taking it. So do not stop giving acetazolamide all of a sudden, as it may result in having more seizures.
What is the ideal time to take Acetazolamide?
Twice a day; morning and evening. Ideally, 10-12 hours apart.
For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.
However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.
It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.
When should Acetazolamide be taken?
Take it at the same time(s) every day to maintain the concentration of drug level in the body. It can usually be taken before or after food, but if it upsets your stomach, try taking it after food. Acetazolamide is a diuretic and can increase urination, so drinking adequate fluids is important unless otherwise advised. To prevent nighttime urination, avoid taking it close to bedtime unless prescribed for night time use.
What if I miss a dose?
If you miss the dose, it can be taken as soon as you remember within the lapse of 6 hours. Do not take the missed dose if it is close to the next one; just take the next dose as normal. If you miss two or more doses, discuss it with your doctor.
NEVER GIVE A DOUBLE DOSE OF ACETAZOLAMIDE.
If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.
How should I give the medicine?
Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.
Immediate-release and extended-release tablets: Swallow the whole tablet; do not split, chew, or crush them.
Could this medication have any side effects on my child?
Every medication has both positive and potential negative effects. Fortunately, adverse effects are not common for everyone, but it’s essential to be aware of them. Understanding possible side effects allows us to act quickly and effectively if they occur, ensuring that we can address any concerns promptly while continuing to benefit from the intended effects of medications.
Even though it may be rare, few people sometimes may have serious side effects when taking a drug. Consult your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a side effect:
SIDE EFFECTS:
- Hormonal and Metabolic Effects:
– Problems with body fluid balance (like salt and water issues).
– High or low blood sugar levels.
– Low levels of certain salts like potassium or sodium in the body.
- Urinary System (Genitourinary):
– Needing to pee more often than usual.
– Tiny crystals forming in your urine.
- Nervous System:
– Tingling, numbness, or unusual feelings on your skin.
– Trouble with coordination or balance.
– Feeling confused.
- Eye-Related Issues:
– Sudden eye pressure problems, which can affect vision.
– Swelling or detachment of layers inside the eye.
– Difficulty seeing things far away (nearsightedness).
- Kidney Problems:
– Severe kidney issues, including kidney failure.
- Digestive System:
– Loss of appetite or reduced hunger.
Serious Allergic Reactions (Seek Help Immediately):
Contact your doctor or go to the hospital if you notice:
- Skin rash, hives, or intense itching.
- Red, swollen, or blistered skin (sometimes with fever).
- Trouble breathing, wheezing, or a tight chest/throat.
- Difficulty swallowing or speaking, hoarseness.
- Swelling in the mouth, face, lips, tongue, or throat.
Always share any unusual symptoms with your doctor promptly!
Does Acetazolamide cause weight gain?
Acetazolamide is not typically associated with weight gain. In fact, some people may experience a slight weight loss due to its diuretic effect, as it helps the body remove excess fluid.
However, the primary use of acetazolamide is not for weight loss but for treating conditions like glaucoma, epilepsy, altitude sickness, and edema.
If you notice any unexpected weight changes while taking acetazolamide, it’s important to consult your doctor, as this could be related to other factors or a side effect of the medication.
Can other common medicines be taken during the course of Acetazolamide?
Yes, other common medicines such as ibuprofen, paracetamol, antibiotics, or other over-the-counter drugs can generally be taken during the course of acetazolamide, but it’s important to be cautious and consult your doctor for specific recommendations.
Some medicines that could interact with acetazolamide include:
- Diuretics – Other diuretics may enhance the effects of acetazolamide, increasing the risk of dehydration or electrolyte imbalances.
- Lithium – Acetazolamide may increase the levels of lithium in the blood, leading to a risk of lithium toxicity.
- Anticoagulants – Medications like warfarin may have their effects altered when taken with acetazolamide.
- Antiepileptic drugs – The use of other anticonvulsants alongside acetazolamide may require careful monitoring, as they could affect each other’s effectiveness.
- Blood pressure medications – Acetazolamide may lower blood pressure, so combining it with antihypertensive medications may lead to a greater drop in blood pressure.
Always consult with a healthcare provider or pharmacist before starting any new medication while on acetazolamide to avoid potential interactions and side effects.
General Advice:
- Always tell your doctor about all the medications, including over-the-counter drugs, supplements, and herbal products, that you’re currently taking to ensure there are no harmful interactions.
- Do not stop or change your dose of Acetazolamide without consulting your doctor, as abrupt changes can increase the risk of seizures.
What food to avoid while taking Acetazolamide?
Acetazolamide does not have many significant food interactions, but there are a few things to consider:
- High-salt foods: Since acetazolamide is a diuretic, it helps remove excess salt from the body. Consuming a high-salt diet may reduce the effectiveness of the medication.
- Potassium-rich foods: Acetazolamide can cause reduced potassium levels in the body, so it’s important to eat foods that are rich in potassium, such as bananas, oranges, tomatoes, and potatoes, to help maintain normal potassium levels. However, in some cases, your doctor may suggest potassium supplements if needed.
- Alcohol: Drinking alcohol while taking acetazolamide can increase the risk of side effects such as dizziness or drowsiness. It’s good to limit alcohol consumption.
- Caffeine: Consuming large amounts of caffeine may increase the risk of dehydration when combined with acetazolamide.
As always, it’s best to follow your healthcare provider’s recommendations regarding diet while taking acetazolamide.
PREGNANCY AND LACTATION:
Acetazolamide should only be used in pregnancy if absolutely necessary, and only under the guidance and supervision of a healthcare provider. The potential benefits must outweigh the risks, and alternative treatments should be considered whenever possible. The potential effect on the baby has to be discussed with the treating doctor.
Is there any risk if I conceive while taking Acetazolamide?
If you are trying to conceive, it may be advisable to discontinue acetazolamide prior to conception, under the guidance of your doctor, to reduce any risks to the developing fetus.
Can I stop taking Acetazolamide?
Withdrawal from Acetazolamide is not commonly associated with severe effects, but stopping it abruptly can lead to potential issues, particularly if it was being used for conditions like glaucoma, epilepsy, or altitude sickness.
Where should you store Acetazolamide?
- Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.
- Make sure the medicine is out of your child’s reach.
- Store the medication in the same box it was packed in.
For complete information please see the manufacturer’s information leaflet
MONITORING PARAMETERS:
- Intraocular pressure.
- Serum electrolytes.
- Monitor growth in pediatric patients.
- Kidney function test.
How to cope with side effects of Acetazolamide?
- Behavioral Changes: This can include irritability, mood swings, or aggression. Engage in calming activities like reading or drawing, and provide a supportive, stable environment. Monitor closely and communicate with healthcare providers if these changes are significant.
- Dizziness and Coordination Issues: Some children experience dizziness or unsteady movements. Ensure a safe environment with minimal obstacles to prevent falls. Encourage slow movements when standing up or changing positions.
- Loss of Appetite: Offer nutritious, small meals throughout the day and ensure they receive enough nutrients even with a reduced appetite.
However, if any symptoms are preventing you from participating in regular activities or you’re also feeling depressed, it’s important to consult with your healthcare provider.
To conclude a blog about acetazolamide, you can summarize its key benefits, emphasize its role in managing specific conditions, and offer a reassuring tone to readers about its effectiveness and safety when used appropriately. Here’s an example of a closure:
Summary:
Acetazolamide is a versatile medication that plays a vital role in managing epilepsy, fluid buildup, and pressure-related conditions. Its ability to control seizures, reduce high eye pressure, and alleviate altitude sickness makes it a valuable option for patients when prescribed correctly.
While it is generally well-tolerated, understanding how to use it properly and being aware of potential side effects is crucial for maximizing its benefits. Always follow your doctor’s advice, keep up with regular monitoring, and never hesitate to ask questions about your or your child’s treatment.
With proper use, acetazolamide can significantly improve quality of life for those dealing with these conditions. Remember, the goal is not just symptom control but enabling a healthier, more comfortable life.
Author:
1. Dr Praveen Kumar, B.Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
2. Dr. Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
3. Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital