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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Acetazolamide be taken if suffering from gilbert s syndrome?

My daughter has just been prescribed Acetazolamide for glaucoma. She already takes another carbonic anhydrase inhibitor (Trusopt). I have read that this family of drugs is contraindicated for patients with liver disease. My daughter is diagnosed with Gilbert s syndrome and has elevated bilirubin levels. Should she be taking these drugs?
Mon, 23 Feb 2015
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General & Family Physician 's  Response
Thanks for posting your question on HCM.
I really appreciate your concern for your daughters illness.

As you have rightly said, both of the above mentioned drugs act by inhibiting carbonic anhydrase enzyme in the eyes (decreasing the raised intra ocular pressure and hence glaucoma) and in the kidneys producing increase urine formation ( mainly by Acetazolamide).

However Trusopt ( Dorzolamide) is used in the form of eye drops so it has more of localized action in the eye producing minimal side effects like
Bitter taste in the mouth; blurred vision; dry eyes; eye sensitivity to light; or stinging of the eyes.

Acetazolamide is given in the form of tablets for the same purpose but it is known to cause metabolic acidosis and electrolyte imbalance (hypokalemia).

Given along with Dorzolamide the toxicity will be more in the form of metabolic acidosis and hypokalemia which can be detrimental to heart.

Therefore you are advised to consult an ophthalmologist so as to use an alternate medicine with better efficacy and safety.

Wishing your daughter best of health.\
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