Lacétazolamide

Lacétazolamide, typically spelled acetazolamide in English, is a carbonic anhydrase inhibitor of the sulfonamide class. It has several medical uses, most notably as a diuretic and as a treatment for various forms of glaucoma. It is also employed as a preventive measure for high-altitude sickness and, in some cases, as an adjunct in certain neurologic conditions.

Mechanism of action and effects

Lacétazolamide inhibits carbonic anhydrase enzymes in the proximal tubule of the kidney and in other tissues. This reduces the reabsorption of bicarbonate, promoting bicarbonate and fluid loss in the urine and producing a mild metabolic acidosis. In the eye, the reduction of carbonic anhydrase activity lowers aqueous humor formation, contributing to decreased intraocular pressure.

Medical uses

In glaucoma, lacetazolamide lowers intraocular pressure and can be used when other treatments are insufficient or unsuitable. It is used to manage idiopathic intracranial hypertension and to prevent or mitigate high-altitude pulmonary or cerebral edema in some settings. It may be employed as part of combination therapy for certain types of seizures or metabolic disturbances, though it is not a first-line treatment for these conditions.

Administration and formulations

Lacétazolamide is available in oral tablet form and as an injectable preparation; ophthalmic acetazolamide eye drops are also used for local treatment in glaucoma. Dosing depends on the condition being treated and patient factors, with attention to the onset and duration of action of the formulation.

Side effects and precautions

Common adverse effects include fatigue, paresthesias, dizziness, nausea, and taste disturbances. It can cause metabolic acidosis and electrolyte imbalances, and may promote kidney stone formation due to urinary alkalinization. Hypersensitivity to sulfonamides is a concern. It is used with caution in patients with kidney or liver disease, electrolyte disturbances, or dehydration, and in those taking other diuretics or nephrotoxic agents.

See also: carbonic anhydrase inhibitors, glaucoma medications.