What are the indications for Diamox (acetazolamide)?

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From the Guidelines

Diamox (acetazolamide) is primarily indicated for the treatment of glaucoma, altitude sickness, edema, and certain cases of epilepsy and seizures.

Indications

  • Glaucoma: Acetazolamide is used to decrease intraocular pressure in patients with glaucoma, particularly those with primary open-angle glaucoma 1.
  • Altitude Sickness: Acetazolamide is used to prevent and treat altitude sickness, which can occur when people travel to high-altitude areas 1.
  • Edema: Acetazolamide can be used to treat edema associated with congestive heart failure, nephrotic syndrome, and other conditions 1.
  • Epilepsy and Seizures: Acetazolamide may be used as an adjunctive treatment for certain types of epilepsy and seizures, although its use for this indication is less common.

Key Points

  • The typical dose of acetazolamide for glaucoma is 250-500 mg orally, 1-4 times a day 1.
  • For altitude sickness, the typical dose is 250-500 mg orally, 1-2 times a day 1.
  • In patients with edema, acetazolamide may be used in combination with other diuretics, such as loop diuretics, to enhance its effects 1.
  • Acetazolamide should be used with caution in patients with sulfonamide allergy, kidney stones, or certain other medical conditions 1.

The FDA Drug Labels for acetazolamide (PO) do not address this question.

From the Research

Indications for Diamox (Acetazolamide)

The indications for Diamox (acetazolamide) include:

  • Epilepsy: Acetazolamide is used as an antiepileptic agent, particularly for partial, myoclonic, absence, and primary generalized tonic-clonic seizures uncontrolled by other marketed agents 2, 3
  • Glaucoma: Acetazolamide decreases the production of aqueous humor, reducing intraocular pressure 4
  • Edema: Acetazolamide inhibits carbonic anhydrase, leading to increased bicarbonate and cation excretion and causing urinary alkalization and diuresis 4
  • Altitude sickness: Acetazolamide is effective prophylaxis for the prevention of acute mountain sickness (AMS) at doses of 125,250, and 375 mg/bid 5
  • Idiopathic intracranial hypertension: Acetazolamide decreases the production of cerebrospinal fluid (CSF), reducing intracranial pressure (ICP) 4
  • Elevated ICP due to CSF leaks: Acetazolamide can be used to avoid invasive procedures in patients with a CSF leak or elevated ICP 4

Off-Label Uses

Off-label uses of acetazolamide include:

  • Ventilator weaning for chronic obstructive pulmonary disease patients 4
  • Prevention of high-dose methotrexate toxicity and contrast-induced nephropathy 4
  • Treatment of sleep apnoea 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Acetazolamide in the treatment of seizures.

The Annals of pharmacotherapy, 1996

Research

Acetazolamide: Old drug, new evidence?

Epilepsia open, 2022

Research

Evaluating off-label uses of acetazolamide.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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