Page 96 - 2026 SMOG

ACETAZOLAMIDE (DIAMOX)
Class/Mechanism of Action
• Diuretic, Carbonic Anhydrase Inhibitor; Anticonvulsant
Inhibits carbonic anhydrase, causing a decrease in hydrogen ion renal secretion with increased
renal secretion of sodium, potassium, bicarbonate, and water.
˚ Onset of action—PO: 2hr, IV: 2–10min
Indications
• Labeled Indications
˚ Prevention or treatment of symptoms of acute mountain sickness
˚ Edema due to congestive heart failure
Contraindications
• Hypersensitivity to acetazolamide, sulfonamides, or any component of the formulation
• Confirmed low sodium/potassium levels, otherwise none in the emergency setting
Adverse Reactions/Precautions
• May worsen respiratory acidosis
• Drowsiness, decreased alertness, impairment of coordination, nausea, headache
• Flushing of skin, allergic skin reaction, skin photosensitivity
• Pregnancy: Category C
• Lactation: Use caution
Dose/Administration
PEDIATRIC
ADULT (Always reference Broselow Tape)
Altitude Illness (Acute Mountain Sickness) Altitude Illness (Acute Mountain Sickness)
NOTE: For high altitude cerebral edema NOTE: For high altitude cerebral edema
(HACE), dexamethasone is the primary (HACE), dexamethasone is the primary
treatment; however, acetazolamide can be used treatment; however, acetazolamide can be used
(together with dexamethasone) at the AMS dose (together with dexamethasone) at the AMS dose
• IV/IO • PO (IM not recommended due to
˚ Prevention: 125mg q12hr alkaline pH)
Treatment: 250mg q12hr
Prevention: 1.25mg/kg/dose q12hr
˚
Edema (Only with referring doctor or medical ˚ ˚ Treatment: 2.5mg/kg/dose q12hr
director instruction) ■ Maximum dose: 250mg/dose
• PO/IV
˚ 250–500mg once daily or every other day

88 • MEDICATIONS