Acetazolamide for Glaucoma: How It Works, Dosing, and Side Effects
Thinking about acetazolamide for glaucoma? Learn how it lowers eye pressure, when doctors use it, dosing, side effects, and what to expect in the UK.
Acetazolamide for Glaucoma: What It Does and How to Use It
If you’ve been told you have glaucoma, you know keeping eye pressure low is the top priority. One of the medicines doctors often prescribe is acetazolamide, a carbonic anhydrase inhibitor that works inside the eye to drain fluid faster. This article breaks down the basics—what the drug is, how it helps, proper dosing, and what to watch out for—so you can feel confident about your treatment.
How Acetazolamide Lowers Eye Pressure
Acetazolamide blocks an enzyme called carbonic anhydrase. That enzyme normally helps the eye produce aqueous humor, the fluid that fills the front part of the eye. When the enzyme is blocked, less fluid is made, and the existing fluid can drain out more easily. The result is lower intra‑ocular pressure (IOP), which slows the damage to the optic nerve that causes vision loss.
The drug comes in two main forms: oral tablets (usually 125‑250 mg) and a topical eye‑drop version called dorzolamide. Oral acetazolamide is used when a quick, strong pressure drop is needed, while the eye‑drop works well for long‑term maintenance. Some doctors combine both for stubborn cases.
Dosage, Side Effects & What to Watch For
Typical oral dosing starts at 125 mg once or twice a day. Your doctor may raise it to 250 mg twice daily if pressure stays high. The eye‑drop is usually one drop in each eye three times a day. Always follow the exact schedule your prescriber gives you—missing doses can let pressure creep back up.
Common side effects include a tingling feeling in the fingers or toes, mild nausea, and frequent urination. These happen because acetazolamide also affects the kidneys, making you lose a bit more water and salts. Most people find the symptoms fade after a few days as the body adjusts.
Serious reactions are rare but can include severe allergic rash, trouble breathing, or persistent fatigue. If any of these pop up, stop the medicine and call your eye doctor right away.
Because the drug changes acid‑base balance, it’s important to stay hydrated and watch your diet. Too much soda or salty foods can worsen side effects. If you have kidney disease, liver problems, or a history of sulfa‑allergy, tell your doctor—acetazolamide is a sulfonamide and might not be safe for you.
When you start acetazolamide, your doctor will schedule follow‑up appointments to measure IOP and run blood tests. These checks make sure the drug is doing its job without harming your kidneys or causing dangerous electrolyte shifts.
Finally, remember that medication is just one piece of glaucoma management. Keep your regular eye exams, use any prescribed eye‑drops as directed, and protect your eyes from injury. Pairing acetazolamide with a healthy lifestyle—good sleep, balanced diet, and no smoking—gives you the best chance to keep vision stable.
Bottom line: acetazolamide can be a powerful tool to lower eye pressure quickly and safely when used correctly. Follow dosing instructions, stay alert for side effects, and keep in close contact with your eye care team. With the right approach, you can manage glaucoma and protect your sight.