Systemic side effects of carbonic anhydrase inhibitors (Diamox)

Acetazolamide is a systemic carbonic anhydrase inhibitor (Diamox) that is often administered by mouth. With a pressure lowering effect of 30% to 40% it is the most potent drug at our disposal. Unfortunately, the many systemic side effects preclude its use in the long run. Therefore, Diamox is most often prescribed for short term control of high intraocular pressure,  either for transient  pressure spikes or a a temporary measure in patients waiting for other modalidties such as filtering surgery. Contra-indications for the use of Diamox include kidney or liver disease, suprarenal gland failure, and hyperchloremic acidosis