Diuremid tablets are used for the following indications:
treatment of glaucoma: chronic open-angle glaucoma; secondary glaucoma; angle-closure glaucoma (for short-term preoperative therapy and before ophthalmological procedures, to reduce intraocular pressure); treatment of edema: in heart failure; edema caused by the use of drugs; treatment of epilepsy (in combination with other anticonvulsants): petit mal (small seizures) in children; grand mal (large seizures) in adults; mixed form; treatment of altitude sickness (the drug reduces the acclimatization time, but its effect on the manifestations of this disease is insignificant).
Composition
The active substance is acetazolamide (one tablet contains 250 mg of acetazolamide).
Excipients: potato starch, talc, sodium starch glycolate (type A).
Contraindication
increased individual sensitivity to the components of the drug and sulfonamides, impaired liver and kidney function, acute renal failure, liver failure, urolithiasis (with hypercalciuria), hyperchloremic acidosis, hypokalemia, chronic decompensated angle-closure glaucoma (for long-term therapy), diabetes mellitus, uremia, adrenal insufficiency, Addison's disease. Acetazolamide should not be used in patients with cirrhosis of the liver, as this may increase the risk of hepatic encephalopathy.
Method of application
The medicine is taken orally.
Glaucoma treatment
The dose of the drug should be determined individually, depending on the intraocular pressure. Recommended doses for adults:
for open-angle glaucoma - 250 mg (one tablet) 1-4 times a day (a dose of more than 1000 mg (4 tablets) does not increase therapeutic efficacy); for secondary glaucoma - 250 mg (one tablet) every 4 hours, in some patients a therapeutic effect is observed after taking 250 mg (one tablet) twice a day (long-term administration is not indicated); for acute attacks of glaucoma - 250 mg (one tablet) 4 times a day.
Epilepsy treatment
Adults and children: usually 8-30 mg/kg body weight per day. The dose should be administered in 1-4 divided doses. The optimal dose is 250-1000 mg (1-4 tablets).
When using acetazolamide with other anticonvulsants, the initial dose of the first should be 250 mg (one tablet) per day. The dose should be increased gradually if necessary. For children, the dose should not exceed 750 mg per day.
Treatment of edema in heart failure and edema caused by the use of drugs
The initial dose is 250 mg per day (one tablet) in the morning.
The best diuretic effect is observed if the drug is used every other day or every 2 days with a one-day break.
In the treatment of heart failure, acetazolamide should be prescribed against the background of generally accepted therapy (for example, the appointment of digitalis cardiac glycosides, a low-salt diet and replenishment of potassium deficiency).
Treatment of altitude sickness
The recommended daily dose is 500-1000 mg (2-4 tablets), divided into several doses. In case of planned rapid ascent to altitude (more than 500 meters per day), the recommended dose is 1000 mg (4 tablets), divided into several doses.
The medicine should be taken 24-48 hours before ascending, and if symptoms of the disease appear, treatment should be continued for another 48 hours or more if necessary.
Application features
Pregnant women
Acetazolamide crosses the placental barrier. Use of the drug during pregnancy is contraindicated.
Acetazolamide passes into breast milk in small amounts. Breastfeeding should be discontinued during use of the drug.
Children
The drug should be used to treat children from 3 years of age only as an adjunctive therapy for epilepsy.
Drivers
Acetazolamide in high doses can cause drowsiness, and less often fatigue, dizziness, ataxia, and disorientation. Therefore, during treatment with acetazolamide, you should not drive or operate potentially dangerous machinery.
Overdose
In case of overdose, electrolyte imbalance, acidosis and central nervous system disorders (drowsiness, paresthesia) are possible; sometimes - decreased diuresis.
Treatment. Drug withdrawal, symptomatic therapy, bicarbonates in case of acidosis. Effective hemodialysis. There is no specific antidote.
Side effects
Adverse reactions are most often observed at the beginning of treatment.
Immune system disorders: hypersensitivity reactions, including anaphylactic reactions.
From the nervous system and sensory organs: convulsions, paresthesia, hearing impairment/tinnitus, taste disturbance, headache, dizziness, irritability, depression, confusion, ataxia; with prolonged use - disorientation, drowsiness, impaired touch and sensitivity, general weakness, peripheral paralysis; in isolated cases - sensation of hair on the tongue, flaccid paralysis, fatigue.
Gastrointestinal: anorexia, nausea, vomiting, diarrhea, hepatic failure, hepatic colic, intestinal colic, melena, hepatitis, cholestatic jaundice, changes in liver function tests, liver necrosis.
From the blood system: in some cases with prolonged use - hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, bone marrow suppression, aplastic anemia, thrombocytopenic purpura.
From the urinary system: frequent urination, hematuria, glycosuria, renal colic, hyponatremia, hypokalemia, crystalluria, polyuria, renal failure, nephrolithiasis, kidney damage.
Acetazolamide, as a sulfonamide derivative, can cause adverse reactions typical of sulfonamides.
Skin and mucous membranes: skin rash, itching, erythema, urticaria, erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome.
Storage conditions
Store in the original packaging at a temperature not exceeding 25 °C, out of the reach of children.
Shelf life - 3 years.
