Diacarb( acetazolamide) instruction:
Active ingredient Diakarba
Forms of release Diakarba
To whom Diakarb is indicated
- Treatment of chronic open-angle glaucoma
- of secondary glaucoma;
- is an angle-closure glaucoma( for short-term preoperative therapy and before ophthalmic procedures that can provoke an acute attack of angle-closure glaucoma, to reduce intraocular pressure).
- Treatment of edema in heart failure;
- edema caused by medication.
- Treatment of epilepsy( in combination with other anticonvulsants):
- petit mal( small seizures) in children;
- grand mal( large seizures) in adults;
- of mixed form.
- Treatment of altitude sickness.
The drug reduces the time of acclimatization, but its effect on the manifestations of this disease is insignificant.
How to use Diacarb
The drug is taken internally.
Treatment of glaucoma
The dose of the drug is determined individually, depending on the intraocular pressure. Recommended doses for adu
With open-angle glaucoma 250 mg( one tablet) 1 to 4 times a day.
A dose of more than 1000 mg( 4 tablets) does not increase therapeutic effectiveness.
In secondary glaucoma
250 mg( one tablet) every 4 hours. In some patients, a therapeutic effect is observed after taking 250 mg( one tablet) twice daily( long-term use is not indicated).
In acute attacks of closed-angle glaucoma
250 mg( one tablet) 4 times a day.
Treatment of epilepsy
Adults and children
Usually, 8-30 mg / kg body weight per day.
The dose is applied in 1 to 4 doses. The optimal dose is 375 - 1000 mg( 1½ - 4 tablets).
With the simultaneous use of acetazolamide with other anticonvulsants, the initial dose of the first should be 250 mg( one tablet) per day. The dose, if necessary, is increased gradually. For children, the dose should not exceed 750 mg / day.
Treatment of edema with heart failure and edema caused by medication The initial dose of 250 - 375 mg / day( 1 - 1½ tablets) in the morning. The best diuretic effect is observed if the drug is used every other day or 2 days with a one-day break.
In the treatment of heart failure, acetazolamide is prescribed against a background of conventional therapy( for example, the appointment of cardiac glycosides, a diet with a reduced amount of sodium, potassium preparations).
Treatment of altitude sickness
The recommended daily dose is 500-1000 mg( 2-4 tablets) divided into several doses. In the case of a predictable rapid rise in altitude, the recommended dose is 1000 mg( 4 tablets) divided into several doses.
The drug should be taken 24-48 hours before take-off, and in case of manifestations of the disease treatment should be continued for another 48 hours or longer if necessary.
In the case of hypersensitivity, symptoms sometimes occur that can threaten the patient's life, for example Stevens-Johnson syndrome, Laell's syndrome, fast-flowing liver necrosis, agranulocytosis, applastic anemia and hemorrhagic diathesis.
In case of skin or hematologic manifestations, the drug should be discontinued immediately.
Acetazolamide should be given with caution to patients who are taking acetylsalicylic acid( high doses), since there is a possibility of anorexia, respiratory acceleration, lethargy, coma and even death.
Acetazolamide prescribed at doses higher than recommended does not lead to an increase in diuresis, but may cause drowsiness and paresthesia, sometimes even lead to a decrease in diuresis.
The drug may increase acidosis, so it should be administered with caution to patients with pulmonary embolism and emphysema.
The drug leads to alkalization of urine( increase in pH).It is recommended to perform a complete blood test before the treatment and during the course of treatment.
Serum electrolytes are monitored periodically.
Pregnancy: Category C. Acetazolamide penetrates the placental barrier. Acetazolamide was teratogenic and embryotoxic in mice, rats, hamsters and rabbits, at a dose 10 times higher than that recommended for humans, and was administered internally. Adequate and well-controlled clinical studies of teratogenicity in pregnant women have not been conducted. Therefore, the drug should not be given to pregnant women, especially in the first trimester of pregnancy. In any case, when prescribing the drug, pregnant women should carefully weigh the expected benefit to the mother and the potential risk to the fetus.
Lactation. Acetazolamide in a small amount is excreted in breast milk. During the reception of the drug, breast-feeding should be discontinued.
Child's age. Diacarb is used for treatment in children only as adjuvant therapy for epilepsy.
Impact on the ability to drive vehicles and mechanisms.
Acetazolamide in high doses can cause drowsiness, less often fatigue, dizziness, ataxia and disorientation. Therefore, during treatment with acetazolamide, do not control potentially dangerous mechanisms and the car.
Adverse effects Diacarba
Adverse events are most often observed at the beginning of the treatment and include paresthesia, hearing loss or ringing in the ears, loss of appetite, change in taste, nausea, vomiting, diarrhea, and polakiasis( frequent urination), sporadic drowsiness and disorientation.
Acidosis and electrolyte imbalance are possible. There was a passing myopia.
Other adverse events included urticaria, hematuria, glucosuria, hepatic insufficiency, minor paralysis, and photodegensitivity, hepatic and renal colic. Since acetazolamide is a sulfonamide derivative, it can cause undesirable phenomena inherent in the sulfonamide, which includes fever, agranulocytosis, thrombocytopenia, leukopenia and aplastic anemia, bone marrow deficiency, pancytopenia, rash in the form of multiform erythema, Stevens-Johnson syndrome, Laell's syndrome.
To whom is contraindicated Diacarb
Acetazolamide is contraindicated in patients:
- with hypersensitivity to the sulfonamide or to any component of the drug;
- with reduced levels of sodium and potassium in the blood;
- with impaired liver function( risk of encephalopathy in liver disease);
- with impaired renal function;
- with adrenal insufficiency;
- patients with hyperchloroemic acidosis;
- with chronic uncompensated closed-angle glaucoma, which requires long-term treatment;
- with diabetes mellitus;
- with urolithiasis( with hypercalciuria);
- during lactation;
- during pregnancy.
Acetazolamide can enhance the action of folic acid antagonists, hypoglycemic agents, and anticoagulants that take internally. The simultaneous use of acetazolamide with acetylsalicylic acid can lead to severe acidosis and toxic effects on the central nervous system.
With the simultaneous use of acetazolamide with cardiac glycosides or drugs that increase blood pressure, the dose of the first must be changed.
Acetazolamide disrupts the metabolism of phenytoin, increasing the concentration of the latter in the serum. Some patients who took acetazolamide with some anticonvulsants( phenytoin, primidone), had a severe form of osteomalacia.
In case of an overdose, electrolyte imbalances, acidosis and CNS disorders may occur. In this regard, it is necessary to monitor the level of electrolytes, especially the level of potassium and blood pH.
Treatment is symptomatic. There is no specific antidote. In case of acidosis, bicarbonates are assigned to the patient. Acetazolamide is removed during hemodialysis.