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Drug overview for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
Generic name: acetazolamide sodium (a-SEET-a-ZOE-la-mide)
Drug class: Carbonic Anhydrase Inhibitors
Therapeutic class: Cardiovascular Therapy Agents
Acetazolamide is a carbonic anhydrase inhibitor.
Acetazolamide shares the uses of the carbonic anhydrase inhibitors; however, the extended-release capsules are intended for use only for the adjunctive treatment of open-angle (noncongestive, chronic simple) or secondary glaucoma, for short-term preoperative therapy in angle-closure glaucoma (obstructive, narrow-angle) when delay of surgery is desired in order to lower intraocular pressure (IOP), and for prevention or amelioration of symptoms associated with acute high-altitude sickness (mountain sickness). Long-term use of oral carbonic anhydrase inhibitors in the treatment of glaucoma is limited by systemic adverse effects. (See Uses: Glaucoma, in the Carbonic Anhydrase Inhibitors General Statement 52:40.12.) Acetazolamide is used as an adjunct to other anticonvulsants in the management of centrencephalic epilepsies (e.g., petit mal, unlocalized seizures).
Tolerance to the anticonvulsant effects of acetazolamide develop quickly, and the drug may be ineffective for prolonged therapy. Although acetazolamide may be useful in partial, myoclonic, absence, and primary generalized tonic-clonic seizures that have not responded adequately to other anticonvulsants, acetazolamide has not been evaluated in controlled clinical studies in specific seizure types. Acetazolamide is used to increase altitude tolerance in the prevention or amelioration of symptoms (e.g., headache, lassitude, insomnia, nausea, shortness of breath, dizziness) associated with acute mountain sickness in climbers attempting rapid ascent and in those who are very susceptible to the condition despite gradual ascent.
Use of acetazolamide does not obviate prompt descent in patients who develop severe forms of acute mountain sickness (e.g., high-altitude pulmonary and/or cerebral edema). The drug does not prevent acute mountain sickness, but rather shortens the time of acclimatization. Acetazolamide also is used in the treatment and prevention of high-altitude sleep disorders.
Generic name: acetazolamide sodium (a-SEET-a-ZOE-la-mide)
Drug class: Carbonic Anhydrase Inhibitors
Therapeutic class: Cardiovascular Therapy Agents
Acetazolamide is a carbonic anhydrase inhibitor.
Acetazolamide shares the uses of the carbonic anhydrase inhibitors; however, the extended-release capsules are intended for use only for the adjunctive treatment of open-angle (noncongestive, chronic simple) or secondary glaucoma, for short-term preoperative therapy in angle-closure glaucoma (obstructive, narrow-angle) when delay of surgery is desired in order to lower intraocular pressure (IOP), and for prevention or amelioration of symptoms associated with acute high-altitude sickness (mountain sickness). Long-term use of oral carbonic anhydrase inhibitors in the treatment of glaucoma is limited by systemic adverse effects. (See Uses: Glaucoma, in the Carbonic Anhydrase Inhibitors General Statement 52:40.12.) Acetazolamide is used as an adjunct to other anticonvulsants in the management of centrencephalic epilepsies (e.g., petit mal, unlocalized seizures).
Tolerance to the anticonvulsant effects of acetazolamide develop quickly, and the drug may be ineffective for prolonged therapy. Although acetazolamide may be useful in partial, myoclonic, absence, and primary generalized tonic-clonic seizures that have not responded adequately to other anticonvulsants, acetazolamide has not been evaluated in controlled clinical studies in specific seizure types. Acetazolamide is used to increase altitude tolerance in the prevention or amelioration of symptoms (e.g., headache, lassitude, insomnia, nausea, shortness of breath, dizziness) associated with acute mountain sickness in climbers attempting rapid ascent and in those who are very susceptible to the condition despite gradual ascent.
Use of acetazolamide does not obviate prompt descent in patients who develop severe forms of acute mountain sickness (e.g., high-altitude pulmonary and/or cerebral edema). The drug does not prevent acute mountain sickness, but rather shortens the time of acclimatization. Acetazolamide also is used in the treatment and prevention of high-altitude sleep disorders.
DRUG IMAGES
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The following indications for ACETAZOLAMIDE SODIUM (acetazolamide sodium) have been approved by the FDA:
Indications:
Peripheral edema due to chronic heart failure
Peripheral edema
Professional Synonyms:
Edema of extremities
Peripheral edema due to CHF
Peripheral edema due to congestive heart failure
Indications:
Peripheral edema due to chronic heart failure
Peripheral edema
Professional Synonyms:
Edema of extremities
Peripheral edema due to CHF
Peripheral edema due to congestive heart failure
The following dosing information is available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
Dosage of acetazolamide should be adjusted according to the patient's requirements and response. Dosage of acetazolamide sodium is expressed in terms of acetazolamide.
No enhanced Administration information available for this drug.
DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
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ACETAZOLAMIDE SOD 500 MG VIAL | Maintenance | Adults inject 5 mg/kg by intravenous route once daily in the morning |
DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
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ACETAZOLAMIDE SOD 500 MG VIAL | Maintenance | Adults inject 5 mg/kg by intravenous route once daily in the morning |
The following drug interaction information is available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
There are 1 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
Drug Interaction | Drug Names |
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Methenamine/Sulfonamides SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Methenamine is hydrolyzed to formaldehyde in acidic urine. Sulfonamides may form an insoluble precipitate with formaldehyde in the urine.(1,2) CLINICAL EFFECTS: The concurrent administration of methenamine and sulfamethizole or sulfathiazole is likely to form a precipitate in the urine.(1-3) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Methenamine should not be administered to patients receiving sulfonamides.(1-3) DISCUSSION: Methenamine is hydrolyzed to formaldehyde in acidic urine. An in vitro study showed that addition of methenamine and mandelic acid to saturated solutions of sulfamethizole at pH 5.0 and 6.0 produced a precipitate in one hour.(4) |
MB CAPS, ME-NAPHOS-MB-HYO 1, METHENAMINE, METHENAMINE HIPPURATE, METHENAMINE MANDELATE, URELLE, URETRON D-S, URIBEL TABS, URIMAR-T, URNEVA, URO-MP, URO-SP, UROGESIC-BLUE, UROQID-ACID NO.2, URYL |
There are 4 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
Drug Interaction | Drug Names |
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Topiramate/Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Topiramate is a weak carbonic anhydrase inhibitor and can induce renal bicarbonate loss, resulting in metabolic acidosis. It can also reduce urinary citrate excretion and increase urinary pH, posing a risk for nephrolithiasis. As well, carbonic anhydrase inhibitors can cause decreased sweating and elevated body temperature, predisposing patients to heat-related disorders.(1) CLINICAL EFFECTS: The concurrent use of topiramate with another carbonic anhydrase inhibitor may increase the risk of metabolic acidosis and kidney stone formation.(1) Concurrent use of topiramate with other carbonic anhydrase inhibitors may increase the incidence of oligohidrosis and hyperthermia, especially in pediatric or adolescent patients.(1-2) Overheating and dehydration can lead to brain damage and death. PREDISPOSING FACTORS: Patients with conditions that predispose to acidosis (such as renal disease, severe respiratory disorders, status epilepticus, diarrhea, and being on a ketogenic diet) may be at increased risk of experiencing adverse effects from concurrent carbonic anhydrase inhibitors.(1) Pediatric and adolescent patients and patients with dehydration may be more likely to experience heat-related disorders.(1) PATIENT MANAGEMENT: The US manufacturer of topiramate states that the concurrent use of topiramate with other carbonic anhydrase inhibitors should be avoided. Patients receiving concurrent therapy should be monitored for the appearance of or worsening of metabolic acidosis, nephrolithiasis, and hyperthermia.(1) Check serum bicarbonate at baseline and periodically during treatment. Monitor for signs and symptoms of metabolic acidosis: hyperventilation, fatigue, anorexia, arrhthymias, stupor. Monitor for signs and symptoms of heat stroke: skin feels very hot with little or no sweating, confusion, muscle cramps, rapid heartbeat, or rapid breathing. Monitor for signs and symptoms of dehydration: dry mouth, urinating less than usual, dark-colored urine, dry skin, feeling tired, dizziness, or irritability. If signs or symptoms of metabolic acidosis, dehydration, oligohidrosis, or elevated body temperature occur, a decreased dose or discontinuation of zonisamide should be considered. DISCUSSION: Topiramate is a weak carbonic anhydrase inhibitor. Carbonic anhydrase inhibitors increase urinary bicarbonate excretion, reduce urinary citrate excretion and increase urinary pH. Concurrent use of topiramate with other carbonic anhydrase inhibitors may increase the risk of metabolic acidosis and kidney stone formation and should therefore be avoided.(1) Case reports of decreased sweating and elevated temperature have been reported, especially in pediatric patients. Some cases resulted in heat stroke that required hospital treatment.(1) |
EPRONTIA, QSYMIA, QUDEXY XR, TOPAMAX, TOPIRAMATE, TOPIRAMATE ER, TROKENDI XR |
Methenamine-Sodium Phosphate/Thiazides; Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Thiazide diuretics and carbonic anhydrase inhibitors may elevate urinary ph preventing the conversion of methenamine to formaldehyde and mandelic acid.(1) CLINICAL EFFECTS: Concurrent administration may result in alkalinization of the urine causing methenamine to be less effective.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving concurrent therapy should be monitored for urinary ph and any worsening symptoms of their infection, including dysuria, flank pain, or fever.(1) DISCUSSION: Administration of thiazide diuretics and carbonic anhydrase inhibitors may result in alkalinization of the urine resulting in therapeutic failure of methenamine. Formaldehyde is released by acid hydrolysis from methenamine resulting in bactericidal concentrations at urinary ph 5.0 to 5.5. Above urinary ph 6.0 there is insufficient quantities of formaldehyde and methenamine released to achieve a therapeutic response.(1) |
UROQID-ACID NO.2 |
ZONEGRAN, ZONISADE, ZONISAMIDE | |
XELSTRYM |
There are 5 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
Drug Interaction | Drug Names |
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Sympathomimetics/Urinary Alkalinizers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Unionized sympathomimetic amines will be reabsorbed into systemic circulation from the distal tubules of the kidneys. CLINICAL EFFECTS: Enhanced sympathomimetic activity and increased risk of sympathomimetic toxicity. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Watch patient for enhanced sympathomimetic side effects when urinary alkalinizers are concomitantly used. A lower dose of certain sympathomimetics may be required. DISCUSSION: Signs and symptoms of sympathomimetic toxicity include euphoria, confusion, delirium, hallucinations and nervousness. |
AKOVAZ, BENZPHETAMINE HCL, EMERPHED, EPHEDRINE HCL, EPHEDRINE SULFATE, EPHEDRINE SULFATE-0.9% NACL, EPHEDRINE SULFATE-NACL, LISDEXAMFETAMINE DIMESYLATE, MIDODRINE HCL, REZIPRES, VYVANSE |
Acetazolamide; Methazolamide/Aspirin (Greater Than 100 mg); Salicylates SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Acetazolamide and methazolamide may reduce blood pH, causing a shift of salicylates from plasma into tissues (eg, central nervous system). Alternatively, toxicity may be due to salicylate-induced displacement of the carbonic anhydrase inhibitor from its protein binding sites and inhibition of renal tubular secretion. CLINICAL EFFECTS: An increase in the pharmacologic effects of salicylates with possible toxicity may occur. PREDISPOSING FACTORS: High doses of salicylates, low body weight. PATIENT MANAGEMENT: Avoid the combination if possible. If it is necessary to administer these drugs concurrently, monitor salicylate levels and monitor the patient for symptoms of toxicity. Adjust the dose as needed. DISCUSSION: Two young patients with unimpaired renal and hepatic function were found to have developed metabolic acidosis after treatment for glaucoma and joint pain with a combination of salicylates and carbonic anhydrase inhibitors in normal doses.(1) A 67-year old woman and a 75-year old woman taking carbonic anhydrase inhibitors for therapy of glaucoma and high doses of aspirin for arthritis developed severe acid-base imbalance and salicylate intoxication.(2) Neither patient exhibited ill effects when taking high aspirin doses without a carbonic anhydrase inhibitor. Carbonic anhydrase inhibitor-induced acidemia increases the risk of developing salicylate intoxication in patients receiving high aspirin doses. Two elderly patients, who were chronically receiving aspirin developed lethargy, incontinence, and confusion after dosing with acetazolamide.(3) These effects could have been due to either drug (see mechanism). |
ACETYL SALICYLIC ACID, ASA-BUTALB-CAFFEINE-CODEINE, ASCOMP WITH CODEINE, ASPIRIN, BALSALAZIDE DISODIUM, BISMUTH SUBSALICYLATE, BUTALBITAL-ASPIRIN-CAFFEINE, CARISOPRODOL-ASPIRIN, CARISOPRODOL-ASPIRIN-CODEINE, CHOLINE MAGNESIUM TRISALICYLAT, COLAZAL, DISALCID, DURLAZA, MB CAPS, NORGESIC, NORGESIC FORTE, ORPHENADRINE-ASPIRIN-CAFFEINE, ORPHENGESIC FORTE, PHENYL SALICYLATE, SALSALATE, SODIUM SALICYLATE, URELLE, URETRON D-S, URIBEL TABS, URIMAR-T, URNEVA, URO-MP, URO-SP, YOSPRALA |
Lithium/Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Carbonic anhydrase inhibitors may increase the renal excretion of lithium, either by alkalinization of the urine or by impairing the proximal tubular reabsorption of lithium. CLINICAL EFFECTS: Concurrent use of a carbonic anhydrase inhibitor may result in decreased levels and clinical effectiveness of lithium. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Lithium levels should be monitored in patients receiving concurrent therapy or if the carbonic anhydrase inhibitor is withdrawn from concurrent therapy. The dose of lithium may need to be adjusted. DISCUSSION: One study involving six subjects showed that the concurrent use of a single dose of both lithium carbonate and acetazolamide caused a 27% to 31% increase in the urinary excretion of lithium.(1) Acetazolamide has been used in combination with other agents to treat lithium toxicity.(2) |
LITHIUM CARBONATE, LITHIUM CARBONATE ER, LITHIUM CITRATE, LITHIUM CITRATE TETRAHYDRATE, LITHOBID |
Memantine; Amantadine/Urinary Alkalinizers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Memantine and amantadine elimination is impaired by urinary alkalinization.(1,2) CLINICAL EFFECTS: Potentiation of memantine or amantadine effects may be observed. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Monitor patient for adverse reactions such as dizziness, headache, or confusion if a urinary alkalinizer is required. The memantine or amantadine dose may need to be adjusted when a urinary alkalinizer is started or stopped.(1,2) DISCUSSION: The clearance of memantine was reduced by about 80% under alkaline urine conditions at pH 8. Urine alkalinization may lead to an accumulation of memantine with a possible increase in adverse effects. Urine pH is also altered by diet and clinical state of the patient (e.g., renal tubular acidosis or severe infections of the urinary tract). Hence, memantine should be used with caution under these conditions.(1) A study in rats showed that concomitant administration of sodium bicarbonate with amantadine caused a decrease in amantadine renal clearance (1.16 vs. 0.76). Amantadine's area-under-the-curve (AUC) was increased approximately 78%.(3) A study in 12 healthy subjects showed that plasma concentrations of memantine are dependent on urine pH. Alkaline urine pH caused a 79% reduction in renal clearance.(4) |
AMANTADINE, AMANTADINE HCL, GOCOVRI, MEMANTINE HCL, MEMANTINE HCL ER, MEMANTINE HCL-DONEPEZIL HCL ER, NAMENDA, NAMENDA XR, NAMZARIC, OSMOLEX ER |
Metformin/Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Carbonic anhydrase inhibitors increase bicarbonate excretion which may cause metabolic acidosis.(1) High systemic concentrations of metformin may result in lactic acidosis.(2,3) Topiramate, a mild carbonic anhydrase inhibitor, may also increase systemic exposure to metformin.(1) CLINICAL EFFECTS: Carbonic anhydrase inhibitors may increase the risk for metformin associated lactic acidosis.(1-3) Untreated lactic acidosis may be fatal. Symptoms of lactic acidosis include malaise, myalgias, respiratory distress, low blood pH, increased anion gap and elevated blood lactate.(2) Carbonic anhydrase inhibitors linked to this monograph are acetazolamide, dichlorphenamide, methazolamide, sulthiame, topiramate, and zonisamide. PREDISPOSING FACTORS: Risk factors for metformin associated lactic acidosis include renal impairment,sepsis, dehydration, excessive alcohol intake, acute or chronic metabolic acidosis, hepatic insufficiency, acute heart failure, metformin plasma levels > 5 micrograms/mL, and conditions which may lead to tissue hypoxia. Geriatric patients may also be at higher risk due to slower metformin clearance and increased half-life in this population. The risk for metabolic acidosis is higher with increased doses of either agent. PATIENT MANAGEMENT: For patients receiving concurrent therapy, monitor renal function and assure that patient does not have risk factors for metformin associated lactic acidosis. Discontinue metformin when risk factors are present. If both drugs are given, monitor renal function and for signs and symptoms of metformin toxicity (lactic acidosis) such as malaise, myalgias, respiratory distress, increasing somnolence, and respiratory distress. Laboratory results which may signal lactic acidosis include: low pH, an increased anion gap, and increased lactate to pyruvate ratio. Manufacturer recommendations: the manufacturer of metformin recommends caution with concomitant use of carbonic anhydrase inhibitors due to an increased risk for metformin associated lactic acidosis.(2) The manufacturer of topiramate notes that topiramate can frequently cause metabolic acidosis and that metformin should not be used in patients with metabolic acidosis.(1) DISCUSSION: A literature search for lactic acidosis due solely to the combination of metformin and carbonic anhydrase inhibitors or topiramate did not reveal any case reports of symptomatic metabolic acidosis due to this combination. Never-the-less, since carbonic anhydrase inhibitors act by inhibiting the reabsorption of bicarbonate in the renal tubule, some lowering of systemic bicarbonate and pH is common and supports the plausibility of this interaction. In addition, a pharmacokinetic interaction has been described with topiramate. A study in healthy volunteers evaluated the effect of topiramate 100 mg every 12 hours on the kinetics of metformin 500 mg every 12 hours. Mean metformin exposure (area-under-curve or AUC) was increased 25%.(1) |
ACTOPLUS MET, ALOGLIPTIN-METFORMIN, DAPAGLIFLOZIN-METFORMIN ER, GLIPIZIDE-METFORMIN, GLYBURIDE-METFORMIN HCL, INVOKAMET, INVOKAMET XR, JANUMET, JANUMET XR, JENTADUETO, JENTADUETO XR, KAZANO, METFORMIN ER GASTRIC, METFORMIN ER OSMOTIC, METFORMIN HCL, METFORMIN HCL ER, PIOGLITAZONE-METFORMIN, RIOMET, SAXAGLIPTIN-METFORMIN ER, SEGLUROMET, SITAGLIPTIN-METFORMIN, SYNJARDY, SYNJARDY XR, TRIJARDY XR, XIGDUO XR, ZITUVIMET, ZITUVIMET XR |
The following contraindication information is available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 7 contraindications.
Absolute contraindication.
Contraindication List |
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Adrenocortical insufficiency |
Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min |
Chronic kidney disease stage 5 (failure) GFr<15 ml/min |
Hepatic cirrhosis |
Hyperchloremic acidosis |
Hypokalemia |
Hyponatremia |
There are 4 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
Severe List |
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Chronic kidney disease stage 3A (moderate) GFR 45-59 ml/min |
Chronic kidney disease stage 3B (moderate) GFR 30-44 ml/min |
Disease of liver |
Recurrent calcium renal calculi |
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
Moderate List |
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Diabetes mellitus |
Kidney disease with likely reduction in glomerular filtration rate (GFr) |
Suicidal ideation |
The following adverse reaction information is available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 29 severe adverse reactions.
More Frequent | Less Frequent |
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None. |
Crystalluria Depression Hematuria Kidney stone |
Rare/Very Rare |
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Abnormal hepatic function tests Acidosis Agranulocytosis Anaphylaxis Aplastic anemia Black tarry stools Blood dyscrasias Choroidal effusion Flaccid paralysis Glycosuria Hemolytic anemia Hepatic necrosis Hyperglycemia Hypoglycemic disorder Hypokalemia Idiopathic thrombocytopenic purpura Jaundice Leukopenia Obstructive hyperbilirubinemia Pancytopenia Renal failure Secondary angle-closure glaucoma Seizure disorder Stevens-johnson syndrome Toxic epidermal necrolysis |
There are 24 less severe adverse reactions.
More Frequent | Less Frequent |
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Anorexia Diarrhea Dysgeusia Fatigue Malaise Nausea Vomiting |
Drowsy Hyponatremia |
Rare/Very Rare |
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Acute cognitive impairment Ataxia Dizziness Erythema Fever Headache disorder Hearing disorder Injection site sequelae Myopia Paresthesia Parosmia Polyuria Skin photosensitivity Tinnitus Urticaria |
The following precautions are available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
None |
Severe Precaution
None |
Management or Monitoring Precaution
None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for ACETAZOLAMIDE SODIUM (acetazolamide sodium):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for ACETAZOLAMIDE SODIUM (acetazolamide sodium)'s list of indications:
Peripheral edema | |
R60 | Edema, not elsewhere classified |
R60.1 | Generalized edema |
R60.9 | Edema, unspecified |
Peripheral edema due to chronic heart failure | |
R60 | Edema, not elsewhere classified |
R60.9 | Edema, unspecified |
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