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Re: Using Acetazolamide to treat sleep apnea above 5000 feet

Posted: Thu Apr 11, 2019 11:07 am
by brookfox
ChicagoGranny wrote:
Thu Apr 11, 2019 7:40 am
Thus, the acidosis caused by carbonic
anhydrase inhibitors (acetazolomide in this case) may increase the
likelihood and severity of salicylate toxicity in patients taking salicylates, and conversely, the acidosis caused by salicylates
may increase the likelihood and severity
of the acidotic symptom complex4
in patients taking carbonic anhydrase inhibitors. We describe herein two patients in
whom the combination of carbonic anhydrase inhibitor therapy of glaucoma and
aspirin therapy of chronic arthritis was
almost disastrous.

https://www.sciencedirect.com/sdfe/pdf/ ... t-page-pdf
Nice find. To summarize from that article:

Case1:a 67-year-old woman with longstanding rheumatoid arthritis underwent elective cataract surgery on Dec. 15, 1976. The following day, she began receiving 500 mg of acetazolamide twice a day. At discharge three days later, the dosage was changed to 250-mg acetazolamide tablets four times a day. She continued to take her preadmission aspirin dosage of 975 to 1,600 mg five times daily, which she had been taking uneventfully for 18 years. On Jan. 6, 1977, she was brought to the emergency room somnolent and complaining of a three-week history of progressively worsening ano­rexia, lethargy, decreased motivation, insomnia, tin­nitus, and tachypnea.

Case2:A 75-year-old hypertensive, nondiabetic woman had required 100 to 150 mg of dichlorphenamide per day for chronic open-angle glaucoma, and 975 mg of aspirin four to five times daily for chronic osteoarthritis for several years. In February 1975, during a hospital stay for tibial osteotomy, serum electrolytes were: sodium, 136 mEq/liter; postass-ium, 3.5 mEq/liter; chloride, 111 mEq/liter; and C02, 19 mEq/liter. On Aug. 26, 1975, after trial therapy with ibuprofen, the patient began taking 650 mg of buffered aspirin four times a day in addition to her usual aspirin dosage.

Re: Using Acetazolamide to treat sleep apnea above 5000 feet

Posted: Thu Apr 11, 2019 11:13 am
by ChicagoGranny
brookfox wrote:
Thu Apr 11, 2019 11:07 am
brookfox
Right, they were taking relatively large doses of aspirin. It's undetermined whether one low dose per day would cause a problem.

Re: Using Acetazolamide to treat sleep apnea above 5000 feet

Posted: Fri Apr 12, 2019 9:03 am
by Chapalauser
ChicagoGranny wrote:
Thu Apr 11, 2019 11:13 am
brookfox wrote:
Thu Apr 11, 2019 11:07 am
brookfox
Right, they were taking relatively large doses of aspirin. It's undetermined whether one low dose per day would cause a problem.
Thank you for interpreting the report. In my case, I think a max of 500 mg Acet per day and 81mg aspirin would be safe but I will confirm at my next visit with my sleep doc.

Re: Using Acetazolamide to treat sleep apnea above 5000 feet

Posted: Sat Apr 13, 2019 7:52 am
by ChicagoGranny
Chapalauser wrote:
Fri Apr 12, 2019 9:03 am
81mg aspirin
Especially if you are older, be aware of the potential for stomach bleeding. One sign of stomach bleeding is a dark stool.