From the Research
Acetazolamide should be prescribed at a dose of 500-750 mg/day for altitude sickness prevention in individuals ascending to altitudes above 3500 meters, as this dose has been shown to be the most effective in minimizing symptoms of acute mountain sickness 1. The medication works by causing mild metabolic acidosis, which stimulates breathing and increases oxygen levels in the blood, helping the body acclimatize faster to high altitudes. Some key points to consider when prescribing acetazolamide for altitude sickness prevention include:
- Starting the medication 24-48 hours before ascent and continuing for at least 48 hours after reaching the target altitude, or longer if symptoms persist
- Common side effects include increased urination, tingling in the fingers and toes, and altered taste for carbonated beverages
- Acetazolamide should be avoided by those allergic to sulfa drugs, and patients with kidney problems or severe liver disease should consult their doctor before use
- Medication should complement other prevention strategies like gradual ascent, proper hydration, and avoiding alcohol and sedatives at altitude It's also important to note that the effectiveness of acetazolamide can vary depending on the individual and the specific altitude, and that other medications such as dexamethasone may also be effective in preventing acute mountain sickness 2. However, based on the most recent and highest quality study, a dose of 500-750 mg/day of acetazolamide is recommended for altitude sickness prevention in individuals ascending to altitudes above 3500 meters 1.