Acetazolamide Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Unlicensed preparation

Available preparations

Diamox 500mg vial

Acetazolamide 500mg vial (Mylan)

Reconstitution

Water for injections

• Ideally reconstitute each vial with 10ml to reduce injection pain - but must use at least 5ml per 500mg vial

Methods of intravenous administration

Slow intravenous injection (preferred method)

• Administer required dose over 3 to 5 minutes ^{(ref 2)}

Dose in adults

Glaucoma

• Give 250mg to 1g per twenty-four hours - usually in divided doses for amounts greater than 250mg
• Some references suggest that for secondary, acute (closed angle) glaucoma that the initial dose may be 250 to 500mg, with a maintenance dose of 125-250mg every 4 hours (250mg every 12 hours has been effective in the short term treatment of some patients) ^{(ref 1)}

Epilepsy

• Give 250 to 1000mg daily in divided doses

Congestive heart failure or drug induced oedema

• For diuresis, the starting dose is usually 250mg to 375mg once daily mane
• If, after an initial response, the patient fails to lose oedema fluid, do not increase the dose but allow for kidney recovery by giving dose on alternate days

Metabolic alkalosis (unlicensed use) ^{(ref 1)}

• 500mg as a single dose, and reassess need based on acid-base status

Renal impairment

• Avoid in CrCl less than 10ml/min ^{(ref 3)}

Storage

Store below 25⁰C

References

UK SPC April 2020

1: Lexicomp- accessed online16th December 2021

2: Medusa accessed online 16th December 2021

3: Renaldrugdatabase- accessed online 16th December 2021

Therapeutic classification

Carbonic anhydrase inhibitors