From the Guidelines
Diamox (acetazolamide) can cause several side effects, including increased risk of diarrhoea, dysgeusia, fatigue, nausea, paraesthesia, tinnitus, vomiting, depression, and rarely renal stones, as reported in a study published in the Journal of Neurology, Neurosurgery and Psychiatry 1.
Common Side Effects
- Tingling or numbness in the hands, feet, or lips
- Altered taste (particularly making carbonated beverages taste flat)
- Increased urination
- Drowsiness
- Fatigue Some people may experience nausea, vomiting, loss of appetite, or diarrhea.
Less Common Side Effects
- Severe skin reactions
- Unusual bleeding or bruising
- Hearing problems or ringing in the ears
- Vision changes
- Severe allergic reactions Patients should be warned of the adverse side effects of acetazolamide, which are well recognised, and include those mentioned above, as well as others, such as depression and renal stones 1.
Important Considerations
- People with sulfa allergies should avoid Diamox, as it is a sulfonamide derivative.
- Kidney stones may develop in some patients, so adequate hydration is important while taking this medication.
- Patients should contact their healthcare provider if they experience severe or persistent side effects. A more recent study published in the European Respiratory Review in 2021 also reported adverse events associated with acetazolamide, including paraesthaesia, vertigo, and unpleasant taste 1. However, the study published in the Journal of Neurology, Neurosurgery and Psychiatry in 2018 provides a more comprehensive list of side effects associated with acetazolamide 1.
From the FDA Drug Label
OVERDOSAGE No data are available regarding acetazolamide overdosage in humans as no cases of acute poisoning with this drug have been reported. Animal data suggest that acetazolamide is remarkably nontoxic. No specific antidote is known. Treatment should be symptomatic and supportive. Electrolyte imbalance, development of an acidotic state, and central nervous effects might be expected to occur Serum electrolyte levels (particularly potassium) and blood pH levels should be monitored. The FDA drug label does not answer the question.
From the Research
Common Side Effects of Diamox (Acetazolamide)
- Paraesthesias: The risk of paraesthesias is increased with Diamox, with a numbers needed to harm (NNH) of 2.3 2.
- Taste disturbances (dysgeusia): The risk of dysgeusia is also increased, with an NNH of 18 2.
- Polyuria: Diamox increases the risk of polyuria, with an NNH of 17 2.
- Fatigue: The risk of fatigue is increased, with an NNH of 11 2.
Serious Side Effects of Diamox (Acetazolamide)
- Stevens-Johnson syndrome (SJS): Diamox has been associated with SJS, a rare but life-threatening condition 3, 4, 5.
- Aplastic anaemia: There is a substantial increase in the risk of developing aplastic anaemia with Diamox treatment, with a relative risk of 13.3 6.
- Toxic epidermal necrolysis (TEN): Diamox has been associated with TEN, a severe and sometimes fatal condition 3, 4.