Acetazolamide

Generic name
Acetazolamide
Brand name
ATC Code
S01EC01
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Acetazolamide

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

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No information

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

No information is present at this moment.

Available formulations

No information is present at this moment.

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

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.

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.

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.

Interactions

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

ANTIGLAUCOMA PREPARATIONS AND MIOTICS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

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

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

Changes

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