Epilepsy

8mg/kg to 30mg/kg a day, given in divided doses.
Maximum dose: 750mg a day.

The following alternate dosing schedule may be suitable:

Children aged 12 to 18 years

250mg to be given 2 to 4 times daily

Children aged 1 month to 12 years

Initial dose: 2.5mg/kg to be given 2 to 3 times daily.
Maintenance dose: 5mg/kg to 7mg/kg to be given 2 to 3 times daily.
Maximum dose: 750mg day.

Glaucoma (unlicensed)

Children aged 12 to 18 years

250mg to be given 2 to 4 times daily.

Children 1 month to 12 years

5mg/kg to be given 2 to 4 times daily, adjusted according to individual patient response.
Maximum dose: 750mg a day.

Raised Intracranial pressure

Children aged 1 month to 12 years

Initial dose: 8mg/kg to be given three times daily (maximum daily dose 100mg/kg).

Glaucoma

Epilepsy

Pre-menstrual fluid retention

Associated oedema

Contraindications

Adrenal insufficiency
Hepatic cirrhosis
Hyperchloraemic acidosis
Hypokalaemia
Hyponatraemia
Long term use in chronic non-congestive narrow angle glaucoma
Pregnancy
Severe hepatic impairment
Severe renal impairment

Precautions and Warnings

Elderly
Impaired glucose tolerance
Breastfeeding
Diabetes mellitus
Disorder of acid-base balance
Electrolyte imbalance
Hepatic impairment
History of nephrolithiasis
Obstructive pulmonary disease
Pulmonary emphysema
Renal impairment
Urinary obstruction

Reduce dose in patients with moderate renal impairment
Advise ability to drive/operate machinery may be affected by side effects
Diuresis is not dose-related
Blood counts should be performed before and periodically during treatment
Monitor serum electrolytes before and during treatment
Consider AGEP if feverish generalised erythema occurs
Advise patients to report any unusual rash to the prescriber
Advise patients/carers to seek medical advice if suicidal intent develops
Discontinue if hypersensitivity reactions occur
Discontinue immediately if any severe fall in blood counts occur
Discontinue permanently if AGEP is diagnosed

Pregnancy and Lactation

Pregnancy

Acetazolamide is contraindicated during pregnancy.

The manufacturer does not recommend using acetazolamide during pregnancy. Animal studies have shown teratogenic effects at doses in excess of ten times those recommended in humans. Human data is limited and as such a potential risk cannot be ruled out.

Lactation

Use acetazolamide with caution during breastfeeding.

The manufacturer advises caution if acetazolamide is used when breastfeeding. Whilst available data indicates acetazolamide is present in human breast milk, the quantity is not considered to be sufficient to cause adverse effects in the breastfed infants. Effects in exposed infants are unknown.