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Methazolamide is an effective carbonic anhydrase inhibitor primarily used to manage glaucoma by lowering intraocular pressure and reducing the risk of vision loss. This FDA-approved medication comes in 25 and 50mg tablets and is suitable for adults and children, with dosages adjusted for specific needs. It works by decreasing bicarbonate production, thus reducing fluid formation in the eye. Common side effects comprise of nausea, dizziness, and changes in taste, with more severe reactions like allergic symptoms and liver issues possible. Methazolamide should be used under strict medical guidance to avoid complications such as overdose and interactions with other drugs like high-dose aspirin. Always store it properly and consult with a healthcare provider for personalized usage instructions.

Methazolamide Overview

Used chiefly in glaucoma therapy, Methazolamide acts as a robust carbonic anhydrase inhibitor to decrease intraocular pressure. Its active ingredient, Methazolamide, helps decrease fluid production in the eye, which can effectively manage and prevent vision loss associated with elevated eye pressure. Approved by the FDA, Methazolamide alters the production of bicarbonate ions, reducing aqueous humor formation and aiding in conditions like altitude sickness by modifying blood pH levels.

Available in tablet form, Methazolamide comes in 25mg and 50mg strengths. It’s typically taken orally, with or without food, and is suitable for adults and children, though dosages for children are carefully adjusted based on body weight. For adults, the common dosage ranges from 50 to 100 mg, taken two to three times a day, with a maximum of 200 mg three times daily. The medication inhibits the enzyme responsible for fluid production in the eye and various other processes influenced by bicarbonate levels.

While Methazolamide is generally well-tolerated, it can result in side effects like nausea, dizziness, and changes in taste. More severe reactions may include allergic responses, vision changes, and symptoms of liver issues. It’s crucial to follow dosing instructions carefully to avoid complications such as overdose, which can lead to serious health concerns like electrolyte imbalance and respiratory problems. Store the medication at room temperature away from moisture and light, and ensure it’s kept out of reach of children. Patients should discuss all potential interactions and contraindications with their healthcare provider, especially if they have a history of sulfa drug allergies or are using high-dose aspirin.

Uses of Methazolamide 

  • Glaucoma

Methazolamide Dosage

This medication comes as a tablet and has the following strengths.


  • 25mg
  • 50mg

Recommended Dosage for Different Patients/Methazolamide


  • For Glaucoma: The typical adult dosage for treating glaucoma is 50 to 100 mg of Methazolamide two to three times per day. The maximum recommended dosage is 200 mg three times per day.


  • For Glaucoma: Methazolamide is used cautiously in pediatric patients, with doses carefully calculated based on body weight and the child’s condition. It’s essential to consult a pediatric ophthalmologist or specialist for precise dosing.

Elderly Patients:

  • Elderly patients may need lower doses due to potentially decreased kidney function and other age-related changes that affect drug metabolism and excretion. Dosing in elderly patients should start at the lower end of the dosing range and be adjusted based on tolerance and effectiveness.

Patients with Kidney or Liver Disease:

  • For those with kidney impairment: Methazolamide should be used with caution, and doses may need to be lowered to prevent accumulation of the drug and toxicity since the kidneys primarily eliminate Methazolamide.
  • For those with liver disease: Caution is also advised as metabolic acidosis may be exacerbated by liver dysfunction.

Pregnant or Breastfeeding Women:

  • Methazolamide should be used during pregnancy only if the benefit justifies the probable risk to the fetus. It is unknown if Methazolamide passes into breast milk; consult your healthcare provider for guidance before use if you are breastfeeding.


[Note: Remember, these recommendations may vary from person to person. Discuss it with your medical expert, and they’ll customize your dosage accordingly.]

How to Take Methazolamide?

  • Take Methazolamide Precisely as prescribed by your certified medical expert. Do not take it in larger or smaller amounts or longer than recommended.
  • Methazolamide is typically taken orally with a glass of water. Depending on your doctor’s instructions, it can be taken with or without food.
  • The frequency of doses will depend on the condition being treated. Your doctor will provide a schedule that you should follow closely.
  • Continue taking the medication for the full prescribed length of time, even if symptoms improve. Abruptly stopping the medication can lead to complications.
  • Regular check-ups with your healthcare expert are important to monitor your condition and the efficacy of the treatment. Your doctor may customize your dose based on your response to the medication.
  • Be aware of possible side effects & contact your doctor if you experience significant or concerning symptoms.
  • Inform your doctor about all other medications you are taking, as Methazolamide can interact with other drugs, potentially causing adverse effects.

[Note: The appropriate dosage for you will be determined by your medical expert, who will consider your specific condition and the relevant drug guidelines and research. Adjustments may be made over time as necessary.]

How Does Methazolamide Work?

Methazolamide works by inhibiting an enzyme called carbonic anhydrase. This enzyme is crucial for producing bicarbonate ions in the body. By blocking this enzyme, Methazolamide reduces bicarbonate production, increasing the excretion of bicarbonate, sodium, water, and potassium in the urine. This action helps to decrease the production of aqueous humor (fluid in the eye) and reduces intraocular pressure, which is beneficial in treating conditions like glaucoma. Additionally, by altering the bicarbonate levels in the blood, Methazolamide can help manage and prevent altitude sickness by helping to balance the pH of the blood, making it more acidic and stimulating breathing.

Important Safety Information

Methazolamide Side Effects

Common side effects of Methazolamide may include:

  • Nausea
  • Changes in taste
  • Dizziness
  • Confusion
  • Tremor
  • Constipation
  • Vomiting
  • Fatigue
  • Headache
  • Weakness
  • Increased urination
  • Decreased appetite
  • Diarrhea
  • Worsening gout
  • Drowsiness
  • Increased sensitivity of the skin to sunlight
  • Loss of blood sugar control (if you are diabetic)
  • Changes in vision
  • Ringing in your ears (tinnitus) or hearing problems
  • Tingling feeling in the extremities
  • A general feeling of being unwell (malaise)

Serious side effects of Methazolamide may include:

  • Allergic reactions (e.g., rash, itching, swelling)
  • Severe dizziness or drowsiness
  • Vision changes (e.g., blurred vision, eye pain)
  • Signs of liver problems (e.g., persistent nausea, stomach/abdominal pain, yellowing eyes/skin)
  • Signs of a severe allergic reaction (e.g., rash, itching/swelling, severe dizziness, trouble breathing)

[Note: Remember that not all possible side effects are listed here. Always speak with your healthcare expert for guidance on side effects.]

Methazolamide Warnings

  • History of sulfa medication allergy: Rarely, methazolamide users may experience severe allergic reactions leading to severe skin rashes, liver damage, and blood disorders. Inform your provider and pharmacist about any medication allergies, particularly sulfa drugs. Seek immediate medical assistance if you observe signs of an allergic reaction, such as hives, blistered or peeling skin, difficulty breathing, or tongue or throat swelling.
  • Regular high-dose aspirin use: Notify your provider if you use daily aspirin and specify the dosage. Methazolamide, a carbonic anhydrase inhibitor, can interact with aspirin, especially at high doses. This combination may cause symptoms like decreased appetite, rapid breathing, fatigue, or coma.

Methazolamide Precautions

  • Inform your medical expert about any allergies you have, including allergies to Methazolamide or its inactive ingredients, which might lead to allergic reactions or other health issues.
  • Before starting Methazolamide, disclose your medical history to your healthcare provider, especially if you have adrenal gland problems (e.g., Addison’s disease), liver disease (e.g., cirrhosis), respiratory issues (e.g., COPD, emphysema), diabetes, gout, kidney problems (e.g., kidney stones), mineral imbalances (e.g., low sodium/potassium, hyperchloremic acidosis), or hyperthyroidism.
  • This medication may cause dizziness or drowsiness. Refrain from driving, operating heavy machinery, or doing activities that require sharp alertness until you understand how Methazolamide impacts you.
  • Limit alcohol consumption and discuss marijuana (cannabis) use with your doctor.
  • Methazolamide can increase sensitivity to sunlight. Limit sun exposure, avoid tanning beds/lamps, and use sunscreen and protective clothing outdoors. Notify your doctor promptly if you experience sunburn or skin redness/blistering.
  • Before undergoing surgery, inform your surgeon or dentist about all medications you use, including prescriptions, over-the-counter drugs, and herbal supplements.
  • Use Methazolamide during pregnancy only if clearly needed and as directed by your doctor, weighing the risks and benefits.
  • Consult your doctor before breastfeeding while using Methazolamide, as it’s unclear whether the medication passes into breast milk.

Methazolamide Contraindications 

Contraindications refer to specific health conditions or situations that make it unsafe to take a medication. If you have any of these conditions or circumstances, inform your healthcare provider, as Methazolamide may not be suitable for you:

  • Low sodium or potassium levels due to kidney, liver, or adrenal gland issues
  • Elevated acid levels in the body (hyperchloremic acidosis)
  • Long-term treatment for closed-angle glaucoma

Methazolamide Missed Dose

If you miss a dose of Methazolamide, take it as soon as you remember. However, if it is almost time for your next scheduled dose, drop the missed dose and resume your routine dosing schedule. Do not take a double dose to make up for the missed one, as this could lead to potential overdose symptoms. Always follow your healthcare provider’s instructions regarding missed doses.

[Note: If you miss a dose of your medication and are uncertain about the timing of your next dose, promptly contact your doctor or pharmacist for guidance.]

Methazolamide Overdose 

If you suspect an overdose of Methazolamide, seek immediate medical attention. Symptoms of an overdose may include drowsiness, confusion, nausea, vomiting, rapid breathing, and disturbances in electrolyte balance. It is crucial to address an overdose promptly to prevent serious complications. Always keep medication out of reach of children and follow prescribed dosages closely to avoid accidental overdose.

[Note: If you take more than the recommended dose, seek immediate medical assistance or contact the Poison Help line at 1-800-222-1222.]

Methazolamide Storage

  • Store at an average temperature (20-25°C or 68-77°F).
  • Keep away from light and moisture.
  • Keep the container tightly closed.
  • Do not store it in the bathroom.
  • Keep out of reach of children and pets.
  • Discard expired medication properly.

[Note: Consult your healthcare professional for guidance on how to properly dispose of unused medicine and for any storage-related inquiries you may have.]

Methazolamide Interactions

Diuretics: Combining methazolamide with other diuretics can reduce the risk of dehydration and electrolyte imbalance.

Aspirin and other Salicylates: High doses of salicylates can increase the effects of methazolamide, potentially leading to severe side effects.

Anti-seizure Medications: Drugs like phenytoin or topiramate may interact with methazolamide, affecting its efficacy and increasing side effects.

Lithium: Methazolamide can decrease the effectiveness of lithium used for bipolar disorder treatment.

Blood Pressure Medications: Some antihypertensive drugs may have enhanced effects when taken with methazolamide, leading to low blood pressure.

Steroids: Corticosteroids may exacerbate electrolyte imbalances caused by methazolamide.

[Note: This list of drug interactions with Methazolamide is not exhaustive. Be sure to inform your doctor about all prescription drugs, over-the-counter medicines & herbal products you are using.]

Methazolamide Alternatives

[Note: Your healthcare provider will determine the best treatment for you. Avoid using any alternative medications without professional advice, as self-medicating could lead to serious side effects.] 

Frequently Asked Questions

Does methazolamide function as a diuretic?

Yes, methazolamide is classified as a diuretic due to its mechanism of action as a carbonic anhydrase inhibitor. This medication operates in the kidneys, prompting the body to produce more urine. Although primarily used to reduce fluid levels in the eye, such as in the treatment of glaucoma, methazolamide also has the properties of a mild diuretic.

Should I keep using my glaucoma eye drops along with methazolamide?

It’s common for some people to need multiple medications to manage their glaucoma effectively. If your eye pressure remains high despite using eye drops, your healthcare provider may suggest adding methazolamide to your treatment plan. Alternatively, they might recommend using methazolamide instead of your current eye drops. If you’re unsure, Always confirm which medications you should be using with your provider.

Is methazolamide suitable for treating altitude sickness?

Methazolamide is not officially approved for treating altitude sickness. Nonetheless, research indicates it could be an effective alternative for individuals unable to take acetazolamide. It’s essential to consult your healthcare provider to determine the most appropriate medication for altitude sickness management.

Is it safe to drink alcohol while taking methazolamide?

There is no direct interaction between alcohol and methazolamide. However, it’s advisable to avoid alcohol when you first start taking methazolamide, as alcohol can intensify specific side effects like blurred vision and drowsiness.

How quickly does Methazolamide start to work?

When taken as a 50 mg tablet twice daily, Methazolamide is slightly less effective than Acetazolamide, which is typically administered at 250 mg four times daily or as 500 mg sustained-release (SR) preparations twice daily. After taking a 50 mg dose of Methazolamide, the intraocular pressure (IOP) decreases within 1-2 hours, reaches its lowest level between 4-6 hours, and returns to baseline within 12-24 hours.

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