Elderly Patients: Start with a lower dose (e. g., 125 mg twice daily) and monitor closely for side effects, particularly electrolyte imbalances and cognitive changes. Dosage adjustments should be gradual.
Patients with Renal Impairment: Reduce the dose based on creatinine clearance. Consult dosing guidelines specific to acetazolamide and renal function. Closely monitor serum electrolytes.
Patients with Hepatic Impairment: Use caution. Acetazolamide is primarily metabolized by the kidneys, but hepatic impairment may still affect its pharmacokinetics. Lower doses and frequent monitoring are recommended.
Patients with Hypokalemia or Hyponatremia: Acetazolamide can worsen these conditions. Correct electrolyte imbalances before initiating treatment and monitor serum levels frequently during treatment.
Pregnant and Breastfeeding Women: Use only if clearly needed, weighing potential benefits against risks to the fetus or infant. Consult relevant guidelines and discuss extensively with the patient.
Patients with Sulfa Allergy: Acetazolamide is a sulfonamide derivative; individuals with a history of sulfa allergy should avoid this medication. Alternatives should be explored.
Children: Dosing is weight-based and requires careful consideration. Pediatric guidelines should be consulted. Close monitoring for side effects is crucial.
Note: This information is for guidance only. Always consult prescribing information and individual patient factors before determining the appropriate acetazolamide dosage for glaucoma. Regular monitoring of electrolytes and renal function is necessary for all patients.
