![]() ![]() ![]() ![]() 3.5, 95% CI −0.5 to 1.4).Ĭonclusions: Day of ascent acetazolamide demonstrated higher rates of AMS compared with traditional dosing by a small margin. There was a lower incidence of severe AMS (1993 LLQ >5) in the day of ascent group ( n = 5, 10%, NNT = 2.3) compared with night before dosing ( n = 12, 22%, NNT = 3.1) (95% CI −28 to 3.6), and lower average symptom severity in the day of ascent group (3 vs. 3.7), with the CI just surpassing the predetermined 26% noninferiority margin. There was 9% greater incidence of AMS in the day of ascent acetazolamide group (48.0% vs. Results: One hundred four participants completed the study, with 54 (52%) randomized to night before acetazolamide and 50 (48%) to day of ascent dosing, without differences in baseline characteristics. Primary outcome was incidence of AMS with the two different dosing patterns, assessed by the 1993 Lake Louise Questionnaire (LLQ) of ≥3 with headache and a minimum of 1 for other symptom. Healthy low altitude adults ascended from 1240 m (4100 ft) to 3810 m (12,570 ft) during summer 2018 on White Mountain, California. ![]() Methods: Double-blind, randomized, controlled noninferiority trial of acetazolamide 125 mg twice daily beginning either the night before or the morning of ascent. The objective of this study was to evaluate the efficacy of day of ascent dosing of acetazolamide for AMS prevention. Important: If you do develop symptoms of acute mountain sickness, descend to a lower altitude as soon as possible to prevent potentially life-threatening swelling in the brain.Background: Acetazolamide is the most common medication used for prevention of acute mountain sickness (AMS), usually administered the day or night before ascent. Ibuprofen typically is well-tolerated, but it can cause gastrointestinal and/or kidney problems, especially if you’re dehydrated-so be sure to drink plenty of water, too. Heading for the high hills? If you want to try replicating this study’s results, researchers suggested taking 600 mg of ibuprofen six hours before starting your ascent, then three more 600-mg doses every six hours after that (unless you’re asleep, in which case you can take the next dose when you wake up). (This study did not look at other types of nonsteroidal anti-inflammatory drugs as possible preventive approaches to altitude sickness.) Why the drug helps: Though the jury’s still out on the exact cause of acute mountain sickness, researchers believe inflammation plays a role…and ibuprofen is an anti-inflammatory. Results: 69% of placebo users developed symptoms of altitude sickness, compared with only 43% of ibuprofen users-which means that ibuprofen decreased the odds of developing the ailment by one-third. The other group received four 600-mg doses of ibuprofen-one dose at 8 am (six hours before beginning their ascent)…the second and third doses at 2 pm and 8 pm…and the final dose at 8 am the next morning, after spending the night on the mountain. The study involved 86 participants who lived at low altitudes and were making their way up California’s White Mountains by driving and hiking to a final altitude of 12,570 feet. Good news from a recent study: Ibuprofen (Advil, Motrin), which is sold over the counter for mild-to-moderate pain, fever and inflammation, may help travelers acclimate better to higher elevations. But these require prescriptions and may cause side effects (nausea, dizziness, insomnia, delirium) that are as debilitating as altitude sickness itself. Medications commonly used to treat the ailment, also called “acute mountain sickness,” include the diuretic acetazolamide (Diamox) and the corticosteroid dexamethasone. If only heading to the mountains for vacation didn’t mean battling altitude sickness! The debilitating symptoms-headache, fatigue, dizziness, nausea, vomiting, breathlessness, sleep disturbances-though short-lived, spell misery for more than 25% of travelers who visit altitudes above 8,000 feet. ![]()
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