When Acetazolamide (Diamox) came to the market in 1982 by drug maker Teva it was designed to treat Glaucoma. By accident it was discovered that one of the effects of the drug could be utilized to assist high altitude climbers and trekkers acclimatize to the effects of low oxygen pressure, the cause of acute mountain sickness (AMS).
It is not a cure, but rather a way to lessen the impacts of rapid altitude gain. It works chemically re-acidifying the blood. This acts as a respiratory stimulant, accelerating acclimatization. As it is a diuretic, expect to urinate more than you normally would as the drug forces your kidneys to excrete bicarbonate. Taking Diamox on a high altitude climb is not a guarantee that you will not suffer from altitude sickness. It just stacks the odds in your favor.
Many mountain myths have surfaced surrounding this “wonder drug” and we hope to clarify its performance with the following myths and facts.
Just the Facts Please
MYTH: Diamox conceals altitude symptoms.
FACT: Diamox quickens acclimatization. As acclimatization occurs, symptoms improve. Diamox does not hide anything, so if you get altitude sickness, you will still have symptoms. If you feel well, you are well.
MYTH: Diamox prevents AMS during rapid ascent.
FACT: This is not myth, but rather partial truth. Diamox lessens AMS risks and that’s why it is recommended for climbers on fast ascents. This protection is not absolute so don’t feel assured that a rapid ascent on Diamox is without big-time risk. If you ascend so rapidly that AMS strikes, it can hit you suddenly, severely and fatally.
MYTH: Diamox prevents AMS from getting worse during ascent.
FACT: Diamox does not protect against worsening AMS with a continued ascent.
MYTH: If Diamox is stopped, symptoms worsen.
FACT: There is no rebound effect. When Diamox is stopped, acclimatization slows to your natural rate. If AMS is still present, it takes longer for you to improve. If AMS is not present, you still need to ascend at a managed rate. You don’t get sick simply by stopping Diamox.
Like all powerful drugs, Diamox has its upsides and downsides. The side effects could include, but are not limited to, fatigue, drowsiness, tingling fingers and toes, decreased libido, vomiting and diarrhea. To assuage worries, consider that the World Health Organization placed it on its list of essential medications.
Everyone tolerates the drug differently, but for maximum impact when trekking at high altitudes, it’s best to follow your doctor’s recommended dose, usually 125mg to 250mg one to two days before the climb and then once or twice daily throughout the ascent.
So the dilemma is this – I know I’m prone to altitude sickness, but I hate taking drugs. Adventure travel with Tusker and its advanced medical high altitude techniques gives you as good a chance to get to the top without drugs as any company on the mountain. But there is still no guarantee. Diamox could be that extra buffer you need to help get you to the top.
Consult your doctor, do your own homework and talk to others who have used the drug. It’s your body and your climb. Take it seriously.