Drug & supplement interaction

Ketogenic Diet + Methazolamide

Methazolamide brand name: Neptazane.

Moderate Interaction
The bottom line Moderate

Ketogenic Diet has a moderate interaction with Methazolamide. Theoretically, combining carbonic anhydrase inhibitors with the ketogenic diet can increase the risk of kidney stones.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ketogenic Diet and Methazolamide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CARBONIC ANHYDRASE INHIBITORS

Why this applies to Methazolamide

Methazolamide falls under CARBONIC ANHYDRASE INHIBITORS — the group Ketogenic Diet interacts with.

Theoretically, combining carbonic anhydrase inhibitors with the ketogenic diet can increase the risk of kidney stones.
Carbonic anhydrase inhibitors can increase the risk of kidney stones by worsening metabolic acidosis. The ketogenic diet can also increase the risk of metabolic acidosis and kidney stones. The combination of carbonic anhydrase inhibitors and the ketogenic diet seems to worsen metabolic acidosis in some patients. Bicarbonate levels should be measured in individuals on the ketogenic diet using carbonic anhydrase inhibitors.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about pairing Methazolamide with a ketogenic diet. Methazolamide is a carbonic anhydrase inhibitor, and one of its quirks is that it can nudge your blood toward being slightly more acidic (a state called metabolic acidosis). A keto diet can push in that same direction. Stack the two together and, in some folks, that acid-leaning effect adds up, which may raise the odds of kidney stones over time.

I'll be honest, this is mostly theoretical and based on anecdotal reports, so don't panic. But it's worth a chat with your doctor. They may want to check your bicarbonate level with a simple blood test and watch for things like flank pain, tingling in the hands or feet, or feeling unusually tired. Staying well hydrated helps too. Don't change anything on your own.

References
  1. van der Louw E, van den Hurk D, Neal E, et al. Ketogenic diet guidelines for infants with refractory epilepsy. Eur J Paediatr Neurol. 2016;20(6):798-809. PubMed
  2. Kossoff EH, Zupec-Kania BA, Auvin S, et al. Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. 2018;3(2):175-192. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ketogenic Diet Also Interacts With Other Medications

Ketogenic Diet has 136 moderate, 122 minor known drug interactions in our database — the Methazolamide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ketogenic Diet

Covers the 2,830 medications we’ve checked against Ketogenic Diet. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Methazolamide

This page covers Ketogenic Diet only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methazolamide page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 187 moderate · 24 minor.

From our pharmacist’s overview on the Methazolamide page

“Methazolamide (Neptazane) treats glaucoma by lowering pressure inside the eye, and because it also has mild water-pill effects it can nudge blood pressure and potassium on its own. That is exactly where most of the 218 supplements on this page press, and the list earns real caution.”

Reviewed by 2 · Jul 18, 2026

Open the Methazolamide interaction page

How much people look this up

Where Ketogenic Diet and Methazolamide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ketogenic Diet
Steady interest

#1,048 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Methazolamide
Steady interest

#1,695 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Eating pattern

About Ketogenic Diet

What is Ketogenic Diet?

  • Weight loss
  • Type 2 diabetes and blood sugar control
  • Drug-resistant epilepsy (especially in children)
  • Reducing appetite
  • Athletic and metabolic interest

The ketogenic diet is a very low-carbohydrate, high-fat eating plan that shifts the body to burn fat for fuel. It has the strongest evidence as a medical therapy for hard-to-treat epilepsy and may help short-term weight loss and blood sugar, but it can be hard to sustain and is not right for everyone. Talk with a doctor or pharmacist before starting, especially if you have a medical condition or take medication.

Read the full Ketogenic Diet monograph & all interactions
Medication

About Methazolamide

What Is Methazolamide Used For?

Brand name: Neptazane

Methazolamide tablets are used to treat eye conditions where lowering intraocular pressure (pressure inside the eye) is expected to help. These include chronic open-angle glaucoma and secondary glaucoma.

Methazolamide tablets are also used before surgery in acute angle-closure glaucoma, when reducing eye pressure ahead of the procedure is needed. Note that long-term use in angle-closure glaucoma is not appropriate.

See full Methazolamide drug information
Keep checking

Other Drugs & Ketogenic Diet

Browse every other medication we’ve checked against Ketogenic Diet — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
136Moderate
122Minor
2,571No known interaction
Moderate

136 interactions

Showing 60 of 136 moderate interactions — see all 136 on the Ketogenic Diet page.

Minor

122 interactions

Showing 60 of 122 minor interactions — see all 122 on the Ketogenic Diet page.

No interaction 2,571 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Following Ketogenic Diet While Taking Methazolamide: Common Questions

Can you follow Ketogenic Diet while taking Methazolamide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ketogenic Diet and Methazolamide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.