Diamox: Effective Management of Elevated Intracranial Pressure
| Product dosage: 250mg | |||
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Synonyms | |||
Diamox (acetazolamide) is a carbonic anhydrase inhibitor primarily indicated for the management of glaucoma, epilepsy, and altitude sickness. It functions by reducing the production of aqueous humor in the eye and promoting diuresis, thereby decreasing intraocular and intracranial pressure. This medication is available in tablet and extended-release capsule forms, offering flexibility in dosing regimens tailored to individual patient needs. Its established efficacy and well-documented safety profile make it a cornerstone in therapeutic protocols where pressure reduction is critical.
Features
- Contains acetazolamide as the active ingredient
- Available in 125 mg and 250 mg tablet strengths
- Also offered in 500 mg extended-release capsules
- Prescription-only medication
- Manufactured under strict pharmaceutical quality standards
- Compatible with long-term therapy under medical supervision
Benefits
- Effectively lowers intraocular pressure in glaucoma patients, helping to preserve vision
- Reduces frequency and severity of epileptic seizures in specific syndromes
- Prevents and alleviates symptoms of acute mountain sickness during rapid ascent
- Decreases intracranial pressure in conditions like pseudotumor cerebri
- Provides predictable pharmacokinetics for consistent therapeutic outcomes
- Supports adjunctive therapy in heart failure cases by promoting diuresis
Common use
Diamox is predominantly prescribed for open-angle glaucoma, secondary glaucoma, and preoperatively in acute angle-closure glaucoma to lower intraocular pressure before surgery. It is utilized as an adjunctive treatment for certain types of epilepsy, particularly absence seizures. In mountaineering and high-altitude travel, it is employed prophylactically and therapeutically for acute mountain sickness. Off-label uses include managing idiopathic intracranial hypertension, metabolic alkalosis, and periodic paralysis syndromes.
Dosage and direction
For glaucoma: Adults typically receive 250 mg to 1 g daily in divided doses, usually every 6-8 hours. For epilepsy: 8-30 mg/kg daily in divided doses, not to exceed 1 g daily. For altitude sickness: 125 mg twice daily starting 24-48 hours before ascent and continuing 48 hours after reaching target altitude. Extended-release capsules are generally administered once or twice daily. Always take with food to minimize gastrointestinal upset. Dosage adjustments are necessary for elderly patients and those with renal impairment.
Precautions
Regular monitoring of electrolyte levels, particularly potassium and bicarbonate, is essential during therapy. Use with caution in patients with respiratory acidosis, diabetes, or hepatic impairment. May cause drowsiness or blurred vision—avoid driving or operating machinery until response is determined. Patients should maintain adequate hydration but avoid excessive water intake. Pulmonary function should be monitored in patients with obstructive lung disease. Periodic complete blood counts are recommended during prolonged therapy.
Contraindications
Hypersensitivity to acetazolamide or sulfonamides. Severe renal disease, hyperchloremic acidosis, Addison’s disease, or adrenal gland failure. Concurrent use with high-dose aspirin. Severe hepatic impairment or cirrhosis. Low sodium or potassium levels. Chronic non-congestive angle-closure glaucoma.
Possible side effect
Common: paresthesia, particularly perioral and digital; fatigue; gastrointestinal disturbances including nausea, vomiting, and diarrhea; altered taste perception (especially for carbonated beverages). Less common: metabolic acidosis, hypokalemia, drowsiness, confusion, photosensitivity. Rare but serious: Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, crystalluria, renal calculi, fulminant hepatic necrosis.
Drug interaction
Significant interactions occur with salicylates (increased risk of toxicity), amphetamines (prolonged effect), cyclosporine (increased nephrotoxicity), and phenytoin (reduced acetazolamide efficacy). Enhances effects of furosemide and other diuretics. May decrease lithium excretion. Potentiates hypoglycemic effects of antidiabetic drugs. Concurrent use with other carbonic anhydrase inhibitors should be avoided.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent therapeutic effect. For extended-release formulations, do not crush or chew to catch up on missed doses.
Overdose
Symptoms include electrolyte imbalance, metabolic acidosis, drowsiness, confusion, tinnitus, nausea, vomiting. Severe overdose may lead to convulsions, coma, or respiratory depression. Treatment is supportive and symptomatic: gastric lavage if recent ingestion, correction of electrolyte abnormalities and acid-base balance. Hemodialysis may be effective in severe cases. Contact poison control center immediately for guidance.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from moisture and light. Keep in original container with tight closure. Do not store in bathroom or near sink. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual response to medication may vary. Proper diagnosis and therapeutic monitoring are essential for safe and effective use. The prescribing physician should be aware of the patient’s complete medical history and concurrent medications.
Reviews
Clinical studies demonstrate Diamox’s efficacy in reducing intraocular pressure by 40-60% in glaucoma patients. Mountaineering research shows 75-90% effectiveness in preventing acute mountain sickness when properly dosed. Epilepsy studies indicate significant reduction in seizure frequency when used adjunctively. Patient reports frequently mention effective symptom control but note common side effects like paresthesia and taste alterations. Overall satisfaction is high when prescribed for appropriate indications with proper monitoring.