Climbing? Trouble sleeping?

Planning on going above 3000m? For many, myself included as I live at sea level, this can present significant problems. As I usually don’t have as much time for acclimatization due to work constraints, this paper helped me determine what the best dose of acetazolamide is for prevention of acute mountain sickness.

In their analysis, they found a fair amount of attrition due to this study being limited to non-native, non hypobaric studies (ie, people who actually went to the mountains and weren’t from there). Final determination was that the lowest dose of 250mg studied had the least side effects, but also needed a higher number needed to treat than the highest dose of 750mg.

Low EV, Avery AJ, Gupta V, Schedlbauer A, Grocott MP. Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis. BMJ. 2012 Oct 18;345:e6779 [PMC3475644]

Sadly, they didn’t study lower doses than the 250mg, so no way to see if there is a lower effective dose from this study. However, other authors feel that it is time to stop studying acetazolamide against placebo, and instead start doing combination drug studies. I can’t say I disagree.

Penninga L, Wetterslev J, Penninga EI, Gluud C. Acetazolamide for the prevention of acute mountain sickness: time to move on. High Alt Med Biol. 2013 Mar;14(1):85-6. [PMID 23537267]

Further Reading

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EBM Gone Wild

Wilderness Medicine

Emergency physician with interests in wilderness and prehospital medicine. Medical Director of the Texas State Aquarium, Padre Island National Seashore, Robstown EMS, and Code 3 ER | EBM gone Wild | @EBMGoneWild |

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