Acemox

Introduction
Acemox is a medicine used to reduce pressure in the eyes. This pressure can be caused by or lead to an illness called glaucoma. If the pressure in your eye is too high it can damage your sight. Acemox works by decreasing the amount of fluid inside the eye. You can take Acemox with or without food. The dose will depend on your condition and how your respond to the medicine. Try to take it at the same time each day. It is important to keep taking this medicine until your doctor tells you not to. Use this medicine regularly to get the most benefit from it even if you feel well. The most common side effect is headache. Other side effects include feeling tired, dizziness and taste change. Make sure you read the leaflet that comes with your medicines and tell your doctor if you are bothered by side effects or they do not go away. It may be possible to adjust your dose or try a different medicine. This drug is not recommended during pregnancy and you should ask your doctor before taking it if you have kidney or liver disease, heart trouble or diabetes.

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Uses of Acemox
Glaucoma
Side effects of Acemox
Common
Headache
Dizziness
Tiredness
Frequent urge to urinate
Tingling sensation of extremity
Numbness of extremity
Loss of appetite
Excitement
Feeling sick
Diarrhea
Taste change
Flushing (sense of warmth in the face, ears, neck and trunk)
How to use Acemox
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Acemox may be taken with or without food, but it is better to take it at a fixed time.
How Acemox works
Acemox is a carbonic anhydrase inhibitor. It works in glaucoma by decreasing the production of aqueous humour (fluid in the eye), thereby lowering the increased eye pressure. It also acts on the kidneys to remove extra water and electrolytes through urine to relieve fluid retention and oedema (swelling). In epilepsy, it relieves seizures (fits) by stabilizing electrical activity in the brain.
What if you forget to take Acemox?
If you miss a dose of Acemox, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Acemox helps lower high pressure in the eye and reduce the risk of vision loss.
Usually used in combination with other anti-glaucoma medications.
Take it as per dose and duration suggested by your doctor.
Use caution while driving or doing anything that requires concentration as Acemox can make you very drowsy.
It may cause a tingling sensation in hands and feet. Take potassium-rich foods (banana and coconut water), and get potassium levels checked regularly.
Brief Description
Indication
Adult: PO Diuresis 250-375 mg/day. Glaucoma; Epilepsy 250-1,000 mg/day. Prophylaxis of high altitude sickness 500-1,000 mg/day. Epilepsy >12 years Tablet: 8-30 mg/kg/day PO qDay or divided q6-12 hr; not to exceed 30 mg/kg/day or 1 g/day Acute Altitude Sickness >12 years Immediate release: 500-1000 mg/day PO divided q8-12hr Hepatic impairment: Contraindicated in marked hepatic impairment.

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Administration
Concomitant use w/ high-dose aspirin may cause anorexia, tachypnoea, lethargy, metabolic acidosis, coma and death. May increase serum levels of phenytoin, resulting to increased risk of osteomalacia. May decrease serum concentrations of primidone. Additive effects w/ other carbonic anhydrase inhibitors. May increase the effects of folic acid antagonists. May decrease urinary excretion of amphetamine and quinidine. May prevent the urinary antiseptic effect of methenamine. May increase lithium excretion. Increased risk of renal calculus formation w/ Na bicarbonate. May increase ciclosporin levels.
Adult Dose
Potassium supplements may be required. Impaired hepatic or renal function; diabetes. Monitor plasma electrolytes and blood count regularly. IM route is not recommended. Caution when driving or operating machinery. Elderly. Lactation: Enters breast milk; not recommended

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Renal Dose
Acetazolamide specifically inhibits the enzyme carbonic anhydrase which catalyses the reversible reaction involving the hydration of CO2 and dehydration of carbonic acid. It increases the excretion of HCO3 ions and as well as Na and K leading to alkaline diuresis. Carbonic anhydrase is also inhibited in the CNS to retard abnormal and excessive discharge from neurons.
Contraindication
<12 years: Safety and efficacy is not established

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Mode of Action
Should be taken with food.

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Precaution
Glaucoma, Epilepsy, Idiopathic intracranial hypertension, Altitude sickness
Side Effect
Renal impairment: Contraindicated in marked renal impairment.
Pregnancy Category Note
Drowsiness, paraesthesia, ataxia, dizziness, thirst, anorexia, headache; confusion, malaise, depression; GI distress, metabolic acidosis, polyuria, hyperuricaemia, renal calculi, nephrotoxicity, hepatic dysfunction. Potentially Fatal: Rarely, skin reactions or blood dyscrasias.

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Interaction
Hypersensitivity to sulphonamides; sodium or potassium depletion, hepatic insufficiency; hepatic cirrhosis; hyperchloraemic acidosis; severe renal impairment; severe pulmonary obstruction; chronic noncongestive angle-closure glaucoma; adrenocortical insufficiency. Pregnancy, lactation.