A carbonic anhydrase inhibitor used to treat acute mountain sickness and high altitude periodic breathing.

A respiratory stimulant.

Used as a respiratory stimulant in patients with COPD and metabolic alkalosis.

The drug of choice for prevention of acute mountain sickness.

Mechanism of respiratory stimulation is based on the inhibition of renal carbonic anhydrase enzyme, which decreases serum bicarbonate and arterial pH, leading to increased minute ventilation via stimulation of peripheral and central chemoreceptors.

The primary mechanism combating hypobaric hypoxia of high altitude is through a bicarbonate diuresis that induces a compensatory respiratory alkalosis.

Increases nocturnal oxygen saturation and partially improves sleep apnea in otherwise untreated obstructive sleep apnea patients at altitude.

Patients with obstructive sleep apnea spending three days at moderately elevated altitude, combination of acetazolamide and auto CPAP therapy compared to auto CPAP alone resulted in improved nocturnal oxygen saturation and apnea/hypopnea index ( Latshang TD et al).

Reduces the activity of carbonic acid in the body.

It reduces proximal tubule is sodium reabsorption and may improve diuretic efficiency when added to loop diuretics, potentially facilitating volume overload management.

Used to treat glaucoma and may be part of treatment plans for congestive heart failure and seizure disorders.

Itinhibits the resorption of sodium and bicarbonate ions in the renal proximal tubule, resulting in natriuresis and diuresis.

The addition of acetazolamide to a loop diuretic therapy in patients with acute decompensated heart failure results in  greater incidence of successful decongestion.

May cause dizziness, drowsiness and increase the sensitivity of skin to sunlight.

A sulfa-based drug.

Trade name Diamox.

Tablets 125mg, 250mg

500mg prolonged release

500 mg PO/IV, followed by 125-250 mg PO q4hr

Sustained-release: 500 mg PO q12hr

Open angle glaucoma

250 mg-1 g PO/IV qDay or divided q6-12hr

Sustained-release: 500 mg PO q12hr

Acute altitude sickness

Immediate release: 500-1000 mg/day PO divided q8-12hr

Extended release: 500-1000 mg PO q12-24hr

Congestive heart failure

CHF-associated edema

250-375 mg (5 mg/kg) PO qAM  


8-30 mg/kg/day PO qDay or divided q12hr  


Tablet: 8-30 mg/kg/day PO qDay, OR divided q6-12 hr; not to exceed 30 mg/kg/day or 1 g/day  

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