Diamox for altitude sickness

Has anyone taken Diamox (acetazolomide) for altitude sickness? If you have, or know someone who did, did you have any side effects? Did you take it as needed or scheduled before and during the ascent?

thanks

My understanding is you take it several days before you ascend, then while at altitude. It takes a while for the drug to play around with your blood chemistry. If you google it, you should be able to find the dosing schedule.

It is a diuretic so will dehydrate you if you don't take extra
care to drink enough. Dehydration will increase you altitude
symptoms. Going cold turkey off coffee when ascending can increase
symptoms in some folks too.

Here are a few good resources:

http://www.traveldoctor.co.uk/altitude.htm

http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=NIR&obj=altitude.htm

http://www.merck.com/mmpe/sec21/ch320/ch320a.html


I have no personal experience, altitude doesn't seem to affect me, but several of my patient's have used it with good results.

Thanks very much for all the links, especially the CDC one!

Just back from Nepal.

Well if you think that you are prone to AMS that recommended start for Diamox theraphy is at 3500 meters (prophylactic approach). They come in 250mg form and you should be taking pills one in the morning one in the evening. I never took Diamox (multiple times over 5000 m) but a lot of my friends did and I carry it with me anyways since there is no rule on who will get the AMS. More common approach is to start the theraphy when you start experiencing mild symptoms of AMS (light headache, etc). If you start experiencing serious symptoms of AMS it is too late to take diamox and you should descent. Diamox also should not be used as a "safty pill" meaning pushing to hard and taking it to fight of symptoms.

Diamox is a diueretic (like coffee) and will keep you dehydrated. Also that means frequent trips to the bathroom; not a problem during day but problem while sleeping. Ever tried getting out of the tent at 6000 meters, 7 times to pee at 0 degrees? Buddy of mine record is 15 times in one night. Makes it for bad night and crappy climb the next day.

If you follow general rules and use acclimatization days and carefuly calculate your ascent rates I don't think you will need Diamox. A lot of times I see people who push themselves 1500 meters up in one day make too big jumps and wonder why they cough up bloody foam. My girl who was with me on this trip and it was her first high altitude adventure followed all the rules and had no problems. Just remember go slow, like a yak

This may happen if you don't take diamox (Polak on the left, Cho La Pass at 5000 something in Annapurna Region Nepal):

Yes, you can take it 24-48 hr before a rapid ascent. It should be continued 48 hrs after descent. Polak has great point about going slow anyway to avoid the necessity of acetazolamide. You can take it up to 250mg four times daily, but twice daily dosing is fine. *NO loading dose is necessary*

Side effects listed in the literature are many, but most common is peeing tons (duh!) I haven't had too many complaints from patients when they come back, but we don't do alot of this medication.