Altitude Sickness: Symptoms, Prevention, and Treatment
What is Altitude Sickness?
Altitude sickness, also known as acute mountain sickness (AMS), is a condition that occurs when the body is exposed to low oxygen levels at high elevations, typically above 8,000 feet. Symptoms can range from mild to severe, and people who experience worsening symptoms while resting require treatment.
Medications for Altitude Sickness
Certain medications can prevent or treat altitude sickness. The best medication depends on several factors, including preventive goals, medical history, specific symptoms, and treatment access.
1. Diamox (Acetazolamide)
Diamox (acetazolamide) is a medication approved by the FDA for preventing or treating altitude sickness. It helps the body adapt to higher elevations. Diamox is recommended for adults and children, and its dosage varies depending on the purpose of use:
- Prevention: 125 mg every 12 hours, or 1.25 mg/kg every 12 hours (max 125 mg per dose)
- Treatment: 250 mg every 12 hours, or 2.5 mg/kg every 12 hours (max 250 mg per dose)
Can I Buy Diamox Over the Counter?
No, Diamox is not available over the counter. A prescription is required to fill this medication at a pharmacy.
2. Procardia (Nifedipine)
Nifedipine, approved for chest pain and high blood pressure, can also be used to prevent and treat fluid buildup in the lungs (pulmonary edema) at high altitudes. It should only be taken for treatment when moving to lower elevations and accessing supplemental oxygen or portable hyperbaric therapy is impossible.
Dosage for nifedipine ER is the same for both prevention and treatment: 20 mg by mouth every 8 hours or 30 mg every 12 hours.
3. Phosphodiesterase-5 Inhibitors
The PDE5 inhibitor drug class, which includes tadalafil and sildenafil, can treat fluid buildup in the lungs at high elevations. These medications are only taken under certain circumstances:
- When traveling to lower elevations is not feasible
- Supplemental oxygen or portable hyperbaric therapy is inaccessible
- Nifedipine is unavailable
Dosage for prevention:
- Tadalafil: 10 mg by mouth every 12 hours
- Sildenafil: 50 mg by mouth every 8 hours
4. Dexamethasone
Dexamethasone, a corticosteroid, is an alternative to Diamox for altitude sickness prevention in adults. It is also recommended for the treatment of acute (short-term) altitude sickness with or without brain swelling (cerebral edema) symptoms.
Dosage:
- Prevention: 2 mg every 6 hours or 4 mg every 12 hours (not recommended in children)
- Treatment: 4 mg every 6 hours or 0.15 mg/kg every 6 hours (max 4 mg per dose)
- Treatment of brain swelling: 8 mg once, then 4 mg every 6 hours (0.15 mg/kg every 6 hours, max 4 mg per dose)
5. Ibuprofen
Ibuprofen can be taken to prevent altitude sickness, but only if Diamox or dexamethasone cannot be taken due to allergies or intolerance. However, if you experience headaches at high elevations, you can take ibuprofen or acetaminophen for treatment.
When to See a Healthcare Provider
Mild symptoms of altitude sickness include:
- Headaches
- Low appetite
- Nausea and vomiting
- Tiredness
These mild symptoms usually resolve on their own within a few days. However, if symptoms worsen while resting, you should seek medical attention and travel to a lower altitude. You should also see a healthcare provider immediately for severe symptoms of brain swelling or fluid buildup in the lungs, such as:
- Balance or movement problems
- Breathing problems
- Confusion
- Cough
- Drowsiness
- Extreme tiredness
- Weakness
Conclusion
Altitude sickness is a condition that occurs when the body is exposed to low oxygen levels at high elevations. Medications like Diamox, nifedipine, and dexamethasone can prevent or treat altitude sickness. Mild symptoms usually resolve on their own, but severe symptoms require immediate medical attention. If you experience worsening symptoms while resting, seek medical attention and travel to a lower altitude.
