Indications: adjunct in glaucoma, reduction of intra- ocular pressure in open-angle glaucoma, secondary glaucoma, and peri-operatively in angle-closure glaucoma.

Cautions: not generally recommended for prolonged use but if given monitor blood count and plasma electrolyte concentration; pulmonary obstruction (risk of acidosis); elderly; pregnancy, avoid extravasation at injection site (risk of necrosis);

Contra-indications: hypokalaemia, hyponatraemia, hyperchloraemic acidosis; severe hepatic impairment; renal impairment, sulphonamide hypersensitivity.

Side Effects: nausea, vomiting, diarrhoea, taste disturbance; loss of appetite, paraesthesia, flushing, headache, dizziness, fatigue, irritability, depression; thirst, polyuria; reduced libido; metabolic acidosis and electrolyte disturbances on long-term therapy; occasionally, drowsiness, confusion, hearing disturbances, urticaria, malaena, glycosuria, haematuria, abnormal liver function, renal calculi, blood disorders including agranulocytosis and thrombocytopenia, rashes including Stevens-Johnson syndrome and toxic epidermal necrolysis; rarely, photosensitivity, liver damage, flaccid paralysis, convulsions; transient myopia reported.

Dose: by mouth or by IV injection, initially 500 mg, subsequent doses 250 mg every 6 hours.