Methazolamide adverse effects

The carbonic anhydrase inhibitors, of which acetazol-amide (rINN), a non-competitive inhibitor, is the prototype, are not suitable for normal diuretic use, because tolerance soon develops. However, they are well suited to brief intermittent use, particularly in the relief of glaucoma and in the prevention of acute mountain sickness. Acetazolamide and methazolamide (rINN) should be used with caution in the long-term control of glaucoma because of its serious systemic adverse effects. However, brinzolamide (rINN) and dorzolamide (rINN) are available for long-term topical administration. 

On average, only 30% to 60% of patients are able to tolerate oral CAI therapy for prolonged periods. Intolerance to CAI therapy results most commonly from a symptom complex attributable to systemic acidosis and including malaise, fatigue, anorexia, nausea, weight loss, altered taste, depression, and decreased libido. Other adverse effects include renal calculi, increased uric acid, blood dyscrasias, diuresis, and myopia. Elderly patients do not tolerate CAIs as well as younger patients. The three available CAIs produce the same spectrum of adverse effects however, the drugs differ in the frequency and severity of the adverse effects listed. Acetazolamide (standard or sustained-release capsules) and methazolamide are considered the best-tolerated CAIs. 

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