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Acetazolamide Disease Interactions

There are 10 disease interactions with acetazolamide:

Major

Carbonic Anhy. Inhibitors (Includes Acetazolamide) ↔ Bone Marrow Depression/Blood Dyscrasias

Severe Potential Hazard, Moderate plausibility

Applies to: History - Blood Dyscrasias, Bone Marrow Depression/Low Blood Counts

The use of carbonic anhydrase inhibitors may rarely cause bone marrow suppression and blood dyscrasias at recommended dosages. Aplastic anemia, thrombocytopenia or thrombocytopenia purpura, leukopenia, agranulocytosis, and hemolytic anemia have been reported. Extreme caution should be exercised if carbonic anhydrase inhibitors are administered to patients with these preexisting conditions. A baseline CBC and platelet count is recommended, as well as monitoring at regular intervals during therapy.

References

  1. McWhae JA, Chang J, Lipton JH "Drug-induced fatal aplastic anemia following cataract surgery." Can J Ophthalmol 27 (1992): 313-5
  2. Lubeck MJ "Aplastic anemia following acetazolamide therapy." Am J Ophthalmol 69 (1970): 684-5
  3. Rentiers PK, Johnston AC, Buskard N "Severe aplastic anemia as a complication of acetazolamide therapy." Can J Ophthalmol 5 (1970): 337-42
View all 9 references
Major

Carbonic Anhyd. Inhibitors (Includes Acetazolamide) ↔ Adrenal Insufficiency

Severe Potential Hazard, Moderate plausibility

Applies to: Adrenal Insufficiency

The use of carbonic anhydrase inhibitors is contraindicated in patients with adrenal insufficiency. The carbonic anhydrase inhibitor effect may exacerbate electrolyte problems that can occur with primary adrenal insufficiency. Extreme caution should be exercised if carbonic anhydrase inhibitors is administered to these patients. Monitoring electrolyte levels is recommended.

References

  1. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
Major

Carbonic Anhyd. Inhibitors (Includes Acetazolamide) ↔ Closed-Angle Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension

The use of carbonic anhydrase inhibitors is contraindicated in patients with closed-angle glaucoma. Carbonic anhydrase inhibitors may mask worsening glaucoma due to decreased intraocular pressure. Extreme caution should be exercised if carbonic anhydrase inhibitors is administered to these patients.

References

  1. Fan JT, Johnson DH, Burk RR "Transient myopia, angle-closure glaucoma, and choroidal detachment after oral acetazolamide." Am J Ophthalmol 115 (1993): 813-4
  2. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
Major

Carbonic Anhydrase Inhibitors (Includes Acetazolamide) ↔ Hypokalemia

Severe Potential Hazard, Moderate plausibility

Applies to: Hypokalemia

The use of carbonic anhydrase inhibitors is contraindicated in patients with hypokalemia . Carbonic anhydrase inhibitors may cause increased potassium excretion. Extreme caution should be exercised if carbonic anhydrase inhibitors is administered and monitoring electrolyte levels is recommended.

References

  1. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
  2. Torres CF, Griggs RC, Moxley RT, Bender AN "Hypokalemic periodic paralysis exacerbated by acetazolamide." Neurology 31 (1981): 1423-8
Major

Carbonic Anhydrase Inhibitors (Includes Acetazolamide) ↔ Hyponatremia

Severe Potential Hazard, Moderate plausibility

Applies to: Hyponatremia

The use of carbonic anhydrase inhibitors is contraindicated in patients with hyponatremia . Carbonic anhydrase inhibitors may cause sodium excretion. Extreme caution should be exercised if carbonic anhydrase inhibitors is administered and monitoring electrolyte levels is recommended.

References

  1. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
Major

Carbonic Anhydrase Inhibitors (Includes Acetazolamide) ↔ Severe Kidney Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The use of some carbonic anhydrase inhibitors is contraindicated in patients with severe kidney disease. Dysuria, crystalluria, renal colic, and other renal lesions have been reported during therapy with carbonic anhydrase inhibitors.

References

  1. Parfitt AM "Acetazolamide and sodium bicarbonate induced nephrocalcinosis and nephrolithiasis: relationship to citrate and calcium excretion." Arch Intern Med 124 (1969): 736-40
  2. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
  3. Parikh JR, Nolan RL, Bannerjee A, Gault MH "Acetazolamide-associated nephrocalcinosis in a transplant kidney." Transplantation 59 (1995): 1742-3
View all 11 references
Major

Carbonic Anhydrase Inhibitors (Includes Acetazolamide) ↔ Severe Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Cirrhosis

The use of carbonic anhydrase inhibitors is contraindicated in patients with marked liver disease or cirrhosis. Carbonic anhydrase inhibitors increase the risk of developing hepatic encephalopathy in these patients. Extreme caution should be exercised if carbonic anhydrase inhibitors are administered in patients with mild to moderate liver disease as the clearance of the drug can be decreased. A dose reduction might be needed and monitoring of the liver function is recommended.

References

  1. Margo CE "Acetazolamide and advanced liver disease." Am J Ophthalmol 101 (1986): 611-2
  2. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
  3. Maren TH "Acetazolamide and advanced liver disease ." Am J Ophthalmol 102 (1986): 672-3
Moderate

Acetazolamide (Includes Acetazolamide) ↔ Pulmonary Obstruction Or Emphysema

Moderate Potential Hazard, Moderate plausibility

Applies to: Chronic Obstructive Pulmonary Disease, Pulmonary Impairment

Acetazolamide should be used with caution in patients with pulmonary obstruction or emphysema where alveolar ventilation might be impaired, as acetazolamide could precipitate or aggravate acidosis.

Moderate

Carbonic Anhydrase Inhibitor Anticonvulsants (Includes Acetazolamide) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The major route of elimination of carbonic anhydrase inhibitors is through the kidney. These drugs should be administered cautiously in patients with reduced renal function and a dose adjustment might be required depending on the level of impairment.

Moderate

Carbonic Anhydrase Inhibitors (Includes Acetazolamide) ↔ Metabolic Acidosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Acidosis, Chronic Obstructive Pulmonary Disease, Diarrhea

Reduced plasma bicarbonate levels and, in some instances, elevated plasma chloride levels may result in metabolic acidosis during long-term therapy with carbonic anhydrase inhibitors. Therapy with carbonic anhydrase inhibitors should be administered cautiously in patients with metabolic or hyperchloremic acidosis or with conditions that predispose to acidosis (renal disease, severe respiratory disorders, diarrhea). The measurement of baseline and periodic serum bicarbonate is recommended. If metabolic acidosis develops (it may be corrected by administration of sodium bicarbonate), and persists, a dose reduction or treatment discontinuation should be considered.

References

  1. Cowan RA, Hartnell GG, Lowdell CP, Baird IM, Leak AM "Metabolic acidosis induced by carbonic anhydrase inhibitors and salicylates in patients with normal renal function." Br Med J (Clin Res Ed) 289 (1984): 347-8
  2. Heller I, Halevy J, Cohen S, Theodor E "Significant metabolic acidosis induced by acetazolamide: not a rare complication." Arch Intern Med 145 (1985): 1815-7
  3. Berthelsen P "Cardiovascular performance and oxyhemoglobin dissociation after acetazolamide in metabolic alkalosis." Intensive Care Med 8 (1982): 269-74
View all 10 references

acetazolamide drug Interactions

There are 371 drug interactions with acetazolamide

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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