Last update June 25, 2020

Acetazolamide

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Carbonic anhydrase inhibitor diuretic that has been used in the treatment of glaucoma, intracraneal hypertension and some types of epilepsy.
Oral administration one to four times a day.

It is excreted in breast milk in clinically insignificant amounts and no problems have been observed in infants whose mothers have taken it (Ibrahim 2019, Söderman 1984). Plasma levels in these infants were very low (Söderman 1984).

Expert authors consider the use of Acetazolamide to be safe during breastfeeding (Belkin 2020, Hale 2019, Briggs 2017, Chen 2010, Schaefer 2007).
American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO/UNICEF 2002).

Alternatives

We do not have alternatives for Acetazolamide since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Acetazolamide is also known as


Acetazolamide in other languages or writings:

Groups

Acetazolamide belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Acetazolamide in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 95 %
Molecular weight 222 daltons
Protein Binding 98 %
VD 0.2 l/Kg
pKa 7.2 -
Tmax 2 - 3 hours
T½ 3 - 9 hours
M/P ratio 0.3 -
Theoretical Dose 0.3 mg/Kg/d
Relative Dose 1.8 %
Ped.Relat.Dose 1 - 3 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. Blumen-Ohana E, Sellem E. [Pregnancy & glaucoma: SFO-SFG recommendations]. J Fr Ophtalmol. 2020 Jan;43(1):63-66. Abstract
  3. Belkin A, Chen T, DeOliveria AR, Johnson SM, Ramulu PY, Buys YM; American Glaucoma Society and the Canadian Glaucoma Society.. A Practical Guide to the Pregnant and Breastfeeding Patient with Glaucoma. Ophthalmol Glaucoma. 2020 Mar - Apr;3(2):79-89. Abstract
  4. Ibrahim A, Hussain N. Brief report: Metabolic acidosis in newborn infants following maternal use of acetazolamide during pregnancy. J Neonatal Perinatal Med. 2019 Nov 16. Abstract
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  7. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  9. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  10. Söderman P, Hartvig P, Fagerlund C. Acetazolamide excretion into human breast milk. Br J Clin Pharmacol. 1984 Abstract

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