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J Gen Intern Med 37(2):415438

Serious side effects are rare when kidney function is normal

This can make different drug regimens intolerable or uncomfortable for patients

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[6] Pharmacodynamic synergy with other carbonic-anhydrase inhibitors (acetazolamide, zonisamide) amplifies the risk of metabolic acidosis and nephrolithiasis, while combined use with valproate has been repeatedly implicated in hyperammonemic encephalopathy even at therapeutic serum valproate levels