Altitude sickness and acetazolamide

Taking 125 mg of acetazolamide twice per day can prevent acute altitude sickness in travelers to elevations above 2,500 miles, especially those who are ascending quickly to extreme heights.

Taking 125 mg of acetazolamide twice per day can prevent acute altitude sickness in travelers to elevations above 2,500 miles, especially those who are ascending quickly to extreme heights. Persons who are not conditioned against the hypoxic environment at these levels are likely to experience nausea, dizziness, and headache along with altered taste, paresthesia, and polyuria. Acetazolamide works against mountain sickness by increasing renal excretion of bicarbonate, which causes mild metabolic acidosis that has the effect of improving respiratory rate and, thus, oxygenation. Compared with dexamethasone and other approaches, it has fewer adverse effects; however, that does not mean it is for everyone. The drug should be avoided, for example, in anyone who has glaucoma, hypokalemia, hyponatremia, or renal or hepatic impairment. It also is not recommended for pregnant women or individuals with sulfonamide allergies and is known to interact with high-dose aspirin, cardiac glycosides, blood pressure medications, and lithium. It is important to recognize that although acetazolamide may help avert acute mountain sickness, there is little evidence to support its use as a treatment for acute cases.