If you’re planning to climb Kilimanjaro, you are likely aware of the potential effects of altitude. Although it affects each person differently, chances are you will experience some symptoms of altitude sickness, also known as acute mountain sickness (AMS). The primary cause of altitude sickness is ascending too quickly.
It is estimated that 75% of people will experience some form of mild AMS above 10,000 feet. It is difficult, if not impossible, to predict who will get sick, as some people are simply more susceptible than others due to their genetic makeup.
Can altitude sickness be treated with OTC or prescription medications?
Yes. Several medications are known to aid acclimatization and treat AMS. Let’s explore some options below.
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Ibuprofen (Advil, Motrin, Aleve)
You might know ibuprofen as a common painkiller, but it can also alleviate symptoms of altitude sickness.
At high altitudes, climbers often experience headaches of varying intensity. These headaches are caused by inflammatory factors that lead to leaky blood vessels and fluid buildup in the brain, increasing pressure in the skull. Ibuprofen, as an anti-inflammatory drug, reduces swelling and inflammation.
Ibuprofen is quickly absorbed and generally well-tolerated. Studies have shown that individuals who took ibuprofen were less likely to develop acute mountain sickness compared to those who took a placebo.
The recommended dose is 600 mg every 8 hours.
2. Acetazolamide (Diamox)
The most popular and effective medication for altitude sickness is acetazolamide, commonly known by its brand name, Diamox. It works by acidifying the blood, which induces metabolic acidosis. This acts as a respiratory stimulant, increasing your breathing rate and improving arterial oxygenation. In simpler terms, it helps you breathe faster, raising the oxygen levels in your body.
The standard dosage is 125 to 250 mg every 12 hours, or 500 mg daily. It should be started 24 hours before the climb and continued throughout the expedition. Diamox is known to be 75% effective in preventing AMS.
If you visit your travel clinic before climbing Kilimanjaro, they will likely prescribe Diamox rather than any of the other medications for acclimatization.
3. Dexamethasone (Decadron)
High Altitude Cerebral Edema (HACE) is a severe form of altitude sickness where the brain swells and stops functioning properly.
Dexamethasone is a potent steroid hormone that acts as an anti-inflammatory agent to treat brain edema. Unlike acetazolamide, which aids acclimatization, dexamethasone treats only the symptoms of altitude sickness. Therefore, someone using dexamethasone should not continue to ascend but rather maintain their altitude or descend.
Dexamethasone is not routinely recommended as a prophylactic for AMS or High Altitude Pulmonary Edema (HAPE), but it can reduce the risk in susceptible individuals.
The recommended dosage is 4 mg every 6 hours. Symptoms typically improve within approximately 6 hours.
4. Sildenafil (Viagra)
At high altitudes, blood vessels constrict, a phenomenon known as pulmonary vasoconstriction. This puts extra strain on the heart and can lead to heart failure. It also raises pulmonary artery pressures, potentially causing blood vessels in the lungs to leak fluid—a life-threatening condition known as high-altitude pulmonary edema (HAPE).
Sildenafil, commonly known as Viagra, acts as a vasodilator. It relaxes blood vessels, allowing more blood to flow freely, counteracting the constriction caused by high altitude and reducing the pressure on the heart and lungs. This helps to lower pulmonary artery pressure and prevent the formation of pulmonary edema fluid, thereby reducing the risk of heart failure and HAPE.
Additionally, sildenafil can improve oxygen delivery to muscles, enhancing physical endurance. Research has shown that Viagra “significantly improved the cardiovascular and exercise performance measures” of participants, boosting their output by up to 45 percent.
The recommended dose of sildenafil is 50 milligrams every eight hours.
5. Nifedipine (Adalat, Procardia)
Nifedipine, similar to Viagra, lowers pulmonary artery pressure but is a less potent drug. This dihydropyridine calcium channel blocker is most commonly used to treat high blood pressure. Nifedipine opens the pulmonary artery, reducing chest tightness and easing breathing.
The recommended dose is a 20mg slow-release capsule every 8 hours or a 30mg slow-release capsule every 12 hours.
