Altitude sickness happens when your body doesn’t get enough oxygen at high elevations—usually above 8,000 feet. Symptoms can be mild or severe. If they get worse even when you’re resting, you’ll need treatment.
Certain medications can help prevent or treat altitude sickness. The best one for you depends on things like your prevention goals, past experiences with meds, specific symptoms, and what treatments are available.
1. Diamox (Acetazolamide)
Diamox (acetazolamide) is FDA-approved to prevent or treat altitude sickness. It helps your body adjust to higher elevations.
Experts strongly recommend acetazolamide for both adults and kids. Here’s how to take it:
Acetazolamide Dosages for Altitude Sickness
| Use | How to Take | Adult Dose | Kids’ Dose (per kg of weight) |
|---|---|---|---|
| Prevention (including brain swelling symptoms) | By mouth | 125 mg every 12 hours | 1.25 mg/kg every 12 hours (max 125 mg per dose) |
| Treatment (short-term altitude sickness) | By mouth | 250 mg every 12 hours | 2.5 mg/kg every 12 hours (max 250 mg per dose) |
For prevention, take Diamox the night before going to higher altitudes. But even if you start taking it the same day you ascend, it can still help.
Can I Get Diamox Without a Prescription?
No, Diamox isn’t available over the counter—you’ll need a prescription.
2. Procardia (Nifedipine)
Nifedipine is FDA-approved for chest pain and high blood pressure. The extended-release (ER) version can also prevent or treat fluid buildup in the lungs at high altitudes.
However, nifedipine should only be used for treatment if:
- You can’t descend to lower elevations
- Supplemental oxygen or portable hyperbaric therapy isn’t available
The dose is the same for prevention and treatment:
- 20 mg by mouth every 8 hours
- OR 30 mg every 12 hours
3. Phosphodiesterase-5 (PDE5) Inhibitors
PDE5 inhibitors like tadalafil and sildenafil are usually used for erectile dysfunction, enlarged prostate, or high blood pressure in the lungs. But they can also treat fluid buildup in the lungs from high altitudes.
Due to limited evidence, these are only used if:
- You can’t go to lower elevations
- Oxygen or hyperbaric therapy isn’t an option
- Nifedipine isn’t available
Prevention doses:
- Tadalafil: 10 mg every 12 hours
- Sildenafil: 50 mg every 8 hours
4. Dexamethasone
Dexamethasone is a steroid with many uses. While it doesn’t help your body adjust to high altitudes, it’s an alternative to Diamox for prevention in adults. It’s also strongly recommended for treating acute altitude sickness (with or without brain swelling).
Dexamethasone Dosages for Altitude Sickness
| Use | How to Take | Adult Dose | Kids’ Dose (per kg of weight) |
|---|---|---|---|
| Prevention (including brain swelling) | By mouth | 2 mg every 6 hours OR 4 mg every 12 hours | Not recommended |
| Treatment (acute altitude sickness) | By mouth, muscle, or vein | 4 mg every 6 hours | 0.15 mg/kg every 6 hours (max 4 mg per dose) |
| Treatment (brain swelling from high altitude) | By mouth, muscle, or vein | 8 mg once, then 4 mg every 6 hours | 0.15 mg/kg every 6 hours (max 4 mg per dose) |
Some studies suggest dexamethasone (8 mg every 12 hours) can also prevent fluid in the lungs if nifedipine or tadalafil isn’t an option.
5. Ibuprofen
Ibuprofen can help prevent altitude sickness, but only if you can’t take Diamox or dexamethasone due to allergies or side effects.
For headaches at high elevations, you can also take ibuprofen or acetaminophen.
When to See a Doctor
Mild symptoms (should improve in a few days):
- Headache
- Low appetite
- Nausea/vomiting
- Tiredness
But if symptoms worsen while resting, go to a lower altitude and get medical help.
Serious symptoms (need immediate care):
- Trouble balancing or moving
- Breathing problems
- Confusion
- Cough
- Drowsiness
- Extreme fatigue
- Weakness
Summary
Altitude sickness happens at high elevations due to low oxygen. You can prevent it by ascending slowly or taking medications.
Symptoms range from mild to life-threatening. Mild ones usually go away on their own, but if they persist at rest, see a doctor. Severe symptoms (like brain swelling or lung fluid) need emergency care.