Warnings

Acetazolamide

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 28, 2025

Warnings

Acetazolamide Risks, Warnings, and Complications

Acetazolamide can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for your condition if you are at an increased risk of adverse reactions from this medication. Some of the potential risks associated with acetazolamide use include:

ALLERGIC REACTIONS TO SULFONAMIDES: Acetazolamide belongs to a group called sulfa drugs or sulfonamides. There are rare reports of severe allergic reactions to these drugs, including toxic epidermal necrolysis, Stevens-Johnson syndrome, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias. Before starting acetazolamide therapy, tell your doctor if you have a sulfa allergy.
ACID-BASE BALANCE AND ELECTROLYTE CHANGES: This drug affects electrolyte levels and the acid base balance in the body. Taking acetazolamide can therefore put you at risk of electrolyte imbalance including hyponatremia (low sodium), hypokalemia (low potassium), and metabolic acidosis or hyperchloremic acidosis (too much acid). Risk factors include kidney problems, lung problems or breathing difficulties, diabetes, and older age above 65.
Call your doctor without delay if you develop nausea, fatigue, weakness, muscle cramps, fast breathing, or confusion.
EFFECTS ON BLOOD SUGAR LEVELS: Acetazolamide can affect blood sugar levels. People with diabetes should talk to their health care provider about how often they should monitor blood sugar levels while on acetazolamide. Call your doctor if you notice higher-than-usual blood sugar levels. Make sure you can recognize hypoglycemia (low blood sugar)—signs and symptoms can include hunger, anxiety, clammy skin, and a fast heartbeat.
DRUG INTERACTIONS: Taking acetazolamide with other drugs such as aspirin can cause tiredness, loss of appetite, breathing problems, coma, and even death.
PREGNANCY RISKS: Animal studies suggest that acetazolamide can cause harm to an unborn baby. There aren’t enough studies in humans, but because of a potential risk of fetal harm, acetazolamide should only be used during pregnancy if absolutely necessary.

Precautions Before Starting Acetazolamide

Tell your doctor if you have ever had an allergic reaction to acetazolamide, any of the active or inactive ingredients in acetazolamide tablets, sulfa drugs, diuretics (water pills), any other carbonic anhydrase inhibitor (for example, dorzolamide, methazolamide, brinzolamide, or zonisamide), or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, nutritional supplements, and herbal products. This can help avoid possible interactions between acetazolamide and your other medicines.

Give your doctor a complete medical history. Acetazolamide may not be safe for people with certain medical problems, such as diabetes, heart disease, liver disease, or kidney disease.

Tell your health care professional if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk.

Precautions During Use of Acetazolamide

Keep all your medical and laboratory appointments during acetazolamide therapy.

Taking acetazolamide can make you drowsy. Do not drive, operate machinery, or participate in any hazardous activities until you know how this medicine affects you. Alcohol can make these side effects worse.

Acetazolamide can increase your skin’s sensitivity to sunlight. Wear protective clothing and sunscreen to lower your risk of sunburn.

Tell your doctor if you become pregnant while on acetazolamide.

Tell all your healthcare professionals you are on acetazolamide, especially before any procedure, including dental treatments.

Acetazolamide Drug Interactions

Other medicines can affect the efficacy of acetazolamide. Taking acetazolamide with other drugs can increase your risk of severe adverse effects. The following medications and acetazolamide interact:

Aspirin
Amphetamines
Diuretics or water pills
Antidepressants
Cyclosporine (Neoral, Sandimmune)
Medications used to treat an irregular heartbeat
Non-steroidal anti-inflammatory drugs such as diflunisal (Dolobid)
Heart medications such as digoxin (Lanoxin)
Antimanic agents such as lithium (Eskalith, Lithobid)
Antiseizure drugs such as phenobarbital, phenytoin, and primidone (Mysoline)
Antacids
Vitamins

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational or illegal drugs because some of these substances can cause serious health complications when used with prescription medications.

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