Prophylaxis of Acute Mountain Sickness Clinical Trial
Official title:
Acetazolamide for the Prevention of High Altitude Illness: a Comparison of Dosing
This is a phase 4, randomized, double-blinded interventional trial comparing alternative doses of Acetazolamide for the prevention of High Altitude Illness.
Acetazolamide, or Diamox, is the standard medical prophylaxis agent for high altitude
illness. The medication is effective in preventing acute mountain sickness (AMS), high
altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Its mechanism is
via inhibition of the carbonic anhydrase enzyme which counteracts the respiratory alkalosis
which occurs during ascent to altitude. It facilitates the excretion of bicarbonate in the
urine. As a result, acetazolamide hastens acclimatization and helps prevent high altitude
disorders.
Current recommended dosing is 125 mg, orally twice daily, started 24 hours prior to ascending
in elevation. Side effects include tingling of the fingers and toes and perioral numbness
which may be erroneously interpreted as stroke symptoms. Since acetazolamide is a mild
diuretic, frequent micturition may occur leading to interruption of daytime activities as
well as broken sleep. These effects can affect safety at high altitude. Acetazolamide is
normally discontinued 2 days after the user has reached their highest elevation or a plateau
in elevation.
A lower dose may be just as effective in preventing high altitude illnesses while preventing
the disconcerting side effects resulting from its use. A smaller dose has not been studied,
however. We will compare the common dose of 125 mg twice daily with a lower dose of 62.5 mg
twice daily.
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