The Use of Acetazolamide During Pregnancy in Intracranial Hypertension Patients

Abstract

There is no convincing evidence for an adverse effect for acetazolamide use in human pregnancy, even when prescribed prior to the 13th week of gestation. While the liberal use of acetazolamide should be avoided during pregnancy, this medication should remain a treatment option in pregnant women when clinically indicated.

Idiopathic Intracranial Hypertension and Pregnancy

“…14,15 In our opinion, as with all medications given to pregnant women, acetazolamide should remain a treatment option if the risk of progressive visual loss is sufficiently high to warrant its use.…”

“…Several reports do not recommend the use of acetazolamide during pregnancy because of potential teratogenicity effects. 14,15 Acetazolamide was thus classified as class C according to the Food and Drug Administration (FDA), indicating that animal studies have shown an adverse effect; however, there are no adequate and well-controlled studies on pregnant women.…”

“…Women with IIH who did not receive acetazolamide during their first trimester of pregnancy served as a control group. 14 This study queried pediatricians and obstetricians caring for the women who received acetazolamide, and no fetal anomalies attributed to the drug were found. The most effective dose for pregnant women has as yet not been determined.…”

Idiopathic intracranial hypertension occurred after spinal surgery: report of two rare cases and systematic review of the literature

“…And the incidence is increasing in parallel with the current worldwide epidemic of obesity [14,15]. Although considerable literature has been published concerning IIH occurred during pregnancy [16,17] and childhood [18,19], there are few studies reported IIH occurred after spinal surgery.…”

Comment on the case report “Possible association between acetazolamide administration during pregnancy and multiple congenital malformations”

“…Finally, we are in agreement with the suggestion of Al-Saleem and Al-Jobair1 regarding the verification of the absence of pregnancy before initiating acetazolamide to women of reproductive age. Nevertheless, the successful use of acetazolamide has been described in a limited number of pregnant women with intracranial hypertension 6,7. As previously remarked by Falardeau et al, clinicians should be aware that “The avoidance of acetazolamide during the first trimester has very little medical justification and is mainly guided by medical–legal rationale” 7.…”