Acetazolamide for altitude sickness

Acetazolamide is a type of diuretic used to treat a variety of conditions, including altitude sickness. It comes in several different forms, including:

• oral tablet
• extended-release oral capsule (“Extended release” means the drug is slowly released into your body over a long period of time.)
• intravenous (IV) solution (this form of acetazolamide is not used for altitude sickness)

Acetazolamide is a generic medication. It also comes as the brand-name version, Diamox. Acetazolamide is only available with a prescription from your doctor. It is not available over the counter (OTC).

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Acetazolamide for altitude sickness prevention

Research suggests that acetazolamide is the most effective drug for preventing altitude sickness. Therefore, take it a few days before starting your ascent to a higher altitude.

Altitude sickness is a condition that can occur when you expose your body to a higher elevation than it’s used to within a short period of time. Symptoms generally occur at altitudes over 2,500 meters (8,202 feet), where the oxygen levels are low. Acetazolamide works to prevent altitude sickness by altering the pH level in your blood. As a result, you’ll need to take more breaths per minute, which will help your body take in more oxygen.

While you can take acetazolamide to relieve altitude sickness symptoms, it’s better to take it for prevention. Acetazolamide is FDA approved for both the prevention and relief of altitude sickness symptoms. It is most effective when you take it before ascending to high altitude. It can also help with mild symptoms if they develop once you’re at a higher altitude.

For more severe cases of altitude-related illness, the CDC recommends dexamethasone. Dexamethasone is a steroid medication that reduces the swelling in your brain caused by high altitude. However, dexamethasone is not approved by the FDA for altitude sickness. It does not help the body adjust to high altitudes as acetazolamide does. The best treatment depends on the severity of your symptoms. If you have any questions, speak with a doctor.

Acetazolamide dosage for altitude sickness

When taking acetazolamide to prevent altitude sickness, doctors recommend starting your treatment 1 to 2 days before ascending to your planned elevation. The usual dose is 500 to 1,000 milligrams (mg) per day, divided into smaller doses. You should continue taking the medication for at least 2 days at high altitude. If you still have symptoms, your doctor may recommend continuing it for longer while you remain at high altitude.

The FDA-approved acetazolamide dosage for altitude sickness prevention is 500 mg to 1,000 mg per day, taken in divided doses. However, the CDC recommends a lower dose of 125 mg every 12 hours (250 mg per day). If you weigh more than 100 kilograms (kg) which is equal to 220 pounds (lb), your doctor may recommend 250 mg every 12 hours. For children, the dose is often based on weight, typically 2.5 mg per kg of body weight. Since different guidelines exist, talk with your doctor about the best dosage for you. For reference 1 kg = 2.205 lb

You can take acetazolamide with or without food. But it is important to drink plenty of fluids with the medication.

How long does acetazolamide take to work for altitude sickness?

Acetazolamide starts to work as soon as you take it, but it may take up to 2 days for the improved oxygen availability to your tissues to take full effect. This is why doctors usually recommend starting acetazolamide 3 days before you start to ascend to your planned elevation.

Is acetazolamide better than ibuprofen for altitude sickness?

Because acetazolamide is only available with a prescription, you may be interested in a different OTC option for altitude sickness. In this case, you can use ibuprofen to help prevent altitude sickness.

Ibuprofen may not work as well as acetazolamide, but it may help treat headaches that can occur on exposure to higher altitudes. Acetaminophen may also help with these types of headaches. You can take 600 mg of ibuprofen or 500 mg of acetaminophen every 8 hours to help treat headaches due to altitude sickness.

Although ibuprofen and other OTC drugs may help with headaches and nausea, they do not help relieve any other symptoms of altitude sickness.

Summary

Acetazolamide is an effective drug for preventing altitude sickness. It helps your body take in more oxygen, and it works best when you take it several days before ascending to elevation.

The usual dosage is around 500 to 1,000 mg per day, divided into smaller doses. Although it starts working right away, it usually takes a few days to make oxygen more available to your tissues.