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Diamox (acetazolamide)

Diamox (acetazolamide) contains the active ingredient acetazolamide and is used to remove excess fluid from the body. It is also prescribed to treat the symptoms of altitude sickness and some forms of epilepsy. It works by blocking carbonic anhydrase, a protein which contributes to fluid retention. This medicine is a diuretic which helps the kidneys remove excess fluid from the body. When you take Diamox (acetazolamide) tablets, the amount of salt (bicarbonate) in the kidneys increases, which helps to rid the body of excess fluid through urinating more than usual, as salt attracts water. Diamox (acetazolamide) is used to reduce and prevent the symptoms of altitude sickness, treat glaucoma (a vision problem), oedema (fluid build-up) and some types of epilepsy. It is a diuretic (water tablet) that aids the removal of excess water from the body, which can occur in a variety of medical conditions.

What is Diamox (acetazolamide)?

Diamox (acetazolamide) contains the active ingredient acetazolamide and is used to remove excess fluid from the body. It is also prescribed to treat the symptoms of altitude sickness and some forms of epilepsy. It works by blocking carbonic anhydrase, a protein which contributes to fluid retention. This medicine is a diuretic which helps the kidneys remove excess fluid from the body. When you take Diamox (acetazolamide) tablets, the amount of salt (bicarbonate) in the kidneys increases, which helps to rid the body of excess fluid through urinating more than usual, as salt attracts water.

When is Diamox (acetazolamide) used?

Diamox (acetazolamide) tablets are used to treat various conditions including altitude sickness, glaucoma fluid retention (oedema), and epilepsy.

Altitude sickness can occur when a person ascends to a height of more than 2,500 metres (8,000 feet) above sea level very quickly. It is common in climbers and skiers who climb high mountains and hills, and can also appear in people who fly to high altitude directly and rapidly. Diamox (acetazolamide) tablets can be taken before an ascent to above 2,500 metres to prevent these symptoms occurring, and also if the symptoms appear after climbing and a rapid descent is not possible. A slow descent can assist the symptoms of altitude sickness but may not be feasible due to the weather or dangerous conditions. It is advisable not just to rely on medication if you are going to travel to altitude, but rather to acclimatise your body to the change.

Altitude sickness is also known as acute mountain sickness (ACM). The symptoms include:

  • Feeling sick;
  • Feeling faint and/or dizzy;
  • General body weakness;
  • Breathing difficulties;
  • Headaches;
  • Vision problems;
  • Fatigue;
  • Loss of appetite;
  • Inability to sleep;
  • Poor judgement.

Altitude sickness occurs because the air pressure decreases the higher a person ascends, so there is less oxygen to breathe. It is a mild condition but if not treated, can rapidly lead to a medical emergency such as high-altitude cerebral oedema (HACE) which is the swelling of the brain due to a lack of oxygen.

Glaucoma is an eye condition that occurs when the optic nerve (connecting the eye to the brain) is damaged. It can lead to a permanent loss of vision if left untreated. Glaucoma is caused by a build-up of fluid in the eye which increases pressure and damages the optic nerve. It usually develops slowly over several years.

It tends to occur mostly but not exclusively in older adults. Other high-risk groups are people of African, Asian or Caribbean origin, those with a family history of glaucoma, people with other eye conditions such as long- or short-sightedness and diabetics. Diamox (acetazolamide) tablets are used to treat glaucoma as they can reduce the build-up of fluid.

Diamox (acetazolamide) tablets are also prescribed to treat fluid retention in the body (oedema) in combination with other medications. This occurs when part of the body swells due to injury or infection. The small blood vessels leak fluid into body tissue, which makes it swell. This can occur in any part of the body.

Epilepsy causes seizures (fits), which temporarily affect how the brain functions. The nerve cells in the brain link to each other through electrical activity, and if there is a sudden burst of activity, this alters the balance of the brain and over- stimulates it. When this happens, an epileptic person may experience a seizure. Diamox (acetazolamide) tablets can be used to stabilise this electrical brain activity by altering the balance of chemicals in the blood, changing the rhythm of the electrical activity and stabilising the brain’s nerve activity.

How do you use Diamox (acetazolamide)?

You should take Diamox (acetazolamide) tablets with water and swallow them whole: do not chew them or the effect will be reduced and the side effects could increase. Try to take Diamox (acetazolamide) tablets with food if they make you feel nauseous or give you diarrhoea.

The dosage required depends on the reason for taking the medicine and a doctor’s instructions should be followed. If you are taking Diamox (acetazolamide) tablets to prevent altitude sickness, you should begin to take them one or two days before you ascend to your destination and continue to take them after you reach a high altitude for a minimum of 48 hours, to control the possible symptoms. If your symptoms become severe, you should consider descending and seek medical advice as this medication will not protect you from severe altitude sickness.

Always take Diamox (acetazolamide) tablets at the same time every day, whatever the reason for taking them. This will help you remember to take them and ensure that the acetazolamide works on your body in a balanced way. As Diamox (acetazolamide) is likely to cause you to urinate more often, it is advisable to take your last Diamox tablet early in the evening to prevent you having to get up in the night.

What dosages are there?

Diamox (acetazolamide) comes in the form of a 250 mg tablet. There are different dosages depending on the condition you are taking it for. Always follow the advice of your doctor when taking this medicine and never take more than the prescribed dose.

The usual dosages are:

  • Altitude sickness:
    one 250 mg Diamox tablet every day prior to and during a climb.
  • Glaucoma:
    adults 250 mg – 1 g in divided doses.
  • Fluid retention:
    adults 250 mg – 375 mg Diamox tablets daily in the morning.
  • Epilepsy:
    adults 250 mg – 1 g in divided doses.

Acetazolamide may be prescribed to children and the dosage will depend on their body weight. It is also important not to suddenly stop this medicine as your condition could get worse. When and if it is the right time to stop taking Diamox (acetazolamide), your doctor will advise you on how to do this. It is also important to note that acetazolamide can change its effectiveness when used for long periods. You should therefore visit your doctor regularly to monitor your condition and check if your dose needs to be changed.

What are the side effects of Diamox (acetazolamide)?

As with all medicines, Diamox (acetazolamide) tablets may cause side effects. These will vary as everyone reacts differently to medication.

The most common side effects to be aware of are:

  • Needing to urinate more often;
  • Feeling thirsty;
  • Feeling sick;
  • Sickness and/or diarrhoea;
  • Headaches;
  • Dizziness;
  • Feeling tired or irritable;
  • Feeling over-excited;
  • Loss of appetite.

You are more likely to experience side effects in the first few days of taking Diamox (acetazolamide) as your body adjusts to it. You may notice that the side effects soon disappear. If you are concerned about side effects when taking Diamox (acetazolamide) tablets, you should speak to your doctor.

When should you not use Diamox (acetazolamide)?

Before taking Diamox (acetazolamide) tablets, you should inform your doctor if you are taking any other medication or are allergic to any of the ingredients in this medication (refer to the package leaflet).

You should not take Diamox (acetazolamide) tablets if you suffer from any of the following:

  • Underactive adrenal glands;
  • Kidney disease;
  • Liver disease;
  • High levels of potassium or sodium in your blood;
  • High levels of chloride in your blood;
  • Chronic non-congestive angle-closure glaucoma.

You should not take Diamox (acetazolamide) tablets if you are pregnant or are planning to become pregnant. You may take it when breastfeeding on the advice of a doctor.

Care should be taken when driving or operating machinery after taking Diamox (acetazolamide) tablets as they can make you feel drowsy and cause dizziness.

It is advisable not to drink alcohol or to reduce your alcohol consumption when taking Diamox (acetazolamide) tablets as it can make the side effects stronger.

Does Diamox (acetazolamide) interact with other medication?

Diamox (acetazolamide) tablets can interact with other medicines, so it is essential you inform your doctor if you are taking any other medication. This includes herbal medicines and those you may be taking for which you do not have a prescription.

Diamox (acetazolamide) can change the effects of some medicines and in particular, you should take care when taking the following:

  • Heart medication;
  • Blood pressure medication;
  • Blood-thinning medication;
  • Aspirin;
  • Medication to lower blood sugar levels;
  • Epilepsy medication;
  • Steroids;
  • Medication containing folic acid;
  • Amphetamines;
  • Carbonic anhydrase inhibitors;
  • Medication to suppress the immune system;
  • Medication to treat high acid levels in the body.

Where can you buy Diamox (acetazolamide)?

You can get Diamox (acetazolamide) tablets at a pharmacy with a prescription.

Can I get Diamox (acetazolamide) without a prescription?

No, Diamox (acetazolamide) is a prescription-only medicine.

References:

Acetazolamide. 15 September 2017. Retrieved 24 August 2019 from https://medlineplus.gov/druginfo/meds/a682756.html Diamox (acetazolamide) tablet.

Facts about Glaucoma. Retrieved 24 August 2019 from https://nei.nih.gov/health/glaucoma/glaucoma_facts Nordqvist, C. (2018, January 30).

What’s to know about altitude sickness? Retrieved 24 August 2019 from https://www.medicalnewstoday.com/articles/179819.php

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