Acute mountain sickness; Treatment and Prophylaxis.
Edema.
Epilepsy.
Glaucoma; Adjunct.

AcetaZOLAMIDE, a non-bacteriostatic sulfonamide, inhibits carbonic anhydrase from catalyzing the reversible hydration of carbon dioxide and dehydration of carbonic acid. In the eye, carbonic anhydrase inhibition reduces aqueous humor production resulting to a decrease in intraocular pressure. It also delays abnormal, paroxysmal excessive discharge from central nervous system neurons and affects promotion of diuresis and urinary alkalinization.

Distribution:
Vd: 0.2 L/kg
Metabolism:
Not metabolized; excreted unchanged in the urine
Excretion:
Renal: 90% ,Dialyzable: yes
Elimination Half Life:
4 to 8 hours

Chronic noncongestive angle-closure glaucoma; long-term use may mask symptoms of worsening glaucoma
Cirrhosis or marked liver disease or dysfunction ; risk of hepatic encephalopathy
Hyperchloremic acidosis
Hypersensitivity to acetaZOLAMIDE or any component of the product
Hypersensitivity to sulfonamides or other sulfonamide derivatives; cross-sensitivity may occur
Hypokalemia
Hyponatremia
Renal dysfunction or marked disease
Suprarenal gland failure

C(FDA) B3(AUS)

Maternal medication usually compatible with breastfeeding.(AAP)
Compatible with breastfeeding.(WHO)
Infant risk cannot be ruled out.(MDX)

Serious:
Dermatologic: Stevens-Johnson syndrome, Toxic epidermal necrolysis due to drug
Endocrine metabolic: Acidosis, Metabolic acidosis
Hematologic: Agranulocytosis, Aplastic anemia, Thrombocytopenia
Hepatic: Hepatic necrosis
Immunologic: Anaphylaxis
Ophthalmic: Angle-closure glaucoma
Other: Sulfonamide adverse reaction

Acute mountain sickness [UpToDate]
Prevention: 125 mg twice daily; beginning either the day before (preferred) or on the day of ascent; may be discontinued after staying at the same elevation for 2 to 3 days or if descent initiated.
Treatment: 250 mg twice daily. Note: With high altitude cerebral edema, dexamethasone is the primary treatment; however, acetazolamide may be used adjunctively with the same treatment dose.
Edema:
250 to 375 mg ORALLY once daily in morning for 1 or 2 days, alternating with a day of rest
Epilepsy:
8 to 30 mg/kg ORALLY daily in divided doses (optimum range, 375 to 1000 mg daily)
adjunct, 250 mg ORALLY once daily
Glaucoma; Adjunct:
tablets: 250 to 1000 mg ORALLY every 24 hours in divided doses
Glaucoma following surgery; Prophylaxis:
500 mg orally 1 hour preoperatively (off-label dosage)
Macular retinal edema:
500 mg/day orally continued for at least 1 month. Dose may be reduced over course of therapy, based on response . Alternatively, 500 mg (extended-release capsule) orally twice daily for 4 weeks; reduce to 500 mg once daily or discontinue for severe adverse effects (off-label dosage)
Periodic ataxia:
250 to 1000 mg/day orally (off-label dosage)

Glaucoma; Adjunct
8 to 30 mg/kg ORALLY daily, divided every 6 to 8 hours

renal impairment, mild (GFR greater than 50 mL/min): increase dosing interval to every 6 hours
renal impairment, moderate (GFR 10 to 50 mL/min): increase dosing interval to every 12 hours
renal impairment, severe (GFR less than 10 mL/min): use not recommended
hemodialysis: 62.5 to 125 mg daily after dialysis; titrate to effect and toxicity

liver disease: use with caution; may induce precoma or coma