How does acetazolamide work?

Acetazolamide: As a carbonic andydrase inhibitor, acetazolamide decreases the rate of carbonic acid and hydrogen ion production of the kidney, this increases the excretion of solutes and the rate of urinary output.

Makes Blood Acidic: We hyperventilate at altitude, trying to grab more oxygen molecules. We blow off too much CO2 & ruin our acid base balance. We feel unwell. Diamox forces kidneys to excrete bicarbonate, (sodium bicarbonate) a base of carbonic acid; speeding the move toward more normal acid base status--something that would take our bodies days to do. With Diamox, we achieve this much more quickly & avoid minor altitude symptoms.