Which carbonic anhydrase inhibitor has cautions similar to acetazolamide but less severe?

• A. Acetazolamide
• B. Methazolamide
• C. Dorzolamide
• D. Latanoprost

Answer: (B)

Carbonic anhydrase inhibitors lower intraocular pressure by reducing bicarbonate formation in the ciliary processes, which decreases aqueous humor production. Because they act systemically on the kidney as well, these drugs share similar cautions such as metabolic acidosis, electrolyte disturbances (like hypokalemia), risk of kidney stones, and considerations for sulfa allergies.

Methazolamide is another systemic carbonic anhydrase inhibitor, so it carries the same types of cautions as acetazolamide. However, its adverse effects are generally milder, making it a option when acetazolamide’s tolerability is an issue.

Dorzolamide is a topical CAI and mainly causes local ocular side effects with less systemic impact, so its cautions aren’t as similar or as severe as those of acetazolamide. Latanoprost is not a carbonic anhydrase inhibitor at all; it’s a prostaglandin analog with a different side effect profile.

So, the drug with cautions similar to acetazolamide but less severe is methazolamide.