Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Acetazolamide

Generic name
Acetazolamide
Brand name
ATC Code
S01EC01

Pharmacokinetics in children

No information

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dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

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Available formulations

No information is present at this moment.

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Dosages

Diuretics for oedema
  • Oral
    • 1 month up to 18 years
      • In the mornings 5 mg/kg/day in 1 dose. Max: 375 mg/day.
      • Duration of treatment:

        2 days on, then 1 day rest. Then repeat this pattern.

    • 1 month up to 18 years
      [2]
      • In the mornings 5 mg/kg/day in 1 dose. Max: 375 mg/day.
      • Duration of treatment:

        2 days on, then 1 day rest. Then repeat this pattern.
Reduction of intracranial pressure
  • Oral
    • 1 month up to 18 years
      [9] [10]
      • Initial dose: 30 mg/kg/day in 3 doses.
      • Maintenance dose: Can potentially be increased to a maximum of 100 mg/kg/day in 3 doses. Max: 1.500 mg/day.

      • Monitor the electrolyte balance and correct with potassium and bicarbonate if necessary.
        Dosage based on case studies.

    • 1 month up to 18 years
      • Initial dose: 30 mg/kg/day in 3 doses.
      • Maintenance dose: Can potentially be increased to a maximum of 100 mg/kg/day in 3 doses. Max: 1.500 mg/day.

      • Monitor the electrolyte balance and correct with potassium and bicarbonate if necessary.
        Dosage based on case studies.
Epilepsy, adjuvant therapy
  • Intravenous
    • 1 month up to 18 years
      • 8 - 30 mg/kg/day in 2 - 3 doses. Max: 1.500 mg/day.

      • Parenteral administration only in emergencies

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Renal impaiment in children > 3 months

Adjustment in renal impairment as specified:

GFR 50-80 ml/min/1.73 m2
Dose adjustment is not required
GFR 30-50 ml/min/1.73 m2
50 percentage of single dose and dosing interval : 12 uur
Then dose depending on the effect, with a maximum of 250 mg twice daily.
GFR 10-30 ml/min/1.73 m2
50 percentage of single dose and dosing interval : 12 uur
Then dose depending on the effect, with a maximum of 250 mg twice daily.
GFR < 10 ml/min/1.73 m2
Generalized recommendations cannot be given.

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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Acidosis (required), impaired kidney and liver function, skin reactions, hypersensitivity reactions. In prolonged use: metabolic acidosis, kidney stones, bone marrow depression.

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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Crossover sensitivity with sulphonamide allergies can occur. In prolonged use, watch out for metabolic acidosis, Be careful in cases of arrhythmia, digoxin use or corticosteroids.

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Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

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Parasympathomimetics
S01EB01
Carbonic anhydrase inhibitors
S01EC03
Beta blocking agents
S01ED01
Prostaglandin analogues
S01EE03
S01EE01
S01EE04
Other antiglaucoma preparations
S01EX
OTHER ANTIGLAUCOMA PREPARATIONS
S01EX

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References

  1. Katayama F, et al, Long-term effectiveness and side effects of acetazolamide as an adjunct to other anticonvulsants in the treatment of refractory epilepsies, Brain Dev, 2002, Apr;24(3), 150-4
  2. Goldshield Pharmaceuticals Ltd., SPC Diamox (RVG 00644), www.cbg-meb.nl, Geraadpleegd 18 augustus 2010, http://db.cbg-meb.nl/IB-teksten/h00644.pdf
  3. Sharan S, et al, The effect of oral acetazolamide on weight gain in children, Can J Ophthalmol, 2010, Feb;45(1), 41-5
  4. Sabri K, et al, The additive effect of topical dorzolamide and systemic acetazolamide in pediatric glaucoma, J AAPOS, 2006, Oct;10(5), 464-8
  5. Zierhut M, et al, Treatment of uveitic macular edema with acetazolamide, Doc Ophthalmol, 1999, 97(3-4), 409-13
  6. Portellos M, et al, Topical versus oral carbonic anhydrase inhibitor therapy for pediatric glaucoma, J AAPOS, 1998, Feb;2(1), 43-7
  7. Haas J., Principles and problems of therapy in congenital glaucoma., Invest Ophthalmol., 1968, Apr;7(2), 140-6
  8. Galin MA, et al, Acetazolamide and outflow facility, Arch Ophthalmol, 1966, Oct;76(4), 493-7
  9. Carrion E, et al, Use of acetazolamide to decrease cerebrospinal fluid production in chronically ventilated patients with ventriculopleural shunts., Arch Dis Child., 2001, Jan;84(1), 68-71
  10. Shinnar S, et al, Management of hydrocephalus in infancy: use of acetazolamide and furosemide to avoid cerebrospinal fluid shunts., J Pediatr, 1985, Jul;107(1), 31-7

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Changes

Changes