Acetazolamide is a carbonic anhydrase inhibitor. This enzyme catalyzes the reversible reaction involving the hydration of carbon-di-oxide and the dehydration of carbonic acid. In the eye, this inhibitory action of Acetazolamide decreases the secretion of aqueous humor and results in a drop in intraocular pressure, a reaction considered desirable in case of glaucoma. Inhibition of carbonic anhydrase in the central nervous system appears to retard abnormal paroxysmal and excessive discharge from central nervous system neurons. So, Acetazolamide is also used as an adjuvant in the treatment of epilepsy.

Acetazolamide is indicated in open angle glaucoma, secondary glaucoma and as an adjuvant in the treatment of edema and epilepsy.

Adults : Initially 250 mg (1 tablet) 4 times daily. Dose should be adjusted later with individual need.

Children : ½ to 2 tablets in divided doses.

In intraocular pressure: 1 tablet 6 hourly. In acute condition, dose should be started with 2 tablets followed by 1 tablet 6 hourly or as directed by the physician

Acetazolamide is contraindicated in cases of marked kidney and liver diseases or dysfunction, in situations in which sodium and or potassium blood serum levels decreased. Acetazolamide is also contraindicated in patients with chronic noncongestive angle closure glaucoma

Common side effects are headache, drowsiness, dizziness, fatigue, anorexia, polyurea, insomnia, gastrointestinal upset.

Pregnancy & Lactation

There are no adequate and well controlled studies in pregnant women and neonates. So, Acetazolamide should be used with care in those physiological conditions.