Carbonic anhydrase inhibitors (CAIs)
- Cause bicarbonate loss + mild diuresis
- Acetazolamide: altitude, glaucoma, IIH
- Topiramate has partial CA inhibition too
- Metabolic acidosis + hypokalemia possible
- Kidney-stone risk rises
- Paresthesias are common with acetazolamide
- Can substantially lower lithium levels
Class at a glance
- Cause bicarbonate loss + mild diuresis
Members / distinctions
- Acetazolamide: altitude, glaucoma, IIH
Pharmacology
- Topiramate has partial CA inhibition too
Other member distinctions
- Metabolic acidosis + hypokalemia possible
- Paresthesias are common with acetazolamide
- Can substantially lower lithium levels
Safety / monitoring
- Kidney-stone risk rises
Self-check
- Which drug has partial carbonic-anhydrase inhibition?
Topiramate. - What metabolic problems can CA inhibition cause?
Metabolic acidosis and hypokalemia.
Drugs in this class (5)
Carbonic anhydrase inhibitors (CAIs) prescription history
Animated chart of estimated U.S. prescriptions per year, Glaucoma medicines (1900–2026). Carbonic anhydrase highlighted from 1953.
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