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Glaupax (Glaupax)
Active substance: acetazolamide
Strengths: 250 mg
Indications: oedema syndrome, especially in combination with alkalosis, in chronic cardiac and cardiopulmonary failure; increased intracranial pressure; primary and secondary glaucoma; petit mal epileptic seizures
Shelf life: long
Pack: 10, 30, 20, 100 pcs
Instructions for use: Glaupax (Glaupax)
Brief reference information compiled from official German sources (Gelbe Liste, Fachinfo, Apotheken Umschau). It does not replace a doctor’s consultation or the package insert. This is a prescription medicine — use it only as directed by a doctor.
Active substance
Acetazolamide (Acetazolamid) — a carbonic anhydrase inhibitor; lowers intraocular pressure by reducing the production of intraocular fluid
Available forms
Tablets 250 mg (white, round, with a cruciform score line, dividable into equal doses); registered pack sizes in Germany — 10, 30, 40, 60 and 100 pcs (100 pcs — N3). Marketing authorisation holder (pharmazeutischer Unternehmer / marketer) — OmniVision GmbH, Puchheim; the actual manufacturer (Hersteller) — Artesan Pharma GmbH & Co. KG, Lüchow
Indications
- Persistently elevated intraocular pressure (ocular hypertension)
- Open-angle glaucoma (long-term reduction of intraocular pressure)
- Acute glaucoma attack — lowering the pressure before surgery; secondary glaucoma resulting from another disease
- Prevention of increased intraocular pressure after cataract and glaucoma surgery
Important: according to the German prescribing information, Glaupax is approved only as an ADD-ON agent in combination with topical medicines that lower IOP (other than carbonic anhydrase inhibitors) — when topical monotherapy has not achieved a sufficient reduction in pressure or when topical therapy is not possible. It is not a first-line medicine.
In the German prescribing information, Glaupax is registered only for ophthalmological indications; epilepsy is NOT among the indications (the word «Epilepsie» appears only in the sections on interactions and warnings). The Swiss Glaupax (compendium.ch, OmniVision AG, Neuhausen) also has only «Glaukom» as an indication — epilepsy is not an indication of the product either in Germany or in Switzerland. Epilepsy is a historical use of the active substance acetazolamide, not of the registered product.
How to take
- Long-term glaucoma therapy: usually 1/2–1 tablet (125–250 mg) once or twice a day — in the morning and evening, with meals, washed down with a glass of water (daily range 125–500 mg)
- Acute glaucoma attack: initial dose 2 tablets (500 mg), then 1/2–1 tablet every 4 hours; the dose is gradually reduced according to the dynamics of intraocular pressure
- The dose and duration of treatment are determined only by a doctor — according to the level of intraocular pressure
Contraindications
- Allergy to acetazolamide (sulfonamide allergy) or other components — an absolute contraindication (allergy to sulfonamides means a cross-reaction)
- Long-term treatment of chronic non-congestive closed-angle glaucoma — reduced IOP may mask disease progression
- Severe impairment of kidney function
- Liver cirrhosis and marked hepatic insufficiency
- Deficiency of sodium or potassium in the blood (hyponatraemia, hypokalaemia), hyperchloraemic acidosis
- Adrenal cortex insufficiency
- Increased excretion of calcium in the urine, calcium deposits in the kidneys
- Pregnancy and breastfeeding
- In children and the elderly (from 65 years) — use only after careful weighing of benefit and risk under a doctor’s supervision (there is insufficient experience; in children acetazolamide may cause growth retardation)
Possible side effects
- Paraesthesia — tingling, numbness in the extremities
- Fatigue, weakness, reduced performance, dizziness, headache
- Taste disturbances, dry mouth, gastrointestinal disorders (nausea, vomiting, diarrhoea)
- Frequent urination; risk of kidney stone formation
- Muscle cramps (most often in the calves)
- Electrolyte imbalance, metabolic acidosis, increased uric acid (gout attacks)
- Transient myopia, decreased blood pressure
Special precautions
- Prescription medicine (verschreibungspflichtig) — dispensed only on a doctor’s prescription
- With long-term use — regular monitoring of blood tests: electrolytes (potassium, sodium), kidney function; the doctor may recommend potassium-rich foods
- Drink enough fluids — prevention of kidney stone formation
- May reduce reaction speed (caution when driving); avoid excessive UV exposure; do not regularly consume liquorice (licorice)
Sources: www.apotheken-umschau.de, www.gelbe-liste.de, www.gelbe-liste.de, www.gelbe-liste.de, www.rote-liste.de, cdn.shop-apotheke.com, compendium.ch
