From the Research
Side effects from acetazolamide can be expected to occur within hours to days after starting treatment, with most common side effects appearing within the first 24-72 hours of therapy. The timing of side effects is influenced by the drug's mechanism of action as a carbonic anhydrase inhibitor, which quickly affects multiple body systems including the kidneys, central nervous system, and blood pH 1.
Common Side Effects
- Tingling in the hands and feet
- Altered taste (particularly for carbonated beverages)
- Fatigue
- Increased urination These side effects are dose-dependent, with higher doses (typically over 250mg twice daily) more likely to cause noticeable effects 1.
Serious Side Effects
More serious side effects like metabolic acidosis, electrolyte imbalances, or kidney stones generally develop after several days to weeks of continued use 1. Patients with kidney or liver impairment may experience side effects sooner or more severely due to altered drug metabolism and clearance.
Management of Side Effects
If troublesome side effects occur, patients should contact their healthcare provider rather than discontinuing the medication abruptly 2. The healthcare provider can assess the severity of the side effects and adjust the dosage or recommend alternative treatments as needed.
Recent Evidence
A recent study published in 2020 found that the risk of common side effects such as paraesthesias, dysgeusia, polyuria, and fatigue increased with higher doses of acetazolamide 1. Another study published in 2024 highlighted the importance of careful patient selection and dosage adjustment to minimize the risk of side effects 2.
Clinical Implications
In clinical practice, it is essential to monitor patients closely for signs of side effects, especially during the initial treatment period. Healthcare providers should also be aware of the potential for dose-dependent side effects and adjust the dosage accordingly to minimize the risk of adverse events 1, 2.