Abstract
Repeated urinary calculi developed in a patient who was treated with methazolamide for glaucoma. Previously, he had developed calculi while receiving acetazolamide.
The factors involved in urinary calculus formation with carbonic anhydrase inhibitor therapy are reviewed. It appears that the incidence of calculus formation is less with methazolamide than with acetazolamide, and patients may be free of urinary symptoms when switched from acetazolamide to methazolamide therapy. It is suggested that the incidence of calculus formation in patients on any carbonic anhydrase inhibitor therapy may be reduced by increasing urine output, restricting calcium in diet, and by the use of aluminum hydroxide gel, oral sodium and potassium phosphates or hydrochlorothiazide.
Similar content being viewed by others
References
becker, b. Use of methazolamide (Neptazane) in the therapy of glaucoma. Comparison with acetazolamide (Diamox). Am. J. Ophthal. 49: 1307–1311 (1960).
becker, b. Personal communication (1971).
— & w. H.middleton. Long-term acetazolamide (Diamox) administration in therapy of glaucomas. Arch. Ophthal. 54: 187–192 (1955).
constant, m. a. & b.becker. The effect of carbonic anhydrase inhibitors on urinary excretion of citrate by humans. Am. J. Ophthal. 49: 929–934 (1960).
gordon, e. e. & s. g.sheps. Effect of acetazolamide on citrate excretion and formation of renal calculi. New. Eng. J. Med. 256: 1215–1219 (1957).
harrison, h. e. & h. c.harrison. Inhibition of urine citrate excretion and production of renal calcinosis in rat by acetazolamide (Diamox) administration. J. Clin. Invest. 34: 1662–1670 (1955).
hastings, a. b., f. c.mclean, l.eichelberger, j. L.hall & e.decosta. Ionization of calcium, magnesium, and strontium citrates. J. Biol. Chem. 107: 351–370 (1934).
howard, j. e. & w.c.thomas Jr. Control of crystallization in urine. Am. J. Med. 45: 693–699 (1968).
persky, l., d.chambers & a.potts. Calculus formation and ureteral colic following acetazolamide (Diamox) therapy. J.A.M.A. 161: 1625–1626 (1956).
scheie, h. g. In discussion of Leopold, I. H., Eisenberg, I. J., and Yasura, J.: Experiences with Diamox in glaucoma. Am. J. Ophthal. 39: 885–888 (1955).
takaku, i., t.asoaka, s.komuro & r.kimura. On urolithiasis following long-term administration of carbonic anhydrase inhibitors in the therapy of glaucoma. Jap. J. Clin. Ophthal. 18: 921–925 (1964).