Acetazolamide Side Effects: What You Need to Know Before Taking It

When you take acetazolamide, a carbonic anhydrase inhibitor used to treat glaucoma, altitude sickness, and certain types of seizures. Also known as Diamox, it works by changing how your body handles fluids and electrolytes. It’s not a typical painkiller or antibiotic — it’s a targeted drug that affects your kidneys, eyes, and brain. Many people take it without issues, but side effects can be surprising if you don’t know what to expect.

One of the most common side effects is tingling in your fingers, toes, or face. It’s not dangerous, but it can feel weird — like your limbs are falling asleep. You might also notice a metallic taste in your mouth, especially after drinking carbonated drinks. That’s acetazolamide messing with your body’s acid-base balance. Some people get more frequent urination, which is intentional — the drug pushes out extra fluid. But if you’re already dehydrated or on diuretics, this can lead to dizziness or low potassium. People with sulfa allergies should avoid it entirely; it’s chemically related to sulfa antibiotics. And if you have liver or kidney problems, your doctor needs to adjust the dose or skip it altogether.

Less common but serious side effects include blood in your urine, severe skin rashes, or signs of an allergic reaction like swelling or trouble breathing. These are rare, but if they happen, stop taking it and get help right away. Long-term use can lead to kidney stones or metabolic acidosis — your blood gets too acidic. That’s why regular checkups matter, especially if you’re on it for months. It’s also not something you should take casually for altitude sickness. You need to start it days before climbing, not just when you feel dizzy at the top.

Acetazolamide doesn’t work the same for everyone. Some people feel fine on it. Others can’t tolerate even a low dose. And it interacts with other drugs — like aspirin, seizure meds, or diuretics — in ways that aren’t always obvious. If you’re taking it for glaucoma, you’ll need eye pressure checks. If you’re using it for altitude, you’ll need to monitor how you feel during your climb. There’s no one-size-fits-all approach.

Below, you’ll find real-world experiences and comparisons from people who’ve taken acetazolamide — and the alternatives they tried when side effects became too much. Some switched to other altitude meds. Others found ways to manage the tingling without quitting. You’ll see what worked, what didn’t, and what doctors actually recommend when things go sideways.