Diacarb (Diamox)

Pharmaceutical name: Acetazolamide

Acetazolamide is used to treat glaucoma and to treat and to prevent acute mountain sickness (altitude sickness). It is also used as a part of some treatment plans for congestive cardiac failure and seizure disorders.

Therapeutic actions:
Diamox blocks the formation of CO2 and H2O from H+ and HCO3. The end result is that bicarbonate is excreted in the urine. Indirectly, it will block the Na/H exchanger in the renal proximal tubule by decreasing the conversion of intracellular CO2 and H2O into bicarbonate and a hydrogen ion that is needed for the Na/H exchanger to reabsorb sodium (and water) back from the tubule lumen. Therefore, there is a natriuretic/diuretic action in addition to the "washing away" of bicarbonate in the urine. The excess luminal water and sodium leads to an increased flow rate that can further disrupt other transporters in the tubule from functioning properly.

What is it used for?:
Diamox is used to treat glaucoma, epileptic seizures, benign intracranial hypertension (pseudotumor cerebri), altitude sickness, cystinuria, and dural ectasia. Acetazolamide is available as a generic drug and is also used as a diuretic.

Contraindications and cautions:
- allergy to any ingredient in Diamox;
- adrenal gland problems,
- low blood levels of potassium or sodium,
- kidney problems,
- liver problems (eg, cirrhosis),
- high blood levels of chloride,
- or other electrolyte problems

Side effects:
Common: Change in taste, diarrhea, increase in amount or frequency of urination, loss of appetite, nausea, ringing in the ears, tingling or pins and needles in hands or feet, vomiting.
Rare: Anemia, black or bloody stools, blood in urine, confusion, convulsions, drowsiness, fever, hives, liver dysfunction, nearsightedness, paralysis, rash, sensitivity to light, severe allergic reaction, skin peeling.

Interactions:
- the risk of Diamox’s side effects may be increased by salicylates (eg, aspirin);
- Diamox may increase the risk of side effects of other carbonic anhydrase inhibitors (eg, methazolamide), cyclosporine, quinidine, phenytoin, amphetamine, or sodium bicarbonate;
- Diamox may decrease effectiveness of primidone, salicylates (eg, aspirin), lithium, or methenamine.