From the Guidelines
The most effective treatment for altitude sickness is immediate descent to a lower elevation, and for mild cases, rest, hydration, and over-the-counter pain relievers like acetaminophen or ibuprofen can help manage symptoms. When it comes to medication, acetazolamide (Diamox) is commonly used to speed acclimatization by increasing breathing rate and reducing alkalinity in the blood, typically at a dose of 125-250mg twice daily 1. For individuals with a history of high-altitude pulmonary edema (HAPE), nifedipine is recommended as a preventative measure, started with ascent and continued for 3 to 4 days after arrival at the terminal altitude 1. Alternatives to nifedipine include PDE5 inhibitors and dexamethasone, which have been shown to reduce the incidence of HAPE in adults 1. Some key points to consider in the treatment of altitude sickness include:
- Rest and hydration to manage symptoms
- Over-the-counter pain relievers like acetaminophen or ibuprofen (400-600mg every 6-8 hours) for mild cases
- Acetazolamide (Diamox) to speed acclimatization
- Nifedipine for individuals with a history of HAPE
- Dexamethasone (4mg every 6 hours) for moderate to severe cases to reduce brain swelling
- Supplemental oxygen for immediate relief when available
- Prevention through gradual ascent (no more than 1,000-1,500 feet per day above 8,000 feet), staying hydrated, avoiding alcohol, and considering acetazolamide 24 hours before ascent if there is a history of altitude sickness. It's crucial to prioritize immediate descent if symptoms worsen, especially with confusion, difficulty walking, or shortness of breath at rest, as severe altitude sickness can be life-threatening 1.
From the Research
Treatment for Altitude Sickness
The treatment for altitude sickness can be categorized into several approaches, including:
- Acclimatization: Adequate acclimatization via controlled ascent remains the most important factor in preventing altitude illness 2, 3, 4
- Rapid Descent: Rapid descent remains the most important treatment factor, although treatment at altitude with various therapies is possible for mild cases with adequate resources 2, 3
- Oxygen Supplementation: Oxygen supplementation is also a crucial factor in treating altitude sickness 3
- Pharmacological Intervention: Pharmacological intervention, such as the use of ibuprofen, can be effective in reducing the incidence of acute mountain sickness 5
- Rest: Rest or beginning to descent is also recommended as part of the treatment 3
- Portable Hyperbaric Chamber: If available, a portable hyperbaric chamber can be used as part of the treatment 3
Prevention of Altitude Sickness
Prevention of altitude sickness is also crucial, and can be achieved through:
- Gradual Ascent: Gradual ascent to allow the body to acclimatize to the higher altitude 2, 6, 4
- Chemoprophylaxis: Chemoprophylaxis with nonsteroidal anti-inflammatory drugs, such as ibuprofen, can be effective in preventing acute mountain sickness 5
- Education: Education on the risks and symptoms of altitude sickness, as well as proper counseling, can help prevent life-threatening conditions 4