The use of acetazolamide for the prevention of high-altitude illness

• Published in: Journal of travel medicine Vol. 27; no. 6
• Main Author: Shlim, David R
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 26.09.2020
• Subjects: Acetazolamide; Airports; Altitude; Diarrhea; High altitude; High-altitude environments; Illnesses; Medicine; Prophylaxis; Risk; Risk assessment; Travel; Travel medicine; Travellers; Trekking; Acetazolamide; high-altitude illness; acute mountain sickness; incidence of altitude illness
• ISSN: 1195-1982; 1708-8305
• DOI: 10.1093/jtm/taz106

Abstract Background Modern travel means that many travellers can arrive abruptly to high-altitude destinations without doing any trekking or climbing. Airports in high-altitude cities mean that travellers can go from sea level to over 3350–3960 m (11 000–13 000 feet) in a matter of hours, putting themselves at risk for high-altitude illness (HAI). Methods Acetazolamide has been shown to be an effective way to help prevent HAI on such itineraries. The risk of HAI on rapid arrival to altitudes over 3350 m (11 000 feet) has been shown to range from 35% to nearly 50%. The risk can be higher for high-altitude trekking. This risk is far higher than most travel medicine risks and is on a par with the risk of travellers’ diarrhea in high risk destinations. Result The use of prophylactic acetazolamide in a dosage of 125 mg every 12 h is highly effective at diminishing the risk of HAI. Conclusion Travel medicine practitioners should become comfortable with assessing the risk of HAI and determining when it is appropriate to offer acetazolamide prophylaxis to prevent HAI.