From the FDA Drug Label
Acetazolamide therapy is contraindicated in situations in which sodium and/or potassium blood serum levels are depressed The answer is no, Diamox (acetazolamide) is not a potassium-sparing drug, it may actually cause hypokalemia as indicated by the need to monitor serum electrolyte levels, particularly potassium, in cases of overdosage 1.
- Key points:
- Contraindicated in situations with depressed potassium blood serum levels
- Monitor serum electrolyte levels, particularly potassium, in cases of overdosage 1
From the Research
Acetazolamide (Diamox) does not typically cause hypokalemia, and its use is not associated with a significant increase in the incidence of hypokalemia, as evidenced by a recent study published in the European journal of heart failure 2. The mechanism of action of acetazolamide, a carbonic anhydrase inhibitor, leads to increased bicarbonate excretion and metabolic acidosis, which promotes potassium retention rather than loss. Key points to consider when using acetazolamide include:
- Monitoring for electrolyte abnormalities, particularly in patients with kidney disease or those taking other medications that affect potassium levels 2
- Being aware of the potential for other electrolyte disturbances, such as hyponatremia and metabolic acidosis 3
- Recognizing the common side effects of acetazolamide, including tingling in the extremities, altered taste, fatigue, and increased urination 4
- Seeking medical attention if symptoms like muscle weakness, irregular heartbeat, or severe fatigue develop, as these could indicate electrolyte disturbances requiring intervention 2 It is essential to prioritize the most recent and highest-quality study, which in this case is the 2023 study published in the European journal of heart failure 2, to guide clinical decision-making and minimize the risk of morbidity, mortality, and decreased quality of life.