ACETAZOLAMIDE FOR INJECTION
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Package:
VIALS (lyophilized powder): 1 x 500 mg.
Dosage:
Direct I.V. route of administration is preferred. I.M. administration is not recommended.
Glaucoma: Adjunct to usual therapy. Chronic simple (open-angle) glaucoma: 250 mg-1 G per 24 hours in divided doses for amounts over 250 mg. Dosage should be adjusted with careful individual attention both to symptomatology and ocular tension. Continuous supervision by a physician is advisable.
Secondary glaucoma and preoperative treatment of some cases of acute congestive (closed-angle) glaucoma: 250 mg every 4 hours. Some cases have responded to 250 mg 2 x daily on short-term therapy. An initial dose of 500 mg followed by 125 or 250 mg every 4 hours may be more satisfactory, depending on the individual case. I.V. therapy may be used for rapid relief of ocular tension in acute cases.
Congestive heart failure: Starting dose is usually 250-375 mg once daily in the morning (5 mg/kg). If, after an initial response, the patient fails to continue to lose edema fluid, do not increase the dose but allow for kidney recovery by skipping medication for a day. Best diuretic results are acheived when given on alternate days, or for two days alternating with a day of rest.
Drug-induced edema: 250-375 mg once daily for one or two days, alternating with a day of rest.
See prescribing information for full details.
Prescribing Restrictions: None
Indications:
Adjunctive treatment of edema due to congestive heart failure, drug-induced edema, chronic simple (open-angle) glaucoma, secondary glaucoma.
Contra-Indications:
Hypersensitivity, patients with depressed sodium and/or potassium blood serum levels, marked kidney and liver disease or dysfunction, suprarenal gland failure, and hyperchloremic acidosis. Cirrhosis. Long-term administration in chronic noncongestive angle-closure glaucoma.
Special Precautions:
Severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia and other blood dyscrasias. If signs of hypersensitivity or other serious reactions occur, discontinue use of drug. Concomitant high dose of aspirin. Increasing the dose does not increase the diuresis and may increase the incidence of drowsiness and/or paresthesia. See prescribing information for full details.
Pregnancy and lactation: Should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pediatrics: The safety and effectiveness have not been established.
Side Effects:
Early in therapy: Paresthesias, particularly a "tingling" feeling in the extremities, hearing dysfunction or tinnitus, loss of appetite, taste alteration and G.I. disturbances such as nausea, vomiting and diarrhea; polyuria, occasional instances of drowsiness and confusion. Metabolic acidosis and electrolyte imbalance may occur. Transient myopia has been reported. See prescribing information for full details.
Drug Interactions:
Thiazide or loop diuretics, corticosteroids, corticotrophin, amphotericin, lithium, aspirin. Mexiletine, flecainide, amphetamines, procainamide, quinidine, quinine, TCADs, hexamine, phenytoin, primidone.
