Lacetazolamide

Lacetazolamide is a medication that belongs to the class of carbonic anhydrase inhibitors and is a sulfonamide derivative. It is used as a diuretic and has applications in conditions such as glaucoma and altitude-related illnesses in various regions.

Mechanism of action and pharmacology: Lacetazolamide inhibits carbonic anhydrase enzymes in the proximal tubule of the kidney and in ocular tissues. In the kidney, this reduces the reabsorption of bicarbonate, sodium, and water, producing bicarbonate-rich urine and a mild non-anion gap metabolic acidosis. In the eye, inhibition of carbonic anhydrase decreases aqueous humor production, which lowers intraocular pressure.

Indications and administration: Clinically, lacetazolamide has been used to lower intraocular pressure in glaucoma and to prevent or treat symptoms of acute mountain sickness in some settings. It is generally administered orally, with dosing tailored to the indication and patient factors; the choice of lacetazolamide may vary by country and availability.

Adverse effects and precautions: Common adverse effects include paresthesias, fatigue, nausea or GI upset, and altered taste. Metabolic acidosis and electrolyte disturbances, such as hypokalemia, can occur; urinary alkalinization may predispose to kidney stone formation. Hypersensitivity to sulfonamides is a potential risk. Caution is advised in patients with renal impairment, hepatic disease, or those taking other diuretics or lithium, as drug interactions may occur. Lacetazolamide is contraindicated in individuals with a known sulfonamide allergy and used with caution in those with significant kidney disease or severe electrolyte abnormalities.

See also: acetazolamide.