Acetazolamide, commonly known by the brand name Diamox, is a medication with a variety of applications. While it's not primarily a weight loss drug, some studies suggest it can lead to weight loss as a side effect. It is crucial to understand its uses, potential side effects, and interactions before considering it.
What is Acetazolamide?
ACETAZOLAMIDE is a medication that reduces swelling related to heart disease. It helps your kidneys remove more fluid and salt from your blood through the urine. It may also be used to treat conditions with increased pressure of the eye, such as glaucoma. It can be used with other medications to prevent and control seizures in people with epilepsy. It can also be used to prevent or treat symptoms of altitude sickness, working by increasing the amount of oxygen in your body. Acetazolamide belongs to a group of medications called diuretics.
According to Ravichandra Karkal, MD, and Rahyanath K., acetazolamide is a potent nonspecific inhibitor of carbonic anhydrase enzymes, which is a sulfa-like moiety. It has been in medical use since 1952. This generic drug is safe, effective, and economically priced and is included in the World Health Organization's list of essential drugs. Acetazolamide is available in both oral and intravenous forms.
Common Brand Names
Diamox.
What conditions is Acetazolamide used to treat?
Acetazolamide is indicated for several conditions, including:
Read also: Weight Loss Guide Andalusia, AL
- Centrencephalic epilepsies.
- Idiopathic intracranial hypertension.
- Secondary glaucoma.
- Preoperatively in acute angle closure glaucoma, where delaying surgery is necessary to lower intraocular pressure.
Takagi S, Watanabe Y, Imaoka T, et al. found that it appears to have a beneficial effect in psychogenic polydipsia.
Important Considerations Before Taking Acetazolamide
Before taking this medication, it's crucial to inform your healthcare team if you have any of the following conditions:
- Diabetes
- Glaucoma
- Kidney disease
- Liver disease
- Low adrenal gland function
- Lung or breathing disease, such as asthma or COPD
- An unusual or allergic reaction to acetazolamide, sulfa, other medications, foods, dyes, or preservatives
- Are pregnant or trying to get pregnant
- Breastfeeding
How to take Acetazolamide
Take this medication by mouth as directed on the prescription label, ideally at the same time every day. It can be taken with or without food. If it upsets your stomach, taking it with food may help. It is important to continue taking it unless your care team advises you to stop.
Potential Drug Interactions
Acetazolamide can interact with several medications, including:
- Methazolamide
- Aspirin and aspirin-like medications
- Cyclosporine
- Lithium
- Medications for diabetes
- Methenamine
- Other diuretics
- Phenytoin
- Primidone
- Quinidine
- Sodium bicarbonate
- Stimulant medications for ADHD, weight loss, or staying awake
This list may not be exhaustive, so it's important to provide your healthcare provider with a complete list of all medicines, herbs, non-prescription drugs, and dietary supplements you use. Also, inform them if you smoke, drink alcohol, or use illegal drugs, as these can also interact with the medication.
Read also: Beef jerky: A high-protein option for shedding pounds?
Precautions While Using Acetazolamide
While using this medication, regular check-ups with your care team are essential to monitor your progress. Let them know if your symptoms don't improve or if they worsen.
Acetazolamide may cause serious skin reactions. Contact your care team immediately if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips, or lymph nodes in your neck or under your arms.
This medication may affect your coordination, reaction time, or judgment. Avoid driving or operating machinery until you know how it affects you. Sit up or stand slowly to reduce the risk of dizziness or fainting.
Common and Serious Side Effects
Common adverse effects of acetazolamide include tingling, palinopsia, dizziness, diuresis, tiredness, confusion, anorexia, and weight loss.
Report any side effects to your care team as soon as possible, especially the following:
Read also: Inspiring Health Transformation
- Allergic reactions (skin rash, itching, hives, swelling of the face, lips, tongue, or throat)
- Aplastic anemia (unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising)
- High acid level (trouble breathing, unusual weakness or fatigue, confusion, headache, fast or irregular heartbeat, nausea, vomiting)
- Infection (fever, chills, cough, or sore throat)
- Kidney stones (blood in the urine, pain or trouble passing urine, pain in the lower back or sides)
- Liver injury (right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue)
- Low potassium level (muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, constipation)
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Some side effects, like blurry vision, change in taste, loss of appetite, and pain, tingling, or numbness in the hands or feet, usually do not require immediate medical attention but should be reported to your care team if they persist or are bothersome.
Acetazolamide and Weight Loss: What Does the Research Say?
While acetazolamide is not a primary weight loss medication, some studies have noted weight loss as a side effect. The connection between acetazolamide and weight loss is complex and not fully understood. It's crucial to approach this topic with caution and consult with healthcare professionals.
Studies on Weight Loss and Acetazolamide
Idiopathic Intracranial Hypertension (IIH): A national clinical trial found that acetazolamide, when combined with a weight loss plan, improves vision for patients with IIH who have mild visual loss. The study, funded by the National Eye Institute (NIH), showed that a weight reduction of five to 10 percent can help improve symptoms of IIH.
- Michael Wall, MD, noted that acetazolamide can help preserve and restore vision for women with IIH when combined with a comprehensive dietary and lifestyle modification plan.
Weight Loss Intervention in IIH: Weil R et al. conducted a study where patients with idiopathic intracranial hypertension and mild visual loss were assigned to either acetazolamide or placebo, all of whom received a 6-month telephone-based weight loss intervention. The participants lost an average of 5.9% of their initial body weight, aligning with the NHLBI guidelines for clinically significant health benefits.
Weight Loss and Papilledema Resolution: Johnson LN, Krohel GB, Madsen RW, et al. studied 15 female patients with idiopathic intracranial hypertension associated with obesity. Weight loss of 3.3% ± 0.5% was observed among patients with a one-grade change in papilledema, and 6.2% ± 0.6% was associated with a three-grade change in papilledema. Approximately 6% weight loss was associated with resolution of marked papilledema. Nine of the ten patients with complete resolution of papilledema also took acetazolamide.
Antipsychotic-Related Weight Gain: In some cases, acetazolamide has been used to counteract weight gain induced by antipsychotic drugs. One case reported that a young obese woman gained significant weight after starting risperidone and developed benign intracranial hypertension. Withdrawing risperidone and adding acetazolamide led to weight loss and improved her symptoms within a month.
Antipsychotic Effects: According to Inoue H, Hazama H, Hamazoe K, et al., acetazolamide has shown some beneficial effects in treating psychosis, with no risk of increasing the primary illness. In a study involving 30 patients with various forms of psychosis, acetazolamide (500-1000 mg) had therapeutic effects in approximately 70% of the patients, particularly those with puberal periodic psychosis, presenile atypical psychosis, and atypical psychosis.
Schizophrenia Treatment: Sacks W, Esser AH, Feitel B, et al. found that twenty-four chronic schizophrenia patients were treated successfully with the addition of acetazolamide plus thiamine to their unchanged existing therapies in a double-blind, placebo-controlled cross-over study.
Ophthalmologists' Concerns
Ophthalmologists have expressed concerns that acetazolamide may retard weight gain when given to children. A retrospective chart review by Sharan S, Dupuis A, Hébert D, et al. of 22 well children with glaucoma taking oral acetazolamide for 3 months or more showed poor weight gain in a small subset of children.
Potential Mechanisms of Weight Loss
The exact mechanisms by which acetazolamide may contribute to weight loss are not fully understood, but several factors may be involved:
- Diuresis: Acetazolamide is a diuretic, meaning it increases the excretion of water and electrolytes through the urine. This can lead to a temporary reduction in body weight due to fluid loss.
- Appetite Suppression: Some individuals may experience a loss of appetite (anorexia) as a side effect of acetazolamide, which can contribute to reduced calorie intake and weight loss.
- Metabolic Effects: Acetazolamide inhibits carbonic anhydrase enzymes, which play a role in various metabolic processes. Inhibition of these enzymes may influence energy metabolism and contribute to weight loss.
Cautions and Considerations
- Not a Primary Weight Loss Drug: Acetazolamide is not approved or intended for use as a primary weight loss medication. Its use for weight loss should only be considered under the guidance and supervision of a qualified healthcare professional.
- Potential Side Effects: Acetazolamide can cause a range of side effects, some of which can be serious. It's essential to weigh the potential benefits against the risks and discuss any concerns with your doctor.
- Underlying Medical Conditions: Acetazolamide is contraindicated in certain medical conditions, such as kidney disease, liver disease, and electrolyte imbalances. It's crucial to disclose your full medical history to your healthcare provider before taking this medication.
- Drug Interactions: Acetazolamide can interact with various medications, potentially leading to adverse effects. Be sure to inform your doctor about all the medications, supplements, and herbal products you are taking.
Alternatives to Acetazolamide for Weight Loss
If you are considering weight loss options, numerous strategies and medications are safer and more effective than using acetazolamide off-label. Some alternatives include:
- Lifestyle Modifications: Diet and exercise are the cornerstones of weight loss. A balanced diet, regular physical activity, and behavior modification techniques can lead to sustainable weight loss.
- Weight Loss Medications: Several FDA-approved weight loss medications are available, such as orlistat, phentermine, liraglutide, and semaglutide. These medications work through different mechanisms to reduce appetite, increase satiety, or block fat absorption.
- Surgical Procedures: Bariatric surgery, such as gastric bypass and sleeve gastrectomy, may be an option for individuals with severe obesity who have not been successful with other weight loss methods.