Acetazolamide

Drug overview for ACETAZOLAMIDE (acetazolamide):

Generic name: ACETAZOLAMIDE (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

ACETAZOLAMIDE 250 MG TABLET
ACETAZOLAMIDE 125 MG TABLET

The following indications for ACETAZOLAMIDE (acetazolamide) have been approved by the FDA:

Indications:
Absence epilepsy
Angle-closure glaucoma
Anoxia due to high altitude
Edema
Malignant glaucoma
Open angle glaucoma
Peripheral edema due to chronic heart failure
Peripheral edema
Secondary glaucoma

Professional Synonyms:
Absence epilepsy simple
Absence seizures
Acosta's disease
Acute mountain sickness
Chronic glaucoma
Compensated glaucoma
Edema of extremities
Edematous sodium retaining conditions
Glaucoma simplex
Hypobaropathy
Minor epilepsy
Narrow angle glaucoma
Open-angle glaucoma
Peripheral edema due to CHF
Peripheral edema due to congestive heart failure
Petit mal epilepsy
Simple glaucoma

Dosing information for ACETAZOLAMIDE
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
ACETAZOLAMIDE 125 MG TABLET	Maintenance	Adults take 1 tablet (125 mg) by oral route 2 times per day
ACETAZOLAMIDE 250 MG TABLET	Maintenance	Adults take 1 tablet (250 mg) by oral route once daily

Generic dosing information for ACETAZOLAMIDE
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
ACETAZOLAMIDE 250 MG TABLET	Maintenance	Adults take 1 tablet (250 mg) by oral route once daily
ACETAZOLAMIDE 125 MG TABLET	Maintenance	Adults take 1 tablet (125 mg) by oral route 2 times per day

The following drug interaction information is available for ACETAZOLAMIDE (acetazolamide):

Contraindicated
Severe
Moderate

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
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

Drug Interaction

Drug Names

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
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 7 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
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
Brinzolamide/Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Brinzolamide and other carbonic anhydrase inhibitors cause a decrease in aqueous humor secretion by slowing the formation of bicarbonate ions with a subsequent reduction of sodium and fluid transport which results in a reduction of intraocular pressure.(1) CLINICAL EFFECTS: If brinzolamide is given with other carbonic anhydrase inhibitors it may cause electrolyte disturbances, because brinzolamide can be absorbed systemically.(1) 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. PATIENT MANAGEMENT: It is not recommended to use brinzolamide with systemic carbonic anhydrase inhibitors. DISCUSSION: Although no human data is available, electrolyte imbalance, development of an acidotic state, and possible nervous system effects may occur following oral administration of brinzolamide and another carbonic anhydrase inhibitor.(1)	AZOPT, BRINZOLAMIDE, SIMBRINZA
Dorzolamide/Carbonic Anhydrase Inhibitors SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Dorzolamide and other carbonic anhydrase inhibitors cause a decrease in aqueous humor secretion by slowing the formation of bicarbonate ions with a subsequent reduction of sodium and fluid transport which results in a reduction of intraocular pressure.(1) CLINICAL EFFECTS: If dorzolamide is given with other carbonic anhydrase inhibitors it may cause electrolyte disturbances, because dorzolamide can be absorbed systemically.(1) 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. PATIENT MANAGEMENT: The manufacturer of dorzolamide states that concurrent use with oral carbonic anhydrase inhibitors is not recommended.(1) DISCUSSION: Although no human data is available, electrolyte imbalance, development of an acidotic state, and possible nervous system effects may occur following administration of dorzolamide and oral carbonic anhydrase inhibitors.(1)	BRIMONIDINE-DORZOLAMIDE, COSOPT, COSOPT PF, DORZOLAMIDE, DORZOLAMIDE HCL, DORZOLAMIDE-TIMOLOL, TIMOLOL-BRIMONI-DORZOL-BIMATOP, TIMOLOL-BRIMONIDIN-DORZOLAMIDE, TIMOLOL-DORZOLAMIDE-BIMATOPRST
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 (acetazolamide):

Overview
Contraindicated
Severe
Moderate

Drug contraindication overview.

No enhanced Contraindications information available for this drug.

There are 7 contraindications. Absolute contraindication.

Contraindication List
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
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
Diabetes mellitus
Kidney disease with likely reduction in glomerular filtration rate (GFr)
Suicidal ideation

The following adverse reaction information is available for ACETAZOLAMIDE (acetazolamide):

Overview
Severe
Less Severe

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

There are 29 severe adverse reactions.

More Frequent	Less Frequent
None.	Crystalluria Depression Hematuria Kidney stone

Rare/Very Rare
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

Rare/Very Rare

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
Anorexia Diarrhea Dysgeusia Fatigue Malaise Nausea Vomiting	Drowsy Hyponatremia

Rare/Very Rare
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 (acetazolamide):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

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 icd codes are available for ACETAZOLAMIDE (acetazolamide)'s list of indications:

Absence epilepsy
G40.A	Absence epileptic syndrome
G40.A0	Absence epileptic syndrome, not intractable
G40.A09	Absence epileptic syndrome, not intractable, without status epilepticus
G40.A1	Absence epileptic syndrome, intractable
G40.A19	Absence epileptic syndrome, intractable, without status epilepticus
Angle-closure glaucoma
H40.2	Primary angle-closure glaucoma
H40.20	Unspecified primary angle-closure glaucoma
H40.20x0	Unspecified primary angle-closure glaucoma, stage unspecified
H40.20x1	Unspecified primary angle-closure glaucoma, mild stage
H40.20x2	Unspecified primary angle-closure glaucoma, moderate stage
H40.20x3	Unspecified primary angle-closure glaucoma, severe stage
H40.20x4	Unspecified primary angle-closure glaucoma, indeterminate stage
H40.21	Acute angle-closure glaucoma
H40.211	Acute angle-closure glaucoma, right eye
H40.212	Acute angle-closure glaucoma, left eye
H40.213	Acute angle-closure glaucoma, bilateral
H40.219	Acute angle-closure glaucoma, unspecified eye
H40.22	Chronic angle-closure glaucoma
H40.221	Chronic angle-closure glaucoma, right eye
H40.2210	Chronic angle-closure glaucoma, right eye, stage unspecified
H40.2211	Chronic angle-closure glaucoma, right eye, mild stage
H40.2212	Chronic angle-closure glaucoma, right eye, moderate stage
H40.2213	Chronic angle-closure glaucoma, right eye, severe stage
H40.2214	Chronic angle-closure glaucoma, right eye, indeterminate stage
H40.222	Chronic angle-closure glaucoma, left eye
H40.2220	Chronic angle-closure glaucoma, left eye, stage unspecified
H40.2221	Chronic angle-closure glaucoma, left eye, mild stage
H40.2222	Chronic angle-closure glaucoma, left eye, moderate stage
H40.2223	Chronic angle-closure glaucoma, left eye, severe stage
H40.2224	Chronic angle-closure glaucoma, left eye, indeterminate stage
H40.223	Chronic angle-closure glaucoma, bilateral
H40.2230	Chronic angle-closure glaucoma, bilateral, stage unspecified
H40.2231	Chronic angle-closure glaucoma, bilateral, mild stage
H40.2232	Chronic angle-closure glaucoma, bilateral, moderate stage
H40.2233	Chronic angle-closure glaucoma, bilateral, severe stage
H40.2234	Chronic angle-closure glaucoma, bilateral, indeterminate stage
H40.229	Chronic angle-closure glaucoma, unspecified eye
H40.2290	Chronic angle-closure glaucoma, unspecified eye, stage unspecified
H40.2291	Chronic angle-closure glaucoma, unspecified eye, mild stage
H40.2292	Chronic angle-closure glaucoma, unspecified eye, moderate stage
H40.2293	Chronic angle-closure glaucoma, unspecified eye, severe stage
H40.2294	Chronic angle-closure glaucoma, unspecified eye, indeterminate stage
H40.23	Intermittent angle-closure glaucoma
H40.231	Intermittent angle-closure glaucoma, right eye
H40.232	Intermittent angle-closure glaucoma, left eye
H40.233	Intermittent angle-closure glaucoma, bilateral
H40.239	Intermittent angle-closure glaucoma, unspecified eye
H40.24	Residual stage of angle-closure glaucoma
H40.241	Residual stage of angle-closure glaucoma, right eye
H40.242	Residual stage of angle-closure glaucoma, left eye
H40.243	Residual stage of angle-closure glaucoma, bilateral
H40.249	Residual stage of angle-closure glaucoma, unspecified eye
Anoxia due to high altitude
T70.29xA	Other effects of high altitude, initial encounter
Edema
R60	Edema, not elsewhere classified
R60.0	Localized edema
R60.1	Generalized edema
R60.9	Edema, unspecified
Malignant glaucoma
H40.83	Aqueous misdirection
H40.831	Aqueous misdirection, right eye
H40.832	Aqueous misdirection, left eye
H40.833	Aqueous misdirection, bilateral
H40.839	Aqueous misdirection, unspecified eye
Open angle glaucoma
H40.1	Open-angle glaucoma
H40.10	Unspecified open-angle glaucoma
H40.10x0	Unspecified open-angle glaucoma, stage unspecified
H40.10x1	Unspecified open-angle glaucoma, mild stage
H40.10x2	Unspecified open-angle glaucoma, moderate stage
H40.10x3	Unspecified open-angle glaucoma, severe stage
H40.10x4	Unspecified open-angle glaucoma, indeterminate stage
H40.11	Primary open-angle glaucoma
H40.111	Primary open-angle glaucoma, right eye
H40.1110	Primary open-angle glaucoma, right eye, stage unspecified
H40.1111	Primary open-angle glaucoma, right eye, mild stage
H40.1112	Primary open-angle glaucoma, right eye, moderate stage
H40.1113	Primary open-angle glaucoma, right eye, severe stage
H40.1114	Primary open-angle glaucoma, right eye, indeterminate stage
H40.112	Primary open-angle glaucoma, left eye
H40.1120	Primary open-angle glaucoma, left eye, stage unspecified
H40.1121	Primary open-angle glaucoma, left eye, mild stage
H40.1122	Primary open-angle glaucoma, left eye, moderate stage
H40.1123	Primary open-angle glaucoma, left eye, severe stage
H40.1124	Primary open-angle glaucoma, left eye, indeterminate stage
H40.113	Primary open-angle glaucoma, bilateral
H40.1130	Primary open-angle glaucoma, bilateral, stage unspecified
H40.1131	Primary open-angle glaucoma, bilateral, mild stage
H40.1132	Primary open-angle glaucoma, bilateral, moderate stage
H40.1133	Primary open-angle glaucoma, bilateral, severe stage
H40.1134	Primary open-angle glaucoma, bilateral, indeterminate stage
H40.119	Primary open-angle glaucoma, unspecified eye
H40.1190	Primary open-angle glaucoma, unspecified eye, stage unspecified
H40.1191	Primary open-angle glaucoma, unspecified eye, mild stage
H40.1192	Primary open-angle glaucoma, unspecified eye, moderate stage
H40.1193	Primary open-angle glaucoma, unspecified eye, severe stage
H40.1194	Primary open-angle glaucoma, unspecified eye, indeterminate stage
H40.12	Low-tension glaucoma
H40.121	Low-tension glaucoma, right eye
H40.1210	Low-tension glaucoma, right eye, stage unspecified
H40.1211	Low-tension glaucoma, right eye, mild stage
H40.1212	Low-tension glaucoma, right eye, moderate stage
H40.1213	Low-tension glaucoma, right eye, severe stage
H40.1214	Low-tension glaucoma, right eye, indeterminate stage
H40.122	Low-tension glaucoma, left eye
H40.1220	Low-tension glaucoma, left eye, stage unspecified
H40.1221	Low-tension glaucoma, left eye, mild stage
H40.1222	Low-tension glaucoma, left eye, moderate stage
H40.1223	Low-tension glaucoma, left eye, severe stage
H40.1224	Low-tension glaucoma, left eye, indeterminate stage
H40.123	Low-tension glaucoma, bilateral
H40.1230	Low-tension glaucoma, bilateral, stage unspecified
H40.1231	Low-tension glaucoma, bilateral, mild stage
H40.1232	Low-tension glaucoma, bilateral, moderate stage
H40.1233	Low-tension glaucoma, bilateral, severe stage
H40.1234	Low-tension glaucoma, bilateral, indeterminate stage
H40.129	Low-tension glaucoma, unspecified eye
H40.1290	Low-tension glaucoma, unspecified eye, stage unspecified
H40.1291	Low-tension glaucoma, unspecified eye, mild stage
H40.1292	Low-tension glaucoma, unspecified eye, moderate stage
H40.1293	Low-tension glaucoma, unspecified eye, severe stage
H40.1294	Low-tension glaucoma, unspecified eye, indeterminate stage
H40.13	Pigmentary glaucoma
H40.131	Pigmentary glaucoma, right eye
H40.1310	Pigmentary glaucoma, right eye, stage unspecified
H40.1311	Pigmentary glaucoma, right eye, mild stage
H40.1312	Pigmentary glaucoma, right eye, moderate stage
H40.1313	Pigmentary glaucoma, right eye, severe stage
H40.1314	Pigmentary glaucoma, right eye, indeterminate stage
H40.132	Pigmentary glaucoma, left eye
H40.1320	Pigmentary glaucoma, left eye, stage unspecified
H40.1321	Pigmentary glaucoma, left eye, mild stage
H40.1322	Pigmentary glaucoma, left eye, moderate stage
H40.1323	Pigmentary glaucoma, left eye, severe stage
H40.1324	Pigmentary glaucoma, left eye, indeterminate stage
H40.133	Pigmentary glaucoma, bilateral
H40.1330	Pigmentary glaucoma, bilateral, stage unspecified
H40.1331	Pigmentary glaucoma, bilateral, mild stage
H40.1332	Pigmentary glaucoma, bilateral, moderate stage
H40.1333	Pigmentary glaucoma, bilateral, severe stage
H40.1334	Pigmentary glaucoma, bilateral, indeterminate stage
H40.139	Pigmentary glaucoma, unspecified eye
H40.1390	Pigmentary glaucoma, unspecified eye, stage unspecified
H40.1391	Pigmentary glaucoma, unspecified eye, mild stage
H40.1392	Pigmentary glaucoma, unspecified eye, moderate stage
H40.1393	Pigmentary glaucoma, unspecified eye, severe stage
H40.1394	Pigmentary glaucoma, unspecified eye, indeterminate stage
H40.14	Capsular glaucoma with pseudoexfoliation of lens
H40.141	Capsular glaucoma with pseudoexfoliation of lens, right eye
H40.1410	Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411	Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412	Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413	Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414	Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.142	Capsular glaucoma with pseudoexfoliation of lens, left eye
H40.1420	Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421	Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422	Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423	Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424	Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.143	Capsular glaucoma with pseudoexfoliation of lens, bilateral
H40.1430	Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431	Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432	Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433	Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434	Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.149	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye
H40.1490	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, stage unspecified
H40.1491	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage
H40.1492	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, moderate stage
H40.1493	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, severe stage
H40.1494	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, indeterminate stage
H40.15	Residual stage of open-angle glaucoma
H40.151	Residual stage of open-angle glaucoma, right eye
H40.152	Residual stage of open-angle glaucoma, left eye
H40.153	Residual stage of open-angle glaucoma, bilateral
H40.159	Residual stage of open-angle glaucoma, unspecified eye
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
Secondary glaucoma
H40.14	Capsular glaucoma with pseudoexfoliation of lens
H40.141	Capsular glaucoma with pseudoexfoliation of lens, right eye
H40.1410	Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411	Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412	Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413	Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414	Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.142	Capsular glaucoma with pseudoexfoliation of lens, left eye
H40.1420	Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421	Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422	Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423	Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424	Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.143	Capsular glaucoma with pseudoexfoliation of lens, bilateral
H40.1430	Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431	Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432	Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433	Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434	Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.149	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye
H40.1490	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, stage unspecified
H40.1491	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage
H40.1492	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, moderate stage
H40.1493	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, severe stage
H40.1494	Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, indeterminate stage
H40.3	Glaucoma secondary to eye trauma
H40.30	Glaucoma secondary to eye trauma, unspecified eye
H40.30x0	Glaucoma secondary to eye trauma, unspecified eye, stage unspecified
H40.30x1	Glaucoma secondary to eye trauma, unspecified eye, mild stage
H40.30x2	Glaucoma secondary to eye trauma, unspecified eye, moderate stage
H40.30x3	Glaucoma secondary to eye trauma, unspecified eye, severe stage
H40.30x4	Glaucoma secondary to eye trauma, unspecified eye, indeterminate stage
H40.31	Glaucoma secondary to eye trauma, right eye
H40.31x0	Glaucoma secondary to eye trauma, right eye, stage unspecified
H40.31x1	Glaucoma secondary to eye trauma, right eye, mild stage
H40.31x2	Glaucoma secondary to eye trauma, right eye, moderate stage
H40.31x3	Glaucoma secondary to eye trauma, right eye, severe stage
H40.31x4	Glaucoma secondary to eye trauma, right eye, indeterminate stage
H40.32	Glaucoma secondary to eye trauma, left eye
H40.32x0	Glaucoma secondary to eye trauma, left eye, stage unspecified
H40.32x1	Glaucoma secondary to eye trauma, left eye, mild stage
H40.32x2	Glaucoma secondary to eye trauma, left eye, moderate stage
H40.32x3	Glaucoma secondary to eye trauma, left eye, severe stage
H40.32x4	Glaucoma secondary to eye trauma, left eye, indeterminate stage
H40.33	Glaucoma secondary to eye trauma, bilateral
H40.33x0	Glaucoma secondary to eye trauma, bilateral, stage unspecified
H40.33x1	Glaucoma secondary to eye trauma, bilateral, mild stage
H40.33x2	Glaucoma secondary to eye trauma, bilateral, moderate stage
H40.33x3	Glaucoma secondary to eye trauma, bilateral, severe stage
H40.33x4	Glaucoma secondary to eye trauma, bilateral, indeterminate stage
H40.4	Glaucoma secondary to eye inflammation
H40.40	Glaucoma secondary to eye inflammation, unspecified eye
H40.40x0	Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified
H40.40x1	Glaucoma secondary to eye inflammation, unspecified eye, mild stage
H40.40x2	Glaucoma secondary to eye inflammation, unspecified eye, moderate stage
H40.40x3	Glaucoma secondary to eye inflammation, unspecified eye, severe stage
H40.40x4	Glaucoma secondary to eye inflammation, unspecified eye, indeterminate stage
H40.41	Glaucoma secondary to eye inflammation, right eye
H40.41x0	Glaucoma secondary to eye inflammation, right eye, stage unspecified
H40.41x1	Glaucoma secondary to eye inflammation, right eye, mild stage
H40.41x2	Glaucoma secondary to eye inflammation, right eye, moderate stage
H40.41x3	Glaucoma secondary to eye inflammation, right eye, severe stage
H40.41x4	Glaucoma secondary to eye inflammation, right eye, indeterminate stage
H40.42	Glaucoma secondary to eye inflammation, left eye
H40.42x0	Glaucoma secondary to eye inflammation, left eye, stage unspecified
H40.42x1	Glaucoma secondary to eye inflammation, left eye, mild stage
H40.42x2	Glaucoma secondary to eye inflammation, left eye, moderate stage
H40.42x3	Glaucoma secondary to eye inflammation, left eye, severe stage
H40.42x4	Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.43	Glaucoma secondary to eye inflammation, bilateral
H40.43x0	Glaucoma secondary to eye inflammation, bilateral, stage unspecified
H40.43x1	Glaucoma secondary to eye inflammation, bilateral, mild stage
H40.43x2	Glaucoma secondary to eye inflammation, bilateral, moderate stage
H40.43x3	Glaucoma secondary to eye inflammation, bilateral, severe stage
H40.43x4	Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
H40.5	Glaucoma secondary to other eye disorders
H40.50	Glaucoma secondary to other eye disorders, unspecified eye
H40.50x0	Glaucoma secondary to other eye disorders, unspecified eye, stage unspecified
H40.50x1	Glaucoma secondary to other eye disorders, unspecified eye, mild stage
H40.50x2	Glaucoma secondary to other eye disorders, unspecified eye, moderate stage
H40.50x3	Glaucoma secondary to other eye disorders, unspecified eye, severe stage
H40.50x4	Glaucoma secondary to other eye disorders, unspecified eye, indeterminate stage
H40.51	Glaucoma secondary to other eye disorders, right eye
H40.51x0	Glaucoma secondary to other eye disorders, right eye, stage unspecified
H40.51x1	Glaucoma secondary to other eye disorders, right eye, mild stage
H40.51x2	Glaucoma secondary to other eye disorders, right eye, moderate stage
H40.51x3	Glaucoma secondary to other eye disorders, right eye, severe stage
H40.51x4	Glaucoma secondary to other eye disorders, right eye, indeterminate stage
H40.52	Glaucoma secondary to other eye disorders, left eye
H40.52x0	Glaucoma secondary to other eye disorders, left eye, stage unspecified
H40.52x1	Glaucoma secondary to other eye disorders, left eye, mild stage
H40.52x2	Glaucoma secondary to other eye disorders, left eye, moderate stage
H40.52x3	Glaucoma secondary to other eye disorders, left eye, severe stage
H40.52x4	Glaucoma secondary to other eye disorders, left eye, indeterminate stage
H40.53	Glaucoma secondary to other eye disorders, bilateral
H40.53x0	Glaucoma secondary to other eye disorders, bilateral, stage unspecified
H40.53x1	Glaucoma secondary to other eye disorders, bilateral, mild stage
H40.53x2	Glaucoma secondary to other eye disorders, bilateral, moderate stage
H40.53x3	Glaucoma secondary to other eye disorders, bilateral, severe stage
H40.53x4	Glaucoma secondary to other eye disorders, bilateral, indeterminate stage
H40.6	Glaucoma secondary to drugs
H40.60	Glaucoma secondary to drugs, unspecified eye
H40.60x0	Glaucoma secondary to drugs, unspecified eye, stage unspecified
H40.60x1	Glaucoma secondary to drugs, unspecified eye, mild stage
H40.60x2	Glaucoma secondary to drugs, unspecified eye, moderate stage
H40.60x3	Glaucoma secondary to drugs, unspecified eye, severe stage
H40.60x4	Glaucoma secondary to drugs, unspecified eye, indeterminate stage
H40.61	Glaucoma secondary to drugs, right eye
H40.61x0	Glaucoma secondary to drugs, right eye, stage unspecified
H40.61x1	Glaucoma secondary to drugs, right eye, mild stage
H40.61x2	Glaucoma secondary to drugs, right eye, moderate stage
H40.61x3	Glaucoma secondary to drugs, right eye, severe stage
H40.61x4	Glaucoma secondary to drugs, right eye, indeterminate stage
H40.62	Glaucoma secondary to drugs, left eye
H40.62x0	Glaucoma secondary to drugs, left eye, stage unspecified
H40.62x1	Glaucoma secondary to drugs, left eye, mild stage
H40.62x2	Glaucoma secondary to drugs, left eye, moderate stage
H40.62x3	Glaucoma secondary to drugs, left eye, severe stage
H40.62x4	Glaucoma secondary to drugs, left eye, indeterminate stage
H40.63	Glaucoma secondary to drugs, bilateral
H40.63x0	Glaucoma secondary to drugs, bilateral, stage unspecified
H40.63x1	Glaucoma secondary to drugs, bilateral, mild stage
H40.63x2	Glaucoma secondary to drugs, bilateral, moderate stage
H40.63x3	Glaucoma secondary to drugs, bilateral, severe stage
H40.63x4	Glaucoma secondary to drugs, bilateral, indeterminate stage
H42	Glaucoma in diseases classified elsewhere