DICHLORPHENAMIDE
(dye-klor-fen'a-mide)
Daranide, Oratrol
Classifications: eye preparation; carbonic anhydrase inhibitor; antiglaucoma
Prototype: Acetazolamide
Pregnancy Category: C
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50 mg tablets
Nonbacteriostatic sulfonamide derivative similar to acetazolamide except that chloride excretion is increased, and thus potential
for significant metabolic acidosis is less.
Lowers IOP by decreasing production of aqueous humor.
Adjunctive treatment of open-angle glaucoma and preoperatively in narrow-angle glaucoma when delay of surgery is desired to
lower IOP. Commonly used in conjunction with a miotic; an osmotic agent may also be used to enhance reduction of IOP in acute
angle-closure glaucoma.
Hypersensitivity to sulfonamides and sulfonamide derivative diuretics; depressed sodium and potassium levels, severe pulmonary
obstruction, marked kidney or liver dysfunction, hyperchloremic acidosis, adrenocortical insufficiency, long-term use in noncongestive
angle-closure glaucoma. Safe use during pregnancy (category C) or lactation is not established.
Respiratory acidosis, reduced respiratory capacity, diabetes mellitus.
Glaucoma
Adult: PO 100–200 mg followed by 100 mg q12h until desired response is obtained PO Maintenance Dose: 25–50 mg 1–3 times/d
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Oral
- Take drug with meals to reduce gastric irritation.
- Store at room temperature.
CNS: Paresthesia, sedation, drowsiness, fatigue, dizziness, ataxia. GI: Anorexia, nausea, vomiting, metallic taste, diarrhea, abdominal discomfort. Hematologic: Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia. Urogenital: Urinary frequency, crystalluria, renal calculi. Skin: Urticaria, pruritus, rash. Other: Weight loss, fever, glycosuria, asymptomatic hyperuricemia.
Drug: Renal excretion of amphetamines, ephedrine, flecainide, quinidine, procainamide, tricyclic antidepressants may be decreased, thereby enhancing or prolonging their effects; increases renal excretion of lithium; excretion of phenobarbital may be increased; amphotericin B, corticosteroids may increase potassium loss; dichlorphenamide-induced hypokalemia may predispose patients taking digitalis glycosides to digitalis toxicity; patients on high doses of salicylates are at higher risk for salicylate toxicity.
Absorption: Well absorbed from GI tract. Onset: 0.5–1 h. Peak: 2–4 h. Duration: 6–12 h.
Assessment & Drug Effects
- Supervise ambulation since drug may cause dizziness and ataxia; other safety precautions may be warranted.
- Monitor for hematologic reactions common to sulfonamides. Obtain baseline CBC and platelet counts before initiating therapy
and at regular intervals.
Patient & Family Education
- Increase fluid intake to a high level to reduce risk of renal calculi. Consult physician.
- Report to physician the onset of sore throat, fever, unusual bleeding or bruising, tremors, flank or loin pain, skin rash.
- Do not drive or engage in other potentially hazardous activities until reaction to drug is known.
- Do not breast feed while taking this drug without consulting physician.
1%)
Canadian drug name; 
Prototype drug