Acetazolamide interactions
Acetazolamide (Diamox), a carbonic anhydrase inhibitor has 216 documented interactions across the FDA labels and fact sheets we index: 31 major, 164 moderate, 20 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (31)
Caution is advised for patients receiving concomitant high-dose aspirin and acetazolamide, as anorexia, tachypnea, lethargy, metabolic acidosis, coma, and death have been reported. (Acetazolamide label, Warnings)
- Aspirin and dipyridamoleantiplatelet agentMajor
Caution is advised for patients receiving concomitant high-dose aspirin and acetazolamide, as anorexia, tachypnea, lethargy, metabolic acidosis, coma, and death have been reported. (Acetazolamide label, Warnings)
- Bisoprolol and hydrochlorothiazidebeta blockerMajor
CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)
• In patients who have demonstrated allergic-type reactions to sulfonamides [ see Warnings and Precautions (5.7) ]. (Celecoxib label, Contraindications)
THALITONE is contraindicated in patients with anuria or hypersensitivity to chlorthalidone or other sulfonamide-derived drugs. (Chlorthalidone label, Contraindications)
- CyclosporineimmunosuppressantMajor
Potassium-Sparing Diuretics Cyclosporine should not be used with potassium-sparing diuretics because hyperkalemia can occur. (Cyclosporine label, Drug interactions)
- DofetilideantiarrhythmicMajor
In the DIAMOND trials, 1252 patients were treated with dofetilide and diuretics concomitantly, of whom 493 died compared to 508 deaths among the 1248 patients receiving placebo and diuretics. (Dofetilide label, Drug interactions)
- Dutasteride and tamsulosin5-alpha reductase inhibitorMajor
If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin-containing products, including JALYN. (Dutasteride and tamsulosin label, Warnings and precautions)
- Empagliflozin and metforminSGLT2 inhibitorMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Empagliflozin and metformin label, Boxed warning)
- Ethacrynic acidloop diureticMajor
Like other diuretics it may precipitate hepatic coma and death. (Ethacrynic acid label, Warnings)
- GentamicinaminoglycosideMajor
The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. (Gentamicin label, Boxed warning)
• Sulfonamide derivatives: Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride tablets.Do not use glimepiride tablets in patients who have a history of an allergic reaction to sulfonamide derivatives. (Glimepiride label, Contraindications)
• Hypersensitivity to sulfonamide derivatives. ▪ Known hypersensitivity to glipizide or any of the product's ingredients ( 4 ). ▪ Hypersensitivity to sulfonamide derivatives ( 4 ). (Glipizide label, Contraindications)
- Glyburide and metforminsulfonylureaMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g. , acute congestive heart failure), excessive alcohol intake, hepatic… (Glyburide and metformin label, Boxed warning)
In patients with hypersensitivity to sulfonamide-derived drugs. (Hydrochlorothiazide label, Contraindications)
- Indapamidethiazide diureticMajor
Known hypersensitivity to indapamide or to other sulfonamide-derived drugs. (Indapamide label, Contraindications)
Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorMajor
Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Lisinopril and hydrochlorothiazide label, Contraindications)
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic… (Metformin label, Boxed warning)
- MinoxidilvasodilatorMajor
Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)
- NeomycinaminoglycosideMajor
The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. (Neomycin label, Boxed warning)
- Phentermine and topiramateCNS stimulantMajor
Avoid use of phentermine and topiramate extended-release capsules with other carbonic anhydrase inhibitors. (Phentermine and topiramate label, Warnings and precautions)
- Pioglitazone and metforminthiazolidinedioneMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
…sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include patients with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. (Quinapril label, Warnings)
- Sitagliptin and metforminDPP-4 inhibitorMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Sitagliptin and metformin label, Boxed warning)
- Sodium bicarbonateantacidMajor
Sodium bicarbonate injection is contraindicated in patients who are losing chloride by vomiting or from continuous gastrointestinal suction and in patients receiving diuretics known to produce a hypochloremic alkalosis. (Sodium bicarbonate label, Contraindications)
- Spironolactone and hydrochlorothiazidealdosterone antagonistMajor
CONTRAINDICATIONS Spironolactone and hydrochlorothiazide tablets are contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, hypercalcemia, hyperkalemia, Addison's disease, and in patients who are allergic to thiazide diuretics or to other sulfonamide-derived drugs. (Spironolactone and hydrochlorothiazide label, Contraindications)
If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin hydrochloride capsules. (Tamsulosin label, Warnings and precautions)
Kidney stones: avoid use with other carbonic anhydrase inhibitors, other drugs causing metabolic acidosis, or in patients on a ketogenic diet ( 5.16 ) (Topiramate label, Warnings and precautions)
Hypersensitivity Hypersensitivity to either drug in the preparation or to other sulfonamide-derived drugs is a contraindication. (Triamterene and hydrochlorothiazide label, Contraindications)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major
Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)
Moderate interactions (164)
- AcarboseantidiabeticModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Diuretics: Use with caution. (Albuterol label, Drug interactions)
- AliskirenantihypertensiveModerate
Risk factors for the development of hyperkalemia include renal insufficiency, diabetes, combination use with ARBs or ACEIs [see Contraindications (4) , Warnings and Precautions (5.2) , and Clinical Studies (14.3) ] , NSAIDs, or potassium supplements or potassium sparing diuretics. (Aliskiren label, Warnings and precautions)
Hypersensitivity reactions to allopurinol tablets may be increased in patients with decreased kidney function receiving thiazide diuretics and allopurinol tablets concurrently. (Allopurinol label, Warnings and precautions)
Give special attention to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or in patients receiving concomitant diuretics and laxatives. (Amiodarone label, Warnings and precautions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Symptomatic hypotension is most likely to occur in patients who have heart failure, severe aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy or have been volume or salt depleted as a result of diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. (Amlodipine and benazepril label, Warnings and precautions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
- ArmodafinilCNS stimulantModerate
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
- Azilsartanangiotensin II receptor blocker (ARB)Moderate
Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with azilsartan medoxomil. (Azilsartan label, Warnings and precautions)
Patients at risk of excessive hypotension include those with the following conditions or characteristics: heart failure with systolic blood pressure below 100 mm Hg, ischemic heart disease, cerebrovascular disease, hyponatremia, high dose diuretic therapy, renal dialysis, or severe volume and/or salt depletion of any etiology. (Benazepril label, Warnings and precautions)
- BrivaracetamanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- Budesonide and formoterolcorticosteroidModerate
Diuretics: Use with caution. (Budesonide and formoterol label, Drug interactions)
Like other members of this class of diuretics, bumetanide probably shares this risk. (Bumetanide label, Warnings)
Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine label, Drug interactions)
Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)
- Butalbital, acetaminophen, and caffeinebarbiturateModerate
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- Candesartanangiotensin II receptor blocker (ARB)Moderate
Symptomatic hypotension is most likely to occur in patients who have been volume and/or salt depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. (Candesartan label, Warnings and precautions)
- Cannabidiol (prescription)anticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- CaptoprilACE inhibitorModerate
Hypotension Excessive hypotension was rarely seen in hypertensive patients but is a possible consequence of captopril use in salt/volume depleted persons (such as those treated vigorously with diuretics), patients with heart failure or those patients undergoing renal dialysis. (Captopril label, Warnings)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)
- CenobamateanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- ChlorpromazineantipsychoticModerate
Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Chlorpromazine label, Precautions)
- Cholestyraminebile acid sequestrantModerate
Drug Interactions Cholestyramine for Oral Suspension USP may delay or reduce the absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics (acidic), or propranolol (basic), as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins, and digitalis. (Cholestyramine label, Drug interactions)
Elderly patients, patients taking diuretics, and those who are volume depleted may be at greater risk for developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Citalopram label, Warnings and precautions)
- ClobazambenzodiazepineModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- ClozapineantipsychoticModerate
Hypokalemia can result from diuretic therapy, diarrhea, and other causes. (Clozapine label, Warnings and precautions)
- CodeineopioidModerate
Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Codeine label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- DesmopressinModerate
…Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)
- DesvenlafaxineSNRIModerate
Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk [see Use in Specific Populations (8.5) and Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Warnings and precautions)
- Dexlansoprazoleproton pump inhibitorModerate
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Dexlansoprazole label, Warnings and precautions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. (Diclofenac label, Warnings and precautions)
Serum potassium levels should be carefully monitored when digoxin is given to patients at high risk of hypokalemia ( e.g. , those receiving diuretics, corticosteroids, or other drugs that commonly lead to potassium loss; those with gastrointestinal losses through diarrhea, vomiting, or nasogastric suction; or those with potassium-losing endocrinopathies or nephropathies). (Digoxin label, Warnings and precautions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- Dorzolamidecarbonic anhydrase inhibitorModerate
Because of possible additive effects with other carbonic anhydrase inhibitors, concomitant use is not advisable. (Acetazolamide label, Drug interactions)
- Dorzolamide and timololcarbonic anhydrase inhibitorModerate
Because of possible additive effects with other carbonic anhydrase inhibitors, concomitant use is not advisable. (Acetazolamide label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveModerate
Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Duloxetine label, Warnings and precautions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Patients at risk of excessive hypotension include those with the following conditions or characteristics: heart failure with systolic blood pressure below 100 mmHg, ischemic heart disease, cerebrovascular disease, hyponatremia, high dose diuretic therapy, renal dialysis, or severe volume and/or salt depletion of any etiology. (Enalapril label, Warnings and precautions)
- EpinephrinesympathomimeticModerate
…Precautions (5.6) and Adverse Reactions (6) ]. β-blockers, such as propranolol Cyclopropane or halogenated hydrocarbon anesthetics, such as halothane Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline… (Epinephrine label, Drug interactions)
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Escitalopram label, Warnings and precautions)
- EslicarbazepineanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Esomeprazole label, Warnings and precautions)
- EthosuximideanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Patients at greater risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors, and the elderly. (Etodolac label, Warnings)
- ExenatideGLP-1 receptor agonistModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- FelbamateanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
…treatment with Class 1 and Class III antiarrhythmics, 4) treatment with monoamine oxidase inhibitors (MAOI's), 5) concomitant treatment with other drug products known to prolong the QT interval and 6) electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs (e.g., diuretics) that may cause electrolyte imbalance. (Fentanyl label, Warnings and precautions)
An effect of this magnitude should not necessitate a change in the fluconazole dose regimen in subjects receiving concomitant diuretics. (Fluconazole label, Drug interactions)
- FludrocortisonecorticosteroidModerate
Amphotericin B or potassium-depleting diuretics (benzothiadiazines and related drugs, ethacrynic acid and furosemide)—enhanced hypokalemia. (Fludrocortisone label, Drug interactions)
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Fluoxetine label, Warnings and precautions)
Diuretics: Use with caution. (Fluticasone and salmeterol label, Drug interactions)
- FluvoxamineSSRIModerate
Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)
Acetazolamide may increase the effects of other folic acid antagonists. (Acetazolamide label, Drug interactions)
- Formoterolbeta-adrenergic agonistModerate
• Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Formoterol label, Drug interactions)
- FosinoprilACE inhibitorModerate
Symptomatic hypotension is most likely to occur in patients who have been volume- and/or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. (Fosinopril label, Warnings)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydrocodone and acetaminophen label, Drug interactions)
Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydromorphone label, Drug interactions)
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. (Ibuprofen label, Warnings and precautions)
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. (Indomethacin label, Warnings and precautions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- Insulin degludecinsulinModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- Insulin detemirinsulinModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- Insulin regular (human)insulinModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Hypotension in Volume or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initialization of treatment with AVAPRO. (Irbesartan label, Warnings and precautions)
Diuretics eplerenone The potential increase in plasma concentrations of eplerenone when coadministered with ketoconazole tablets may increase the risk of hyperkalemia and hypotension. (Ketoconazole label, Drug interactions)
Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors, and the elderly. (Ketorolac label, Warnings and precautions)
- LacosamideanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Lansoprazole label, Warnings and precautions)
- Levalbuterolbeta-adrenergic agonistModerate
Diuretics The ECG changes or hypokalemia that may result from the administration of non-potassium-sparing diuretics (such as loop and thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Levalbuterol label, Drug interactions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- LevomilnacipranSNRIModerate
Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)
- LevorphanolopioidModerate
Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Levorphanol label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- LinezolidantibioticModerate
Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking Linezolid injection. (Linezolid label, Warnings and precautions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Patients at risk of excessive hypotension include those with the following conditions or characteristics: heart failure with systolic blood pressure below 100 mmHg, ischemic heart disease, cerebrovascular disease, hyponatremia, high dose diuretic therapy, renal dialysis, or severe volume and/or salt depletion of any etiology. (Lisinopril label, Warnings and precautions)
Acetazolamide increases lithium excretion and the lithium may be decreased. (Acetazolamide label, Drug interactions)
Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with COZAAR. (Losartan label, Warnings and precautions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Losartan and hydrochlorothiazide label, Warnings and precautions)
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. (Meloxicam label, Warnings and precautions)
- MeperidineopioidModerate
Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Meperidine label, Drug interactions)
Closely monitor patients with risk factors for development of prolonged QT interval (e.g., cardiac hypertrophy, concomitant diuretic use, hypokalemia, hypomagnesemia), a history of cardiac conduction abnormalities, and those taking medications affecting cardiac conduction. (Methadone label, Warnings and precautions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Anticoagulants Metolazone, as well as other thiazide-like diuretics, may affect the hypoprothrombinemic response to anticoagulants; dosage adjustments may be necessary. (Metolazone label, Drug interactions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia [see Use in Specific Populations (8.5) ] . (Mirtazapine label, Warnings and precautions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
- MoexiprilACE inhibitorModerate
Symptomatic hypotension is most likely to occur in patients who have been salt- and volume- depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. (Moexipril label, Warnings)
Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Morphine label, Drug interactions)
Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics, and the elderly. (Nabumetone label, Warnings)
- Nadololbeta blockerModerate
Although beta-blockers should be avoided in overt congestive heart failure, if necessary, they can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Nadolol label, Warnings)
- NalbuphineopioidModerate
Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Nalbuphine label, Drug interactions)
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. (Naproxen label, Warnings and precautions)
- OliceridineopioidModerate
Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oliceridine label, Drug interactions)
Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin-aldosterone system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may be anticipated after initiation of treatment with Benicar. (Olmesartan label, Warnings and precautions)
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole label, Warnings and precautions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone label, Drug interactions)
Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone and acetaminophen label, Drug interactions)
- OxymorphoneopioidModerate
Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxymorphone label, Drug interactions)
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Pantoprazole label, Warnings and precautions)
Geriatric patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Paroxetine label, Warnings and precautions)
- Pentazocine and naloxoneopioidModerate
Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Pentazocine and naloxone label, Drug interactions)
- PerampanelanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- PerindoprilACE inhibitorModerate
Symptomatic hypotension is most likely to occur in patients who have been volume or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea or vomiting [see Dosage and Administration (2.1) ] . (Perindopril label, Warnings and precautions)
- PhenelzineMAO inhibitorModerate
…hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Acetazolamide modifies phenytoin metabolism with increased serum levels of phenytoin. (Acetazolamide label, Drug interactions)
- Pindololbeta blockerModerate
Although beta-blockers should be avoided in overt congestive heart failure, if necessary, pindolol tablets can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Pindolol label, Warnings)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Addition of a diuretic or other antihypertensive agent to prazosin hydrochloride capsules has been shown to cause an additive hypotensive effect. (Prazosin label, Drug interactions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Caution is advised when beginning, discontinuing, or changing the dose of acetazolamide in patients receiving primidone. (Acetazolamide label, Drug interactions)
Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Prochlorperazine label, Precautions)
- Rabeprazoleproton pump inhibitorModerate
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Rabeprazole label, Warnings and precautions)
Experience with another ACE inhibitor suggests that these increases would be reversible upon discontinuation of ramipril and/or diuretic therapy. (Ramipril label, Warnings and precautions)
- RepaglinidemeglitinideModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- RufinamideanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)
- Salmeterolbeta-adrenergic agonistModerate
• Diuretics: Use with caution. (Salmeterol label, Drug interactions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Sertraline label, Warnings and precautions)
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- SolriamfetolCNS stimulantModerate
Acetazolamide decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect. (Acetazolamide label, Drug interactions)
Special attention should be given to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or patients receiving concomitant diuretic drugs. (Sotalol label, Warnings and precautions)
…drugs that can increase potassium include: ACE inhibitors angiotensin receptor blockers aldosterone blockers non-steroidal anti-inflammatory drugs (NSAIDs) heparin and low molecular weight heparin trimethoprim 7.2 Lithium Like other diuretics, spironolactone oral suspension reduces the renal clearance of lithium, thus increasing the risk of lithium toxicity. (Spironolactone label, Drug interactions)
Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)
- Sumatriptan and naproxentriptanModerate
Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, salt depletion, those taking diuretics and angiotensin-converting enzyme (ACE) inhibitors or ARBs, and the elderly. (Sumatriptan and naproxen label, Warnings and precautions)
Concomitant use of agents associated with hyperkalemia (e.g., potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers) may increase the risk for hyperkalemia [see Adverse Reactions ( 6.1 )] . (Tacrolimus label, Warnings and precautions)
- TapentadolopioidModerate
…use of skeletal muscle relaxants and opioids, consider prescribing naloxone for the emergency treatment of opioid overdose [see Dosage and Administration (2.2) , Warnings and Precautions (5.2 , 5.3) ] Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tapentadol label, Drug interactions)
Hypotension In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of therapy with telmisartan tablets. (Telmisartan label, Warnings and precautions)
- Terbutalinebeta-adrenergic agonistModerate
Diuretics The ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Terbutaline label, Precautions)
- TiagabineanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- TirzepatideGLP-1 receptor agonistModerate
Consideration should be taken in patients being treated with antidiabetic agents. (Acetazolamide label, Drug interactions)
- TobramycinaminoglycosideModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
Lithium Like other diuretics, torsemide reduces the renal clearance of lithium, inducing a high risk of lithium toxicity. (Torsemide label, Drug interactions)
Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tramadol label, Drug interactions)
- TrandolaprilACE inhibitorModerate
Symptomatic hypotension is most likely to occur in patients who have been salt- or volume-depleted as a result of prolonged treatment with diuretics, dietary salt restriction, dialysis, diarrhea, or vomiting. (Trandolapril label, Warnings)
Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations (8.5) ] . (Trazodone label, Warnings and precautions)
- Triamterenepotassium-sparing diureticModerate
The effects of the following drugs may be potentiated when given together with triamterene: antihypertensive medication, other diuretics, preanesthetic and anesthetic agents, skeletal muscle relaxants (non-depolarizing). (Triamterene label, Drug interactions)
- Umeclidinium and vilanterolanticholinergicModerate
• Diuretics: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)
- Valproic acidanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan label, Warnings and precautions)
Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Venlafaxine label, Warnings and precautions)
Control patients with milder ventricular dysfunction, if possible, with optimum doses of digitalis and/or diuretics before verapamil treatment is started [see Drug Interactions ( 7.5 )] . (Verapamil label, Warnings and precautions)
- VigabatrinanticonvulsantModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations ( 8.5 )] . (Vilazodone label, Warnings and precautions)
Also, patients taking diuretics or who are otherwise volume-depleted can be at greater risk. (Vortioxetine label, Warnings and precautions)
Hypokalemia may result from diuretic therapy, diarrhea, and other causes. (Ziprasidone label, Warnings and precautions)
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
Minor mentions (20)
- AmantadineanticholinergicMinor
Urine pH is altered by diet, drugs (e.g., carbonic anhydrase inhibitors, sodium bicarbonate), and clinical state of the patient (e.g., renal tubular acidosis or severe infections of the urinary tract). (Amantadine label, Drug interactions)
- AmbrisentanMinor
Patients required intervention with a diuretic, fluid management, or, in some cases, hospitalization for decompensating heart failure. (Ambrisentan label, Warnings and precautions)
- Amoxicillinpenicillin antibioticMinor
Other Antibacterials Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with the bactericidal effects of penicillin. (Amoxicillin label, Drug interactions)
- Ampicillinpenicillin antibioticMinor
Bacteriostatic Antibiotics : Chloramphenicol, erythromycins, sulfonamides, or tetracyclines may interfere with the bactericidal effect of penicillins. (Ampicillin label, Drug interactions)
- BosentanCYP3A4 inducerMinor
Patients required intervention with a diuretic, fluid management, or hospitalization for decompensating heart failure. (Bosentan label, Warnings and precautions)
- DronedaroneantiarrhythmicMinor
Hypokalemia and Hypomagnesemia with Potassium-Depleting Diuretics Hypokalemia or hypomagnesemia may occur with concomitant administration of potassium-depleting diuretics. (Dronedarone label, Warnings and precautions)
- Finasteride5-alpha reductase inhibitorMinor
…clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives… (Finasteride label, Drug interactions)
- FlecainideantiarrhythmicMinor
Flecainide acetate has been used in a large number of patients receiving diuretics without apparent interaction. (Flecainide label, Drug interactions)
- ImatinibCYP3A4 inhibitorMinor
Weigh patients regularly and manage unexpected rapid weight gain by drug interruption and diuretics. (Imatinib label, Warnings and precautions)
- MacitentanMinor
Postmarketing cases of edema and fluid retention occurring within weeks of starting OPSUMIT, some requiring intervention with a diuretic or hospitalization for decompensated heart failure, have been reported [see Adverse Reactions (6.2) ] . (Macitentan label, Warnings and precautions)
- MemantineMinor
Urine pH is altered by diet, drugs (e.g. carbonic anhydrase inhibitors, sodium bicarbonate) and clinical state of the patient (e.g. renal tubular acidosis or severe infections of the urinary tract). (Memantine label, Drug interactions)
- MethylprednisolonecorticosteroidMinor
Amphotericin B injection and potassium-depleting agents : When corticosteroids are administered concomitantly with potassium-depleting agents (e.g., amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. (Methylprednisolone label, Drug interactions)
- Penicillin Gpenicillin antibioticMinor
Drug Interactions Bacteriostatic antibacterials ( i.e. , chloramphenicol, erythromycins, sulfonamides or tetracyclines) may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (Penicillin G label, Drug interactions)
- PentoxifyllinemethylxanthineMinor
Pentoxifylline extended-release tablets have been used concurrently with antihypertensive drugs, beta blockers, digitalis, diuretics, and antiarrhythmics, without observed problems. (Pentoxifylline label, Drug interactions)
- PrednisolonecorticosteroidMinor
Potassium-depleting agents (e.g., diuretics, Amphotericin B): When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia. (Prednisolone label, Drug interactions)
- PrednisonecorticosteroidMinor
Potassium-Depleting Agents (e.g., Diuretics, Amphotericin B) When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia. (Prednisone label, Drug interactions)
- Silver sulfadiazinesulfonamideMinor
There is a potential cross-sensitivity between silver sulfadiazine and other sulfonamides. (Silver sulfadiazine label, Warnings and precautions)
- TerbinafineantifungalMinor
There is no information available from adequate drug-drug interaction studies with the following classes of drugs: oral contraceptives, hormone replacement therapies, hypoglycemics, phenytoins, thiazide diuretics, and calcium channel blockers. (Terbinafine label, Drug interactions)
- TestosteroneandrogenMinor
In addition to discontinuation of the drug, diuretic therapy may be required. (Testosterone label, Warnings and precautions)
- TriamcinolonecorticosteroidMinor
Amphotericin B injection and potassium-depleting agents: When corticosteroids are administered concomitantly with potassium-depleting agents ( i.e., amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. (Triamcinolone label, Drug interactions)
No significant interaction reported (1)
- Bisoprololbeta blockerNo interaction
Pharmacokinetic studies document no clinically relevant interactions with other agents given concomitantly, including thiazide diuretics and cimetidine. (Bisoprolol label, Drug interactions)
Check Acetazolamide against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.