What are the precautions for taking Acetazolamide?

Acetazolamide, also known as acetazolamide, is an isocyclic sulfonamide and a carbonic anhydrase inhibitor. During medication treatment, patients should pay attention to drug interactions, special medication groups, adverse reactions, drug overdose, usage and dosage, etc.

About Acetazolamide

Acetazolamide is an isocyclic sulfonamide drug synthesized by Willer et al. in 1950. It was once used as an auxiliary treatment for cardiogenic edema and glaucoma.

Recent research has found that Acetazolamide tablets have a broad-spectrum inhibitory effect on carbonic anhydrase in human red blood cells, gastric mucosa, renal parenchyma, pancreas, central nervous system and many other tissue cells, blocking the CO2+H2O(?)H++HCO3- anterograde pathway of intracellular biochemical reactions, thereby correcting biochemical metabolic disorders in many pathological conditions, and thus a series of new clinical uses have emerged.

Precautions for Acetazolamide tablets

1. Drug interactions

1. Aspirin:

It will affect the metabolism of phenytoin and increase the concentration of phenytoin in the body. This may increase or increase the incidence of osteoporosis in some patients taking long-term phenytoin. For patients who require long-term treatment, caution is recommended.

2. Primidone:

Acetazolamide can reduce the anti-epileptic effect by reducing the levels of acetaminophen and its metabolites in plasma.

3. Carbonic anhydrase inhibitors:

Combined use is not recommended because acetazolamide tablets and other carbonic anhydrase inhibitors have a cumulative effect.

4. Folic acid antagonists:

Acetazolamide tablets may increase the effects of other folic acid antagonists.

5. Anti-diabetic drugs:

Acetazolamide tablets may affect blood sugar levels, so patients undergoing anti-diabetic treatment should use it with caution.

6. Amphetamine:

Acetazolamide can reduce the excretion of amphetamine in urine and extend the time and intensity of its action.

2. Special medication groups

1. Pregnancy:

Acetazolamide tablets have teratogenic effects, so they should not be used by pregnant women unless the potential benefits outweigh the potential risks to the fetus.

2. Breastfeeding women:

Because Acetazolamide tablets can cause side effects in babies during breastfeeding, it is not recommended for breastfeeding women.

3. Medication for children:

The safety and effectiveness of acetazolamide tablets in pediatric patients have not been determined, so use by children is not recommended.

4. Medication for elderly patients:

Metabolic acidosis can occur in elderly patients and is severe. Therefore, elderly patients should use it with caution and under the evaluation of a doctor.

3. Laboratory tests:

In order to monitor the common hematological reactions of all sulfa drugs, it is recommended to obtain the patient's baseline CBC and platelet count before starting treatment with acetazolamide tablets and regularly during treatment. If significant changes occur, early discontinuation and initiation of appropriate therapy are important, and regular monitoring of serum electrolytes is recommended.

IV. Adverse reactions:

Acetazolamide tablets may cause adverse reactions common to all sulfonamide derivatives, including thrombocytopenic purpura, hemolytic anemia, crystalluria, kidney stones, bone marrow suppression, allergic reactions, fever, rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), leukopenia, pancytopenia and agranulocytosis. It is recommended that caution be used to detect such reactions early and the drug should be discontinued and treated appropriately.

Five.:

The dosage range of Acetazolamide tablets is 250-4000mg daily, every 6-12 hours. Although the pharmacological effects of Acetazolamide last longer, its plasma half-life is 4-8 hours. Acetazolamide tablets (Acetazolamide) are highly bound to protein and are mainly eliminated by the kidneys. Therefore, if the creatinine clearance rate is less than 50 ml/minute, the dosing frequency should not exceed once every 12 hours.

6. Drug storage:

1. Acetazolamide tablets: It is recommended to store in an environment of 20°C-25°C (68°F-77°F).

2. Acetazolamide intravenous injection: sterile intravenous injection (lyophilized) powder, recommended to be stored at 20°C-25°C (68°F-77°F).

7. Drug overdose:

It is recommended that patients strictly follow the doctor’s instructions to take medication to avoid drug overdose. There is currently no specific antidote, and symptomatic and supportive treatment should be given.

Therapeutic Effect of Acetazolamide Tablets

Objective: To systematically evaluate the efficacy and safety of Acetazolamide Tablets (Acetazolamide) in the treatment of chronic mountain sickness.

Results: 301 documents were obtained through the preliminary search, 113 duplicate documents were removed through EndNote software, and 161 documents that did not meet the inclusion criteria were excluded by reading the titles and abstracts. After reading the full text and eliminating documents with incomplete data, 4 documents (4 in English and 0 in Chinese) were finally included. The total number of samples included was 147, including 82 in the experimental group and 65 in the control group.

Meta analysis results show that Acetazolamide tablets (Acetazolamide) 250 mg can reduce HCT, reduce PCO2, and increase PO2 in the treatment of chronic mountain sickness. The difference is statistically significant compared with the placebo group. It also reduces the CMS score, but the difference is not statistically significant compared with the placebo group.

Acetazolamide tablets (250mg and 500mg) can both increase PO2 and reduce PCO2 in the treatment of chronic mountain sickness, but the difference between the two is not statistically significant. Acetazolamide tablets have minor adverse reactions in the treatment of chronic altitude sickness.

Conclusion: Acetazolamide tablets (250 mg) can reduce the number of red blood cells and increase oxygenation in the treatment of chronic mountain sickness, and the effect is obvious. There is no difference in the efficacy between 250mg and 500mg Acetazolamide tablets in the treatment of chronic mountain sickness.

Acetazolamide tablets (Acetazolamide) treat chronic mountain sickness with few side effects and are safe and reliable.

Contraindications of Acetazolamide Tablets

1. Allergic patients:

It is prohibited for patients who are allergic to any component of Acetazolamide Tablets.

2. Glaucoma:

Patients with chronic non-congestive angle-closure glaucoma should avoid taking Acetazolamide tablets to avoid masking the condition.

3. Liver cirrhosis:

Contraindicated in patients with liver cirrhosis to avoid causing hepatic encephalopathy.

4. Other contraindications:

Contraindicated in patients with adrenal failure and hyperchloric acidosis, significant kidney and liver disease or dysfunction, or reduced serum sodium and/or potassium levels.

Summary

Regarding the above precautions for Acetazolamide tablets, it is recommended that patients strictly follow the doctor's instructions when taking the medication. If any adverse reactions or other abnormalities occur during the medication, they can consult a doctor in time and deal with it.

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