Carbonic anhydrase inhibitor
Acetazolamide
Brand names: Diamox
Adult dose
Dose: Glaucoma: 250 mg 1–4 times daily; IIH: 250–500 mg BD up to 1 g BD; Altitude: 125–250 mg BD
Route: Oral/IV
Frequency: Per indication
Clinical pearls
- IIH first-line; titrate to tolerability
- Counsel on tingling and altered taste of carbonated drinks
Contraindications
- Hyponatraemia/hypokalaemia
- Severe hepatic/renal impairment
- Sulfonamide hypersensitivity
- Adrenal insufficiency
Side effects
- Paraesthesia
- Metabolic acidosis
- Renal stones
- Taste disturbance
Interactions
- High-dose aspirin (toxicity)
- Lithium
Monitoring
- U&E, HCO3⁻
- Symptoms
Reference: BNF; NICE CKS Glaucoma; ABN IIH guideline 2018; SmPC Diamox. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS