Diamox  (U.S.N.L.M.)
Dosing 500mg po (i.e. 250mg X 2 - NOT a 500mg Sequel)  single dose for emergency IOP
reduction.    May  be  followed  by  125 or 250mg po q 4hr  if  necessary.
Consider concomitant miotic. (See Neptazane for alternative drug choice.) 500mg po (i.e. 250mg X 2 - NOT a 500mg Sequel)  single dose for emergency IOP reduction. May be followed by 125 or 250mg po q 4hr if necessary. Consider concomitant miotic. (See Neptazane for alternative drug choice.)
Chem Specs acetazolamide
Quantities 125,  250mg tablets,   500mg 12 hr capsules ("Sequels")
Cost 64.30 / 30tab / 250mg
Class carbonic anhydrase inhibitor
Action Inhibition of carbonic anhydrase II in the ciliary processes presumably slows the
formation of bicarbonate with subsequent reduction in sodium and fluid transport. Inhibition of carbonic anhydrase II in the ciliary processes presumably slows the formation of bicarbonate with subsequent reduction in sodium and fluid transport.
Usage Indicated for adjunctive treatment of chronic simple (open-angle) glaucoma,
secondary glaucoma, and preoperatively in acute angle-closure glaucoma. Indicated for adjunctive treatment of chronic simple (open-angle) glaucoma, secondary glaucoma, and preoperatively in acute angle-closure glaucoma.
Oral CAIs are generally used in optometric practice for very brief treatment of
extremely elevated IOP such as acute angle closure glaucoma. Oral CAIs are generally used in optometric practice for very brief treatment of extremely elevated IOP such as acute angle closure glaucoma.
Contraindications Situations of depressed sodium and/or potassium blood serum levels, marked
kidney or liver disease, suprarenal gland failure, hyperchloremic acidosis.
Hypersensitivity to sulfonamide1 or any other component of this product. Situations of depressed sodium and/or potassium blood serum levels, marked kidney or liver disease, suprarenal gland failure, hyperchloremic acidosis. Hypersensitivity to sulfonamide1 or any other component of this product.
Pediatric use Safety and effectiveness in children not established.
Pregnancy Category C. Teratogenic (defects of the limbs) in mice, rats, hamsters and rabbits.
Fatalities have occurred, although rarely, due to severe reactions to sulfonamides.
Adverse reactions include Stevens-Johnson syndrome, toxic epidermal necrolysis,
fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood
dyscrasias. Common side effects include fatigue, malaise, weight loss, and depression. Fatalities have occurred, although rarely, due to severe reactions to sulfonamides. Adverse reactions include Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias. Common side effects include fatigue, malaise, weight loss, and depression.
(See package insert for other dosing.)
1. Shah, Moshirfar and Hoopes argue that Diamox may be used with caution with a known "Sulfa Allergy" provided its not a previous
"Life Threatening allergic reaction" based on the absence of the arylamine of sulfonamides and the relatively low rate of reported incidents.
https://link.springer.com/article/10.1007/s40123-018-0136-8

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