A Traveller’s Guide To Elevation Sickness Medication
Altitude sickness affects thousands of travellers every year, from those trekking Himalayan passes to visitors simply arriving by plane in Cusco or Addis Ababa. Symptoms can strike quickly and escalate without warning. Understanding your options for elevation sickness medication before you travel is one of the smartest preparations you can make.
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Alternatively, read on to learn five essential things every traveller should know.
1. What Is Altitude Sickness and Who Is at Risk?
Altitude sickness, or acute mountain sickness (AMS), occurs when the body does not acclimatise quickly enough to lower oxygen levels at height. It typically begins above 2,500 metres and can affect anyone, regardless of age or fitness level. Common symptoms include:
- ⇾ Persistent headache, often worse when lying down
- ⇾ Nausea or vomiting
- ⇾ Dizziness and fatigue
- ⇾ Loss of appetite
- ⇾ Difficulty sleeping
- ⇾ Shortness of breath at rest
In more severe cases, AMS can progress to high-altitude pulmonary oedema (HAPE) or high-altitude cerebral oedema (HACE), both of which are medical emergencies requiring immediate descent and treatment.
2. Which Destinations and Altitudes Put You at Greatest Risk?
Not all high-altitude destinations carry the same level of risk. The table below compares popular destinations by altitude and the typical elevation sickness medication considerations for each.
| Destination | Approximate Altitude | AMS Risk Level | Acetazolamide Typically Recommended? | Notes |
|---|---|---|---|---|
| Cusco, Peru | 3,400 m | High | Yes | Arrived at altitude by air; rapid ascent |
| La Paz, Bolivia | 3,640 m | High | Yes | One of the highest capital cities in the world |
| Everest Base Camp, Nepal | 5,364 m | Very High | Yes | Gradual trek; acclimatisation days essential |
| Kilimanjaro, Tanzania | 5,895 m (summit) | Very High | Yes | Rapid ascent profile increases risk |
| Machu Picchu, Peru | 2,430 m | Moderate | Sometimes | Lower risk but symptoms possible for sensitive travellers |
| Addis Ababa, Ethiopia | 2,355 m | Low to Moderate | Rarely | Most travellers acclimatise without medication |
| Lhasa, Tibet | 3,650 m | High | Yes | Arrived by air or rapid overland route |
3. What Is Acetazolamide and How Does It Work?
The most widely used elevation sickness medication is acetazolamide, sold under the brand name Diamox. It is a prescription-only medicine available through a travel health consultation. Here is what you need to know about acetazolamide:
- ⇾ How it works: It stimulates faster and deeper breathing, which helps your body take in more oxygen and speeds up acclimatisation
- ⇾ When to start: Usually one to two days before ascending to altitude and continued for two days after reaching your highest point
- ⇾ Typical dose: 125 mg to 250 mg twice daily (125 mg twice daily is the usual preventative dose, but your clinician will advise the correct dose for you)
- ⇾ Common side effects: Increased urination, tingling in the fingers and toes, and altered taste of carbonated drinks
- ⇾ Who should avoid it: Those with a sulfonamide allergy or certain kidney conditions should discuss alternatives with a clinician
It is important to note that acetazolamide does not mask symptoms if you develop serious AMS. Descent remains the most effective treatment if your condition worsens.
4. What Other Medications May Be Used?
For travellers who cannot take acetazolamide, or those heading to extreme altitudes, other medications may be prescribed alongside or instead:
- ⇾ Dexamethasone: A corticosteroid used to treat severe AMS, HAPE, or HACE, or as an emergency medication on high-altitude expeditions. It does not aid acclimatisation and is not a substitute for gradual ascent
- ⇾ Nifedipine: Used specifically for the prevention and treatment of HAPE in individuals known to be susceptible
- ⇾ Ibuprofen: Some evidence suggests it can help prevent mild AMS headaches, though it is not a replacement for prescription medication on high-risk itineraries
Your clinician at Fermanagh Travel & Health Clinics will assess your full itinerary and health history before recommending any elevation sickness medication.
5. Medication Is Only Part of the Picture: Acclimatisation Tips
Even the best elevation sickness medication works most effectively when combined with sensible acclimatisation practices. Follow these guidelines to reduce your risk:
- ⇾ Ascend gradually, aiming to gain no more than 300 to 500 metres per day above 3,000 m
- ⇾ Build in acclimatisation days, particularly for treks to 4,000 m and above
- ⇾ Stay well hydrated throughout your ascent
- ⇾ Avoid alcohol and sedatives during the first few days at altitude
- ⇾ Do not ascend if you have symptoms of AMS; wait until they resolve
- ⇾ Descend immediately if symptoms worsen, regardless of how close you are to your goal
- ⇾ Consider supplemental oxygen for extreme altitudes or emergency use on expedition treks
The golden rule of altitude travel is: if in doubt, go down.
Frequently Asked Questions About Elevation Sickness Medication
Can I get elevation sickness medication over the counter?
How soon before my trip should I arrange elevation sickness medication?
Does altitude sickness medication work for everyone?
What should I do if I develop severe symptoms despite taking medication?
Is elevation sickness medication safe to take with other travel medications?
Plan Your High-Altitude Adventure Safely
Whether you are trekking to base camp, exploring South American cities, or summiting an African peak, the right elevation sickness medication and preparation can make all the difference. Do not leave this to chance or try to source prescription medicine without professional guidance.