Acetazolamide shares the uses of the carbonic anhydrase inhibitors; however, the extended-release capsules are intended for use only for the adjunctive treatment of open-angle (noncongestive, chronic simple) or secondary glaucoma, for short-term preoperative therapy in angle-closure glaucoma (obstructive, narrow-angle) when delay of surgery is desired in order to lower intraocular pressure, and for prevention or amelioration of symptoms associated with acute high-altitude sickness (mountain sickness).
Acetazolamide is used as an adjunct to other anticonvulsants in the management of centrencephalic epilepsies (e.g., petit mal, unlocalized seizures). Tolerance to the anticonvulsant effects of acetazolamide develop quickly, and the drug may be ineffective for prolonged therapy. Although acetazolamide may be useful in partial, myoclonic, absence, and primary generalized tonic-clonic seizures that have not responded adequately to other anticonvulsants, acetazolamide has not been evaluated in controlled clinical studies in specific seizure types.
Acetazolamide is used to increase altitude tolerance in the prevention or amelioration of symptoms (e.g., headache, lassitude, insomnia, nausea, shortness of breath, dizziness) associated with acute mountain sickness in climbers attempting rapid ascent and in those who are very susceptible to the condition despite gradual ascent. Use of acetazolamide does not obviate prompt descent in patients who develop severe forms of acute mountain sickness (e.g., high-altitude pulmonary and/or cerebral edema). The drug does not prevent acute mountain sickness, but rather shortens the time of acclimatization. Acetazolamide also is used in the treatment and prevention of high-altitude sleep disorders.