Effects of acetazolamide: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major research findings

Acetazolamide is a carbonic anhydrase inhibitor that has been used to treat various conditions, including altitude sickness, sleep apnea, and glaucoma. 4 、 11 、 9 、 8 、 7 、 6 、 5 、 2 、 3 、 1 、 10 Some studies have shown that acetazolamide can improve breathing control, reduce the severity of sleep apnea, and improve oxygenation at high altitudes. 11 、 1 Acetazolamide may also reduce pulmonary artery pressure at high altitudes and prevent high-altitude pulmonary edema, but its effects may be less pronounced than those of other medications such as dexamethasone, tadalafil, and nifedipine. 9 Acetazolamide may also help maintain the integrity of brain vascular endothelium and prevent homocysteine-induced disruption of the blood-brain barrier. 8 Furthermore, acetazolamide has been shown to have diuretic, natriuretic, and chloride-retaining effects in the treatment of volume overload associated with acute heart failure, and it has a good renal safety profile. 5 Acetazolamide has been shown to improve symptoms of altitude sickness and affect breathing control. 1 On the other hand, its preventive effect against high-altitude pulmonary edema may be less pronounced than that of other medications. 9 Acetazolamide has also been suggested to help maintain the integrity of brain vascular endothelium and prevent homocysteine-induced disruption of the blood-brain barrier. 8 Acetazolamide has been shown to have diuretic, natriuretic, and chloride-retaining effects in the treatment of volume overload associated with acute heart failure, and it has a good renal safety profile. 5 Acetazolamide did not show any effect on reducing the incidence of apnea in preterm infants. 2 Acetazolamide can affect performance on the Nagel II anomaloscope, potentially altering the sensitivity of cone cells. 3 Acetazolamide has also been suggested to have anti-proliferative effects on certain types of cancer cells. 10

Benefits and risks

Benefit Summary

Acetazolamide may be helpful for improving symptoms of altitude sickness and reducing the severity of sleep apnea. 11 、 1 It may also help maintain the integrity of brain vascular endothelium and prevent homocysteine-induced disruption of the blood-brain barrier. 8 Acetazolamide has been shown to have diuretic, natriuretic, and chloride-retaining effects in the treatment of volume overload associated with acute heart failure, and it has a good renal safety profile. 5 Acetazolamide has also been suggested to have anti-proliferative effects on certain types of cancer cells. 10

Risk Summary

Acetazolamide may cause side effects such as gastrointestinal symptoms, metabolic acidosis, kidney stones, and vision problems. 4 、 3 Its preventive effect against high-altitude pulmonary edema may be less pronounced than that of other medications. 9

Comparison between studies

Commonalities among studies

Multiple studies have shown that acetazolamide is a carbonic anhydrase inhibitor that is used to treat various conditions. 4 、 11 、 9 、 8 、 7 、 6 、 5 、 2 、 3 、 1 、 10 Many studies suggest that acetazolamide affects breathing control. 11 、 1 、 2

Differences between studies

The effects and side effects of acetazolamide, as well as its indications, administration methods, and so on, differ from study to study. For example, while some studies suggest that its preventive effect against high-altitude pulmonary edema may be less pronounced than that of other medications, 9 others show that it may help maintain the integrity of brain vascular endothelium. 8 The administration methods of acetazolamide also vary across studies, with different studies using oral, intravenous, and inhaled routes.

Consistency and contradictions in the results

Acetazolamide has been suggested to improve altitude sickness symptoms and reduce the severity of sleep apnea, but some studies, such as 9 , suggest that its preventive effect against high-altitude pulmonary edema may be less pronounced than that of other medications. There is also variability in reported side effects across studies.

Important considerations for real-world applications

While acetazolamide may be used to treat conditions like altitude sickness and sleep apnea, the appropriate treatment depends on the risks of side effects and the individual patient's condition. It is crucial to consult a doctor before using acetazolamide and to follow their instructions carefully.

Limitations of current research

Further research is needed to understand the long-term effects and safety of acetazolamide. More research is also needed to clarify how acetazolamide affects various conditions and the mechanisms involved.

Future research directions

Further research is needed to explore the long-term effects and safety of acetazolamide, as well as its effects on various conditions and the mechanisms involved. Specifically, more research is required to investigate its preventive effect against high-altitude pulmonary edema, its impact on brain vascular endothelium, and its anti-proliferative effects on various cancer cells. Studies exploring the combined effects of acetazolamide with other treatment methods are also necessary.

Conclusion

Acetazolamide may be used to treat conditions like altitude sickness and sleep apnea. However, the appropriate treatment depends on the risks of side effects and the individual patient's condition. It is crucial to consult a doctor before using acetazolamide and to follow their instructions carefully. Further research is needed to understand the long-term effects and safety of acetazolamide, as well as its effects on various conditions and the mechanisms involved.

Literature analysis of 11 papers
Positive Content
9
Neutral Content
1
Negative Content
1
Article Type
4
2
1
0
11
1.

The effects of acetazolamide on the ventilatory response to high altitude hypoxia.

Author: BurkiN K, KhanS A, HameedM A

AMS symptom relief
Improved oxygenation

Acetazolamide, a carbonic anhydrase inhibitor, improved oxygenation in subjects exposed to acute high altitude. While it did not affect CO2 chemosensitivity, it increased ventilation and oxygenation at high altitude.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Comparison of the effects of acetazolamide and aminophylline on apnea incidence and on ventilatory response to CO2 in preterm infants.

Author: CordobaE, GerhardtT, RojasM, DuaraS, BancalariE

Augments ventilatory response
Reduced apnea frequency
Decreased pH

Acetazolamide reduced sleep apnea in preterm infants, but did not significantly improve the ventilatory response to CO2. Aminophylline effectively reduced apnea frequency with no significant change in the ventilatory response to CO2.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Acetazolamide affects performance on the Nagel II anomaloscope.

Author: LeysM J, van SlyckenS, NorkT M, OdomJ V

Sensitivity loss reversible
Color vision sensitivity loss

Acetazolamide, a carbonic anhydrase inhibitor, alters the sensitivity of cone populations, particularly the carbonic anhydrase-containing cones. This sensitivity loss is reversible and not clinically significant but suggests that patients on acetazolamide should be excluded from studies comparing color vision in glaucomatous patients to normals.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

4.

Side effects of acetazolamide: a systematic review and meta-analysis assessing overall risk and dose dependence.

Author: SchmicklChristopher N, OwensRobert L, OrrJeremy E, EdwardsBradley A, MalhotraAtul

Side effects

The risk of commonly reported side effects of acetazolamide (AZM) was estimated through meta-analyses. The study found that the risk of these side effects is dose-dependent.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Early effects of acetazolamide on hemoglobin mass and plasma volume in chronic mountain sickness at 5100 m.

Author: ChampigneulleB, StaufferE, RobachP, DoutreleauS, HoweC A, PinaA, Salazar-GranaraA A, HanccoI, GuergourD, BrugniauxJ V, ConnesP, PichonA, VergesS

Reduced Hct

This study assessed the early efficacy of acetazolamide (ACZ) and atorvastatin to reduce hematocrit (Hct) in individuals with Chronic Mountain Sickness (CMS) living in La Rinconada, Peru, the highest city in the world. The study aimed to investigate the underlying mechanisms focusing on intravascular volumes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Effects of acetazolamide on pulmonary artery pressure and prevention of high-altitude pulmonary edema after rapid active ascent to 4,559 m.

Author: BergerMarc Moritz, SarebanMahdi, SchieferLisa Maria, SwensonKai E, TreffFranziska, SchäferLarissa, SchmidtPeter, SchimkeMagdalena M, PaarMichael, NiebauerJosef, CogoAnnalisa, KriemlerSusi, SchweryStefan, PickerodtPhilipp A, MayerBenjamin, BärtschPeter, SwensonErik R

Improved arterial oxygenation
Reduced AMS severity
HAPE prevention ineffective

This randomized, placebo-controlled, double-blind study investigated the efficacy of acetazolamide for preventing high-altitude pulmonary edema (HAPE) in 13 healthy, nonacclimatized lowlanders ascending rapidly to 4,559 m. While acetazolamide showed a non-statistically significant reduction in HAPE incidence, it did not significantly reduce pulmonary artery pressure compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Antiproliferative effects of sulphonamide carbonic anhydrase inhibitors C18, SLC-0111 and acetazolamide on bladder, glioblastoma and pancreatic cancer cell lines.

Author: MussiSilvia, RezzolaSara, ChiodelliPaola, NocentiniAlessio, SupuranClaudiu T, RoncaRoberto

Cancer treatment

Carbonic anhydrase IX/XII are enzymes found on cancer cells. This study compares the inhibitory and antiproliferative effects of different drugs targeting these enzymes in various cancer cell lines.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Effects of acetazolamide on control of breathing in sleep apnea patients: Mechanistic insights using meta-analyses and physiological model simulations.

Author: SchmicklChristopher N, LandryShane, OrrJeremy E, NokesBrandon, EdwardsBradley A, MalhotraAtul, OwensRobert L

Loop gain reduction
Sleep apnea treatment

Obstructive and central sleep apnea affects billions globally and is linked to cardiovascular and neurocognitive issues. High loop gain (ventilatory instability) is a major underlying mechanism and can be pharmacologically lowered with acetazolamide, improving sleep apnea severity. However, individual responses vary. This study aimed to understand factors influencing loop gain reduction following acetazolamide. Meta-analyses revealed acetazolamide primarily reduces plant gain by shifting chemosensitivity without significantly affecting controller gain. Physiological model simulations showed that higher baseline controller gain, paCO2, and lower CO2 production resulted in more pronounced loop gain reduction. These findings provide a framework for understanding acetazolamide's effects on ventilatory control and identifying potential predictors of response.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

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