From the Guidelines
For an 8-day high-altitude hike, start taking acetazolamide 24-48 hours before ascending to altitude and continue throughout your time at high elevation, stopping when you begin your descent or complete your hike. The typical dosage is 125-250 mg twice daily, as recommended for preventing altitude sickness 1. Acetazolamide works by increasing respiratory rate and urination, which helps your body acclimatize faster by reducing the alkalinity in your blood caused by the hyperventilation response to high altitude.
When considering the duration of acetazolamide use, it's crucial to weigh the benefits against potential side effects, such as a transient myopic shift, and ensure proper corrective measures are in place 1. High altitude illness, including acute mountain sickness, is primarily prevented by proper acclimatization, gradual ascent, staying hydrated, and avoiding alcohol and smoking.
Key points to consider during your hike include:
- Staying well-hydrated while taking acetazolamide, as it acts as a diuretic
- Being aware of potential side effects, including increased urination, tingling in fingers and toes, and altered taste for carbonated beverages
- Avoiding acetazolamide if you have sulfa allergies
- Remembering that acetazolamide does not replace proper acclimatization practices like gradual ascent and adequate hydration 1.
From the Research
Acetazolamide Dosage and Duration for High-Altitude Hiking
- The optimal duration for taking acetazolamide before a high-altitude hike is not explicitly stated in the provided studies, but we can infer some guidelines based on the available evidence.
- A study published in 2019 2 suggests that taking acetazolamide on the day of ascent may be effective in preventing acute mountain sickness (AMS), but it may not be as effective as taking it the night before.
- Another study from 2019 3 compared the efficacy of a reduced dose of acetazolamide (62.5 mg twice daily) with the standard dose (125 mg twice daily) and found that the reduced dose was noninferior to the standard dose in preventing AMS.
- A network meta-analysis published in 2018 4 compared the efficacy of different interventions for preventing AMS and found that acetazolamide at 125,250, and 375 mg twice daily was effective in reducing the incidence of AMS.
- A study published in 2014 5 suggested that pre-treatment with low-dose acetazolamide on the day before ascending to high altitude may reduce AMS incidence on the first day at high altitude, but improved oxygen availability to tissues not until the second day of exposure.
Recommendations for 8-Day Hike at High Altitude
- Based on the available evidence, it is recommended to start taking acetazolamide at least 1-2 days before ascending to high altitude 5.
- The duration of acetazolamide treatment is not explicitly stated in the provided studies, but it is generally recommended to continue taking the medication for the duration of the high-altitude exposure 2, 3, 4.
- For an 8-day hike at high altitude, it is recommended to take acetazolamide for the entire duration of the hike, starting 1-2 days before ascent and continuing until descent 2, 3, 4.
- The optimal dosage of acetazolamide is not explicitly stated in the provided studies, but the standard dose of 125 mg twice daily is commonly recommended 2, 3, 4.