methazolamide (Neptazane)
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Introduction
Tradename: Neptazane.
Indications
- adjunctive treatment of open angle or secondary glaucoma
- short-term treatment of narrow-angle glaucoma when delay of surgery is indicated
- open-angle glaucoma[4]
Dosage
Tabs: 25 mg, 50 mg.
Pharmacokinetics
- absorbed slowly from the GI tract
- distributed into many body tissues
- partially metabolized by liver
- 20-30% of the drug is excreted in the urine
elimination via liver
elimination via kidney
Adverse effects
- common (> 10%)
- metallic taste, anorexia, increased urination, malaise, weakness
- less common (1-10%)
- uncommon (< 1%)
- loss of smell, headache, constipation, trembling, tinnitus, myopia, hypokalemia, hypersensitivity, seizures, unsteadiness, melena, paresthesias, fatigue, fever, rash*, metabolic acidosis, hyperglycemia, GI irritation, dry mouth, bone marrow suppression, dysuria, Stevens-Johnson syndrome
- other
- nausea/vomiting
- diarrhea
- sedation
- sulfonamide hypersensitivity reactions
- decrease in uric acid secretion
- bone marrow suppression (rare)
- hemolytic anemia
* rash may be due to sulfa allergy
- drug adverse effects of sulfonamides
- drug adverse effects of diuretics
- drug adverse effects of carbonic anhydrase inhibitor(s)
- drug adverse effects of antihypertensive agents
Drug interactions
- methazolamide increases lithium excretion
- alkalinzation of urine may decrease excretion of:
- enhanced diuretic activity in combination with other diuretics
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) SGLT2 inhibitors (flozins) with diuretics
- drug interaction(s) of diuretics in combination with Zn+2
- drug interaction(s) of antiarrhythmic agents in combination with diuretics
- drug interaction(s) of calcium channel blockers with diuretics
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of diuretics with angiotensin II receptor antagonists
- drug interaction(s) of diuretics with ACE inhibitors
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
Mechanism of action
- inhibitor of carbonic anhydride
- diuretic useful for alkalinization of urine
- decreases formation of aqueous humor
- lowers intraocular pressure
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 8th ed. Gilman et al, eds. Permagon Press/McGraw Hill pg 716
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ 4.0 4.1 Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Deprecated Reference