Diacarb tablets are used for:
- treatment of glaucoma: chronic open-angle glaucoma, secondary glaucoma, glaucoma (to reduce intraocular pressure, during short-term preoperative treatment and before ophthalmological procedures)
- treatment of edema: edema due to heart failure or due to medications; epilepsy (in combination with other anticonvulsants): petit mal in children, grand mal in adults, mixed forms)
- treatment for altitude sickness (the drug reduces the acclimatization time, but its effect on the manifestations of the disease itself is insignificant).
Contraindications
Hypersensitivity to the components of the drug and sulfonamides, impaired liver and kidney function, acute renal failure, liver failure, hyponatremia and/or hypokalemia, Addison's disease, adrenal insufficiency, hyperchloremic acidosis. Acetazolamide is contraindicated in patients with cirrhosis as it may increase the risk of hepatic encephalopathy.
Long-term use of acetazolamide is contraindicated in patients with chronic decompensated angle-closure glaucoma, since in the case of complete closure of the angle of the chamber of the eye, the worsening of glaucoma will be masked by reduced intraocular pressure.
Urolithiasis (with hypercalciuria), diabetes mellitus, uremia.
Instructions for use Diacarb
The daily dosage and treatment regimen may vary. Features of admission depend on the presence of concomitant diseases, the age of the patient, as well as the type and severity of the underlying pathology.
For mild and moderate swelling, you should take 250 to 400 mg of the drug per day once.
For the treatment of an acute attack of glaucoma, adult patients are prescribed 250 milligrams of Diacarb every 4 hours. For pediatric patients, the dosage is calculated at 10-15 mg per kilogram of weight.
To prevent mountain sickness, it is recommended to take 500 mg of the drug 1-2 days before and during the ascent.
For patients with epilepsy, Diacarb is prescribed in a dosage of 250 to 500 mg per day for three days.
Mode of application
The drug is taken orally.
Glaucoma treatment
The dose of the drug is determined individually depending on intraocular pressure.
Recommended doses for adults:
| For open-angle glaucoma | 250 mg (1 tablet) 1-4 times a day. Doses greater than 1000 mg (4 tablets) do not increase therapeutic efficacy. |
| For secondary glaucoma | 250 mg (1 tablet) every 4 hours. In some patients, a therapeutic effect is observed after taking 250 mg (1 tablet) twice a day (long-term administration is not indicated). |
| For acute attacks of angle-closure glaucoma | 250 mg (1 tablet) 4 times a day. |
Treatment of epilepsy
| Adults and children | As a rule, 8-30 mg/kg body weight per day. Apply the dose in 1-4 doses. The optimal dose is 250-1000 mg (1-4 tablets). |
| When using acetazolamide simultaneously with other anticonvulsants, the initial dose of the former should be 250 mg (1 tablet) per day. If necessary, increase the dose gradually. 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 (1 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.
When treating heart failure, acetazolamide should be prescribed against the background of conventional therapy (for example, the prescription of digitalis 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 the case of an expected rapid rise to altitude (more than 500 m per day), the recommended dose is 1000 mg (4 tablets), divided into several doses.
The drug should be taken 24-48 hours before climbing, and if symptoms of the disease appear, treatment should be continued for another 48 hours or more if necessary.
Diacarb®
Acetazolamide is a systemic carbonic anhydrase inhibitor with weak diuretic activity.
Carbonic anhydrase (CA) is an enzyme involved in the hydration of carbon dioxide and dehydration of carbonic acid. Inhibition of carbonic anhydrase reduces the formation of bicarbonate ions with a subsequent decrease in sodium transport into cells. The effects of using the drug Diacarb® are determined by the point of application of the molecule: the choroid plexuses of the brain, the proximal nephron, the ciliary body of the eye, red blood cells.
Acetazolamide is used to treat CSF flow disorders and intracranial hypertension by reducing excess CSF production at the level of the choroid plexuses of the brain. Inhibition of carbonic anhydrase in ependymocytes of the choroid plexus reduces the excess negative charge in ependymal cells and reduces the gradient filtration of plasma into the cavity of the ventricles of the brain.
Acetazolamide is used in the treatment of edema syndrome due to its weak diuretic effect. As a result of inhibition of carbonic anhydrase activity in the proximal nephron, there is a decrease in the formation of carbonic acid and a decrease in the reabsorption of bicarbonate and Na + by the tubular epithelium, and therefore the release of water significantly increases. Acetazolamide increases the excretion of bicarbonates, which can lead to the development of metabolic acidosis. Acetazolamide causes the kidneys to excrete phosphates, magnesium, and calcium, which can also lead to metabolic disorders. Over the next three days of therapy, Na+ reabsorption in the distal nephron is compensatory activated, reducing the diuretic effect of Diacarb®.
After 3 days from the start of use, acetazolamide loses its diuretic properties. After a break in treatment for several days, newly prescribed acetazolamide resumes its diuretic effect due to the restoration of normal carbonic anhydrase activity in the proximal nephron.
Acetazolamide is used to treat glaucoma. During the formation of aqueous humor of the eye, bicarbonate ions are actively transported into the posterior chamber from the cytoplasm of non-pigmented cells to compensate for the positive ion gradient caused by the active transport of Na+ ions.
CA inhibitors block the formation of carbonic acid, thus reducing the production of HCO3-. In the absence of sufficient HCO3- ions, the positive ion gradient increases, which causes a decrease in the secretion of aqueous humor. Inhibition of carbonic anhydrase of the ciliary body reduces the secretion of aqueous humor in the anterior chamber of the eye, which reduces intraocular pressure. Tolerance to this effect does not develop. Iphthalmotonus when taking acetazolamide begins to decrease after 40-60 minutes, the maximum effect is observed after 3-5 hours, intraocular pressure remains below the initial level for 6-12 hours. On average, intraocular pressure decreases by 40-60% from the initial level.
The drug is used as an adjuvant in the treatment of epilepsy, because inhibition of carbonic anhydrase in nerve cells of the brain inhibits pathological excitability.
Overdose
Symptoms of overdose and acute poisoning in humans have not been described. In case of overdose, disturbances in electrolyte balance, acidosis and disorders of the central nervous system (drowsiness, paresthesia) are possible, sometimes - a decrease in diuresis. Therefore, the concentration of electrolytes in the blood plasma, especially potassium, as well as the pH of the urine should be monitored.
Treatment.
Discontinuation of the drug, symptomatic therapy, in case of acidosis, prescribe bicarbonates. Effective hemodialysis. There is no specific antidote.
Pharmacological action, pharmacodynamics and pharmacokinetics
The main therapeutic effects of the drug:
- Decongestant.
- Diuretic.
The drug inhibits the enzyme carbonic anhydrase, which affects water and sodium metabolism in the body. As a result, Diacarb helps eliminate edema of various origins, relieve an attack of acute glaucoma and compensate for the manifestations of a number of other conditions.
By participating in water-salt metabolism, the drug does not affect pH and does not disturb the acid-base balance. The duration of action is no more than 12 hours.
The maximum concentration of Diacarb is achieved in the blood 2 hours after its administration. It has a high ability to bind to protein structures of blood plasma. Able to overcome the placental barrier.
The drug is not metabolized in the body and is excreted in its original form by the kidneys within 24 hours.
Side effects
From the blood side
- Rare: aplastic anemia, thrombocytopenia, agranulocytosis, leukopenia, thrombocytopenic purpura, bone marrow suppression, pancytopenia.
- In some cases, with long-term use - hemolytic anemia.
Metabolism
- Common: anorexia, metabolic acidosis, water and electrolyte imbalance (in combination with hyponatremia and hyperkalemia).
- Frequency unknown: hypocalcemia, weight loss (with long-term use).
From the mental side
- Uncommon: depression.
From the nervous system and sensory organs
- Often: dizziness, disturbance of taste, paresthesia (feeling of crawling in the limbs).
- Uncommon: hot flashes, thirst, headache, irritability, decreased libido.
- Isolated cases have been reported: drowsiness, confusion, flaccid paralysis, convulsions.
- Frequency unknown: ataxia; with long-term use - disorientation, loss of touch, general weakness, peripheral paralysis; in isolated cases - a sensation of hair on the tongue.
From the organs of vision
- Rarely: reverse myopia.
From the organs of hearing and balance
- Rarely: tinnitus, hearing loss.
From the gastrointestinal tract
- Uncommon: nausea, vomiting, diarrhea, melena.
From the liver and biliary tract
- Uncommon: liver dysfunction.
- Rarely: fulminant liver necrosis, hepatitis, obstructive jaundice.
- Frequency unknown: liver failure, hepatic colic.
From the skin and its derivatives
- Rarely: erythema multiforme, Stevens-Johnson syndrome, photosensitivity, skin rash, Lyell's syndrome, urticaria.
- Frequency unknown: acute generalized eczematous pustulosis, itching, erythema.
From the urinary system
- Uncommon: nephrolithiasis, crystalluria, renal colic, kidney damage, polyuria, hematuria, renal failure.
- Rarely: glycosuria.
- Frequency unknown: Frequent urination.
General violations
- Common: fatigue.
- Uncommon: fever.
From the immune system
- Rarely: hypersensitivity reactions, including anaphylactic reactions.
Study
- Very rare: hypoglycemia, hyperglycemia.
Interaction
Acetazolamide may enhance the effect of folic acid antagonists, hypoglycemic agents and anticoagulants taken orally.
Concomitant use of acetazolamide with acetylsalicylic acid can lead to severe acidosis and have a toxic effect on the central nervous system with the risk of anorexia, tachypnea, lethargia, coma with possible death.
When using acetazolamide simultaneously with cardiac glycosides or drugs that increase blood pressure, the dose of the former must be changed.
Acetazolamide disrupts the metabolism of phenytoin, increasing the concentration of the latter in the blood serum. Severe osteomalacia has been observed in patients taking acetazolamide with certain drugs (phenytoin, primidone).
Note!
Description of the drug Diacarb table. 250 mg No. 30 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
Reviews about the medication
Reviews from patients and doctors about the drug Diacarb are very different, both positive and negative.
Most patients note the high effectiveness of the drug, as well as its affordable cost.
Some patients speak negatively about Diakarb. For some it did not help at all, but for others it caused undesirable reactions, due to which they had to stop taking the drug. Most often, patients experience severe muscle weakness and cramps as a result of hypokalemia.
On thematic forums, the question often arises about the possibility of treatment with Diacarb during pregnancy and lactation. Currently, medical professionals do not prescribe it to expectant and nursing mothers, since there is no reliable data on the safety of its use in this category of patients.
