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CARBONIC ANHYDRASE INHIBITORS (Systemic)
Some commonly used brand names are:
In the U.S.—
Another commonly used name for dichlorphenamide is diclofenamide .
Carbonic anhydrase inhibitors are used to treat glaucoma. Acetazolamide is also used as an anticonvulsant to control certain seizures in the treatment of epilepsy. It is also sometimes used to prevent or lessen some effects in mountain climbers who climb to high altitudes, and to treat other conditions as determined by your doctor.
These medicines are available only with your doctor"s prescription, in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carbonic anhydrase inhibitors, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to carbonic anhydrase inhibitors, sulfonamides (sulfa drugs), or thiazide diuretics (a type of water pill). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Carbonic anhydrase inhibitors have not been studied in pregnant women. However, studies in animals have shown that carbonic anhydrase inhibitors cause birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.
Breast-feeding—Carbonic anhydrase inhibitors may pass into the breast milk. These medicines are not recommended during breast-feeding, because they may cause unwanted effects in nursing babies. It may be necessary for you to use another medicine or to stop breast-feeding during treatment. Be sure you have discussed this with your doctor.
Children—Although there is no specific information comparing use of carbonic anhydrase inhibitors in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do in adults.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of carbonic anhydrase inhibitors in the elderly with use in other age groups, these medicines are not expected to cause different side effects or problems in older people than they do in younger adults.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using carbonic anhydrase inhibitors, it is especially important that your health care professional know if you are using any of the following:
Other medical problems—The presence of other medical problems may affect the use of carbonic anhydrase inhibitors. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
Take this medicine only as directed . Do not take more of it and do not take it more often than your doctor ordered. To do so may increase the chance of side effects without increasing the effectiveness of this medicine.
This medicine may be taken with meals to lessen the chance of stomach upset. However, if stomach upset (nausea or vomiting) continues, check with your doctor.
This medicine may cause an increase in the amount of urine or in your frequency of urination. If you continue to take the medicine every day, these effects should lessen or stop. To keep the increase in urine from affecting your nighttime sleep:
However, it is best to plan your dose or doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.
Dosing—The doses of carbonic anhydrase inhibitors will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking the carbonic anhydrase inhibitor .
Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
Precautions While Using This Medicine
This medicine may cause some people to feel drowsy, dizzy, lightheaded, or more tired than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert .
It is important that your doctor check your progress at regular visits. Your doctor may want to do certain tests to see if the medicine is working properly or to see if certain side effects may be occurring without your knowing it.
This medicine may cause a loss of potassium from your body . To help prevent this, your doctor may want you to eat or drink foods that have a high potassium content (for example, orange or other citrus fruit juices) or take a potassium supplement. It is very important to follow these directions. Also, it is important not to change your diet on your own. This is more important if you are already on a special diet (as for diabetes) or if you are taking a potassium supplement. Extra potassium may not be necessary and, in some cases, too much potassium could be harmful.
For diabetic patients :
Your doctor may want you to increase the amount of fluids you drink while you are taking this medicine. This is to prevent kidney stones. However, do not increase the amount of fluids you drink without first checking with your doctor.
For patients taking acetazolamide as an anticonvulsant :
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if either of the following side effects occurs:
Shortness of breath or trouble in breathing
Also, check with your doctor as soon as possible if any of the following side effects occur:
Unusual tiredness or weakness
Blood in urine; difficult urination; mental depression; pain in lower back; pain or burning while urinating; sudden decrease in amount of urine
Bloody or black, tarry stools; clumsiness or unsteadiness; confusion; convulsions (seizures); darkening of urine; fever; hives, itching of skin, skin rash, or sores; muscle weakness (severe); pale stools; ringing or buzzing in the ears; sore throat; trembling; unusual bruising or bleeding; yellow eyes or skin
Symptoms of too much potassium loss
Dryness of mouth; increased thirst; irregular heartbeats; mood or mental changes; muscle cramps or pain; nausea or vomiting; unusual tiredness or weakness; weak pulse
Also, check with your doctor if you have any changes in your vision (especially problems with seeing faraway objects) when you first begin taking this medicine.
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Diarrhea; general feeling of discomfort or illness; increase in frequency of urination or amount of urine (rare with methazolamide); loss of appetite; metallic taste in mouth; nausea or vomiting; numbness, tingling, or burning in hands, fingers, feet, toes, mouth, lips, tongue, or anus; weight loss
Less common or rare
Constipation; dizziness or lightheadedness; drowsiness; feeling of choking or lump in the throat; headache; increased sensitivity of eyes to sunlight; loss of taste and smell; nervousness or irritability
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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