From the Guidelines
Diamox (acetazolamide) is a carbonic anhydrase inhibitor used for several medical conditions, and its dosage varies depending on the condition being treated, with a typical range of 125-1000 mg daily in divided doses. The medication is used for altitude sickness prevention and treatment, glaucoma, idiopathic intracranial hypertension, and as a diuretic for certain conditions. For altitude sickness prevention, the typical dosage is 125-250 mg twice daily, starting 24-48 hours before ascent and continuing for 48 hours after reaching the desired altitude, as supported by studies such as 1 and 1.
Uses and Dosages
- For acute mountain sickness treatment, 250 mg twice daily is often prescribed.
- In glaucoma management, dosages range from 250-1000 mg daily, often divided into 2-4 doses.
- For idiopathic intracranial hypertension, 250-1000 mg daily in divided doses is common, with a popular starting dose of 250–500 mg twice a day, as noted in 1.
- When used as a diuretic, 250-375 mg once daily is typically prescribed.
Side Effects and Precautions
Side effects may include tingling in extremities, altered taste, frequent urination, and kidney stones with long-term use. Patients should maintain adequate hydration while taking this medication, and those with sulfa allergies should use it cautiously as cross-reactivity may occur, as warned in 1. The medication works by inhibiting carbonic anhydrase, which reduces hydrogen ion secretion in the kidneys, increases sodium, potassium, bicarbonate, and water excretion, and reduces cerebrospinal fluid and aqueous humor production.
Recent Guidelines
Recent guidelines, such as those from the European Respiratory Society 1 and 1, support the use of acetazolamide for obstructive sleep apnea, with dosages ranging from 36-1000 mg daily. However, the literature on this topic is limited, and more research is needed to fully understand the effects of acetazolamide on sleep apnea. Additionally, guidelines for idiopathic intracranial hypertension, such as those found in 1, provide recommendations for the use of acetazolamide in this condition.
From the FDA Drug Label
Reconstituted solutions retain their physical and chemical properties for 3 days under refrigeration at 2° to 8°C (36° to 46°F), or 12 hours at room temperature 20° to 25°C (68° to 77°F). The dosage employed in the treatment of chronic simple (open-angle) glaucoma ranges from 250 mg to 1 g of acetazolamide per 24 hours, usually in divided doses for amounts over 250 mg. In treatment of secondary glaucoma and in the preoperative treatment of some cases of acute congestive (closed-angle) glaucoma, the preferred dosage is 250 mg every four hours, although some cases have responded to 250 mg twice daily on short-term therapy The suggested total daily dose is 8 to 30 mg per kg in divided doses. Although some patients respond to a low dose, the optimum range appears to be from 375 to 1000 mg daily For diuresis in congestive heart failure, the starting dose is usually 250 to 375 mg once daily in the morning (5 mg/kg) Recommended dosage is 250 to 375 mg of acetazolamide once a day for one or two days, alternating with a day of rest
The uses of Diamox (acetazolamide) include:
- Glaucoma
- Epilepsy
- Congestive Heart Failure
- Drug induced Edema The dosages of Diamox (acetazolamide) are:
- Glaucoma: 250 mg to 1 g per 24 hours
- Epilepsy: 8 to 30 mg per kg in divided doses, optimum range 375 to 1000 mg daily
- Congestive Heart Failure: 250 to 375 mg once daily in the morning
- Drug induced Edema: 250 to 375 mg once a day for one or two days, alternating with a day of rest 2
From the Research
Uses of Diamox (Acetazolamide)
- Diamox (acetazolamide) is used for various conditions, including: