Diamox is a diuretic and carbonic anhydrase inhibitor (CAI), so the potential for hyponatremia, which is already more dangerous in women, could be significantly elevated. Not just "staying hydrated" but using an isotonic solution (Gatorade) would be important. In high doses of either rhabdomyolysis and kidney failure could be an issue. Could be more metabolic issues also. All of this is just speculation, but electrolyte balance is a definite concern. So basically the usual harm reduction measures of starting with a low dose and seeing what happens, and typical harm reduction measures for possible negative reactions to MDMA (replacing electrolytes) apply. As for more specific interactions, I just am not sure. I'd be surprised if there were any specific studies on the subject.
