Monitor patients closely for common side effects like paresthesias (tingling or numbness), especially in the extremities. These usually resolve with dose adjustment or discontinuation. Acidosis can occur, so regular blood gas analysis might be necessary, particularly in patients with pre-existing renal or respiratory impairment. Frequent monitoring is also recommended for electrolyte imbalances, including hypokalemia and hyponatremia.
Common Adverse Effects
Other frequent side effects include anorexia, nausea, vomiting, and diarrhea. Less common, but potentially serious, are nephrolithiasis (kidney stones) and Stevens-Johnson syndrome. Patients should report any new skin rashes or blistering immediately. Cognitive effects, such as drowsiness or confusion, are possible and warrant careful consideration, especially in older adults or those operating machinery.
Drug Interactions
Acetazolamide’s effect on renal excretion can amplify the effects of other drugs eliminated by the kidneys. Closely monitor patients taking lithium, since acetazolamide increases lithium levels, potentially causing toxicity. Similarly, concurrent use with potassium-wasting diuretics increases the risk of hypokalemia. Caution is advised when combining acetazolamide with drugs that prolong the QT interval, as it can slightly prolong the QT interval itself. Consult prescribing information for specific drugs for detailed interaction profiles.
Managing Adverse Effects
Dose reduction often mitigates mild side effects. Supportive care, including hydration and electrolyte replacement, is crucial for managing more severe adverse reactions. In severe cases, discontinuation might be necessary. Regular monitoring and prompt attention to symptoms are key for safe acetazolamide use.
