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| __NOTOC__
| | #REDIRECT [[Acetazolamide#Warnings]] |
| {{Acetazolamide}}
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| {{CMG}}; {{AE}} {{SS}}
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| ==Warnings and Precautions==
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| Fatalities have occurred, although rarely, due to severe reactions to sulfonamides including [[Stevens-Johnson syndrome]], toxic epidermal necrolysis, fulminant hepatic necrosis, [[anaphylaxis]], [[agranulocytosis]], [[aplastic anemia]], and other blood [[dyscrasias]]. Sensitizations may recur when a sulfonamide is readministered irrespective of the route of administration. If signs of [[hypersensitivity]] or other serious reactions occur, discontinue use of this drug.
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| Caution is advised for patients receiving concomitant high-dose aspirin and DIAMOX, as [[anorexia]], [[tachypnea]], [[lethargy]], metabolic acidosis, [[coma]], and death have been reported.
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| ===PRECAUTIONS:===
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| ====General====
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| Increasing the dose does not increase the diuresis and may increase the incidence of [[drowsiness]] and/or [[paresthesia]]. Increasing the dose often results in a decrease in diuresis. Under certain circumstances, however, very large doses have been given in conjunction with other [[diuretics]]in order to secure diuresis in complete refractory failure.
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| ====Information for Patients====
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| Adverse reactions common to all sulfonamide derivatives may occur: [[anaphylaxis]], [[fever]], [[rash]] (including erythema multiforme, [[Stevens-Johnson syndrome]], [[toxic epidermal necrolysis]]), [[crystalluria]], [[renal calculus]], bone marrow depression, [[thrombocytopenic purpura]], [[hemolytic anemia]], [[leukopenia]], [[pancytopenia]], and [[agranulocytosis]]. Caution is advised for early detection of such reactions and the drug should be discontinued and appropriate therapy instituted.
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| In patients with pulmonary obstruction or [[emphysema]] where alveolar ventilation may be impaired, DIAMOX which may precipitate or aggravate acidosis should be used with caution.
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| Gradual ascent is desirable to try to avoid acute mountain sickness. If rapid ascent is undertaken and DIAMOX is used, it should be noted that such use does not obviate the need for prompt descent if severe forms of high altitude sickness occur, i.e., high altitude [[pulmonary edema]] (HAPE) or high altitude [[cerebral edema]].
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| Caution is advised for patients receiving concomitant high-dose [[aspirin]] and DIAMOX, as [[anorexia]], [[tachypnea]], [[lethargy]], metabolic acidosis, [[coma]], and death have been reported (see WARNINGS).
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| Both increases and decreases in blood [[glucose ]]have been described in patients treated with acetazolamide. This should be taken into consideration in patients with impaired [[glucose ]]tolerance or [[diabetes mellitus]].
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| Acetazolamide treatment may cause electrolyte imbalances, including [[hyponatremia]] and [[hypokalemia]], as well as metabolic acidosis. Therefore, periodic monitoring of serum electrolytes is recommended. Particular caution is recommended in patients with conditions that are associated with, or predispose a patient to, electrolyte and acid/base imbalances, such as patients with impaired renal function (including elderly patients; see PRECAUTIONS, Geriatric Use), patients with [[diabetes mellitus]], and patients with impaired alveolar ventilation. | |
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| Some adverse reactions to acetazolamide, such as [[drowsiness]], [[fatigue]], and [[myopia]], may impair the ability to drive and operate machinery.
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| ====Laboratory Tests====
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| To monitor for hematologic reactions common to all sulfonamides, it is recommended that a baseline CBC and platelet count be obtained on patients prior to initiating DIAMOX therapy and at regular intervals during therapy. If significant changes occur, early discontinuance and institution of appropriate therapy are important. Periodic monitoring of serum electrolytes is recommended.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = DIAMOX SEQUELS (ACETAZOLAMIDE) CAPSULE, EXTENDED RELEASE [DURAMED PHARMACEUTICALS, INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=74e47451-2bc8-496e-88ad-c10002ee8e22 | publisher = | date = | accessdate = 25 February 2014 }}</ref>
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| ==References==
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| {{reflist|2}}
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| {{Anticonvulsants}}
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| {{Antiglaucoma preparations and miotics}}
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| {{Diuretics}}
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| [[Category:Carbonic anhydrase inhibitors]]
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| [[Category:Mountaineering and health]]
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| [[Category:Anticonvulsants]]
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| [[Category:Sulfonamides]]
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| [[Category:World Health Organization essential medicines]]
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| [[Category:Thiadiazoles]]
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| [[Category:Amides]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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