Altitude Sickness Prevention Medication: What You Need to Know

Altitude sickness, or acute mountain sickness (AMS), can affect travelers who ascend to high altitudes too quickly. While gradual acclimatization is the most effective way to prevent AMS, certain medications can reduce the risk of developing symptoms. Here’s a concise overview of the most commonly used drugs for altitude sickness prevention:

1. Acetazolamide (Diamox)

First-line preventive medication

How it works: Acetazolamide helps the body acclimatize more quickly by acidifying the blood, which stimulates deeper and faster breathing.
Dosage:
- Typical preventive dose: 125–250 mg every 12 hours
- Start 1–2 days before ascent and continue for 2–3 days at target altitude or until fully acclimatized
Common side effects: Tingling in fingers/toes, increased urination, altered taste (especially of carbonated drinks), mild nausea
Important notes: Not a treatment for severe AMS; helps prevent or reduce symptoms. Not recommended for people allergic to sulfa drugs without medical advice.

2. Dexamethasone

Corticosteroid used for prevention and emergency treatment

How it works: Reduces inflammation and swelling in the brain, preventing AMS and high-altitude cerebral edema (HACE)
Dosage for prevention: 2 mg every 6 hours or 4 mg every 12 hours
Use cases:
- For those who cannot tolerate acetazolamide
- As a backup for rapid ascents or high-risk individuals
Common side effects: Mood changes, increased appetite, insomnia, elevated blood sugar
Important notes: Effective but should not be used as a substitute for acclimatization. Once stopped, symptoms may rebound unless acclimatization has occurred.

3. Nifedipine (for High-Altitude Pulmonary Edema – HAPE)

Not for routine AMS prevention, but for specific high-risk scenarios

How it works: Lowers pulmonary artery pressure, reducing the risk of HAPE
Dosage: 30 mg slow-release every 12 hours
Used by: High-altitude trekkers or climbers with a history of HAPE
Important notes: Should be used under medical supervision

4. Other Agents (Less Common or Experimental)

Ginkgo biloba: Once considered promising, but studies show mixed results. Not widely recommended for prevention.
Ibuprofen: Can help relieve AMS symptoms but is not a preventive medication.

Key Guidelines:

Always consult a healthcare provider before taking any medication.
Medications should complement, not replace, gradual ascent and acclimatization.
Monitor for side effects, especially when traveling in remote or high-risk environments.