Study characteristics | Mean (SD) or % (NStudies) | Range | NStudies |
General | |||
Age, years | 44 (15) | 19 to 74 | 37 |
% female | 36 (29) | 0 to 98 | 40 |
BMI, kg/m2 | 27 (5.6) | 20 to 40 | 11 |
Weight, kg | 75 (18) | 51 to 108 | 10 |
Height, cm | 165 (5.4) | 160 to 174 | 6 |
Race | 5 | ||
White | 79.2 (17) | 63 to 100 | |
Black | 16 (13) | 0 to 30 | |
Other | 5.2 (4.4) | 0 to 11 | |
Condition | 42 | ||
Acute/chronic mountain sickness | 48 (20) | Na | |
Sleep disordered breathing | 10 (4) | Na | |
Ophthalmologic condition (medical) | 10 (4) | Na | |
Ophthalmologic surgery | 7 (3) | Na | |
Other* | 26 (11) | Na | |
Diuretic use | 42 | ||
Yes | 12 (5) | Na | |
Unclear/no | 88 (37) | Na | |
Query type (for side effects) | 42 | ||
Active | 52 (22) | Na | |
Unclear/passive | 48 (20) | Na | |
Overall bias† | 42 | ||
Low | 24 (10) | Na | |
Unclear | 33 (14) | Na | |
High | 43 (18) | Na | |
Intervention | |||
Acetazolamide | |||
Total daily dose‡, mg | 542 (371) | 125 to 4000 § | 42 |
Total daily dose/kg‡, mg/kg | 6.9 (4.6) | 3.1 to 23 | 15 |
Total daily dose (categorical) | 42 | ||
<400 mg | 29 (12) | Na | |
400–600 mg | 50 (21) | Na | |
>600 mg | 21 (9) | Na | |
Doses per day | 1.8 (0.7) | 1 to 4 | 42 |
Days of administration (continuous) | 17 (32) | 1 to 180 | 42 |
Days of administration (categorical) | 42 | ||
<3 days | 26 (11) | Na | |
3 to 7 days | 40 (17) | Na | |
>7 days | 33 (14) | Na | |
Cumulative dose¶, 1000*mg*days | 17 (68.3) | 0.125 to 450 | 42 |
Renal adjustment | 42 | ||
Yes** | 31 (13) | Na | |
No | 69 (29) | Na | |
K supplementation | 42 | ||
Standing | 5 (2) | Na | |
As needed | 2 (1) | Na | |
Unclear/no | 93 (39) | Na | |
No. subjects, acetazolamide arm | 30 (25) | 6 to 118 | 42 |
No. subjects, placebo arm | 29 (25) | 5 to 119 | 42 |
Lab changes (mean difference acetazolamide − placebo) | |||
Mean difference | range | NStudies | |
pH | −0.07 (0.02) | −0.11 to −0.02 | 11 |
pCO2 | −2.8 (2.8) | −6.7 to 2.9 | 13 |
pO2 | 4.9 (3.4) | 0.7 to 10.5 | 9 |
Bicarbonate | −4.5 (1.4) | −7 to −2.9 | 7 |
Chloride | 3.3 (0.3) | 3 to 3.6 | 2 |
Sodium | 0 (1.4) | −1 to 2 | 3 |
Potassium | −0.3 (0.1) | −0.5 to −0.2 | 3 |
Creatinine | Na | Na | 0 |
*'Other’ includes refractory dysuria (n=1), idiopathic intracranial hypertension (n=1), post-laparoscopy pain (n=1), pulmonary hypertension (n=1), acute respiratory failure +metabolic alkalosis (n=1), COPD (n=2), migraines (n=1), essential tremor (n=1) and healthy volunteers (n=2).
†Based on ‘highest’ bias across five domains (selection, performance, detection, attrition, reporting bias).
‡40 studies reported ‘total daily dose’ versus 2 reported ‘total daily dose per kg’; when possible both measures were estimated using weight/BMI from the same or similar studies (data shown in this table include estimated measures).
§One trial29 escalated the total daily up to 4000 mg if tolerated; for the analyses we used the reported mean dose of 2500 mg.
¶Cumulative dose=total daily dose × days of administration.
**No study directly adjusted the acetazolamide dose based on renal function, but 13 studies either included only healthy subjects or specifically excluded subjects with renal dysfunction.
BMI, body mass index; COPD, chronic obstructive pulmonary disease; No, Number of.