Glaucoma: chronic, open-angle, secondary or closed-angle glaucoma (short-term pre-operative treatment to lower intraocular pressure). Swelling in heart failure or caused by drugs. Epilepsy (in combination with other anticonvulsant medicines): petit mal in children, grand mal, mixed forms. acute altitude disease - the drug shortens the acclimation time, but its effect on the symptoms of this disease is small.
Composition:
1 tabl contains 250 mg of acetazolamide.
Action:
A strong carbonic anhydrase inhibitor. Carbonate anhydrase catalyzes the course of a reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid. Inhibition of carbonic anhydrase reduces the resorption of sodium and water. Acetazolamide ceases to have a diuretic effect after three days of use. A few-day break in administration causes normal carbonic anhydrase activity to be restored and the re-use of the drug induces a diuretic effect. Acetazolamide increases the excretion of potassium, sodium, Magnesium, Calcium, phosphates and bicarbonates. It reduces the secretion of aqueous humor, which lowers the intraocular pressure. It is well absorbed from the gastrointestinal tract, reaching the maximum concentration in the blood after 1-3 hours. It is excreted unchanged in the urine. It passes through the placenta barrier and in small amounts into breast milk.
Contraindications:
Hypersensitivity to sulphonamides or other ingredients of the preparation. Hyponatraemia, hypokalaemia. Renal and hepatic impairment (risk of developing encephalopathy in liver diseases), Calcium stones. Adrenal insufficiency. Hyperlloric acidosis. Chronic decompensated glaucoma with a closed angle of perception (during long-term treatment).
Precautions:
Caution use in patients with embolism or emphysema (risk of aggravation of acidosis). Acetazolamide alkalises the urine. In the case of skin lesions or changes in the blood picture, the preparation should be immediately discontinued.
Pregnancy and lactation:
In animals, acetazolamide has been shown to be embryotoxic and teratogenic at doses 10 times greater than those used in humans. Acetazolamide crosses the placenta barrier. There are no clinical trials on the safety of the preparation in pregnant women, therefore it should not be used during pregnancy, especially in the first trimester. Acetazolamide is excreted in breast milk in small amounts. Because of the potential risk of side effects in fed infants, a decision should be made to discontinue treatment or discontinue breast-feeding while taking the medicine.
Side effects:
Paresthesia, hearing or tinnitus disorders, lack of appetite, dysgeusia, nausea, vomiting, diarrhea, pollakiuria, metabolic acidosis, electrolyte disturbance, transient myopia, urticaria, hematuria, glucosuria, hepatic failure, fulminant liver necrosis, flaccid paralysis, hypersensitivity to light, anaphylactic reactions, hepatic and renal colic, fever, bone marrow suppression (agranulocytosis, thrombocytopenia, leukopenia, aplastic anemia, pancytopenia), haemorrhagic diathesis, Lyell's syndrome, erythema multiforme, including Stevens-Johnson syndrome. Occasionally, drowsiness and confusion may occur.
Dosage:
Orally. In the treatment of glaucoma, the dose should be determined individually depending on the intraocular pressure, in the open angle glaucoma - 250 mg 1-4 times a day; in secondary glaucoma - 250 mg every 4 h (in some patients during short-term therapy, the therapeutic effect is observed after 250 mg 2 times a day), in acute attacks of glaucoma - 250 mg 4 times a day. In epilepsy (adults and children): usually 8-30 mg / kg daily in 1-4 divided doses; the optimal dose is 375-1000 mg per day; the maximum daily dose for children is 750 mg; When acetazolamide is co-administered with other anticonvulsants, 250 mg of acetazolamide is given once a day, if necessary by gradually increasing the dose. Edema in circulatory insufficiency and induced by drugs: initially 250-375 mg once daily every other day or for the Next 2 days with a one-day break, administered in the morning.Acute altitude disease: 500-1000 mg per day in divided doses; during fast climbing: 1000 mg daily in divided doses, the preparation should be used 24-48 h before climbing, in case of symptoms of the disease the treatment should be continued.
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