5 Medications to Help Prevent or Treat Altitude Sickness

Altitude sickness refers to symptoms of low oxygen, which may occur at elevations of at least 8,000 feet above sea level. Certain medications can prevent or treat this condition.

1. Acetazolamide

Acetazolamide (formerly sold under the brand name Diamox) is approved by the Food and Drug Administration (FDA) for preventing or treating altitude sickness. This altitude sickness medication helps your body adapt to higher elevations.

Acetazolamide is strongly recommended for use in adults and children. The following table summarizes how to take it for altitude sickness.

Acetazolamide Dosages for Altitude Sickness
Use	Route of Administration	Adult Dosage	Children Dosage Based on per Kilogram (kg) Weight
Prevention of altitude sickness, including brain swelling symptoms	By mouth	125 milligrams (mg) every 12 hours	1.25 mg/kg every 12 hours; max of 125 mg per dose
Treatment of acute (short-term) altitude sickness	By mouth	250 mg every 12 hours	2.5 mg/kg every 12 hours; max of 250 mg per dose

To prevent altitude sickness, take acetazolamide the night before traveling to higher elevations. However, it can still provide some benefit if you take it on the day that you start increasing your altitude.

Can I Buy Acetazolamide Over the Counter?

Acetazolamide is not an OTC product. Pharmacies require a prescription to fill this medication for you.

2. Procardia (Nifedipine)

The FDA approved nifedipine for chest pain and high blood pressure. Nifedipine extended-release (ER) can also be taken to prevent and treat a condition of fluid buildup in your lungs (pulmonary edema) at high altitudes.

However, nifedipine should only be taken for treatment when moving to lower elevations and accessing supplemental oxygen or portable hyperbaric therapy (an oxygen treatment) are impossible.

The dosage for nifedipine ER does not change for prevention or treatment. It is either:

• 20 mg by mouth every eight hours
• 30 mg every 12 hours

3. Phosphodiesterase-5 Inhibitors

The phosphodiesterase-5 (PDE5) inhibitor drug class has several uses:

• Erectile dysfunction (ED)
• Enlarged prostate
• High blood pressure in the lungs (pulmonary hypertension)

PDE5 inhibitors, such as tadalafil or sildenafil, can also treat fluid buildup in the lungs from high elevations. However, due to low-quality evidence, these medications are only taken under the following circumstances:

• When traveling to lower elevations is not feasible
• When supplemental oxygen or portable hyperbaric therapy is inaccessible
• When nifedipine is unavailable

When taken for prevention, the dosages are:

• Tadalafil: 10 mg by mouth every 12 hours
• Sildenafil: 50 mg by mouth every eight hours

4. Dexamethasone

Dexamethasone is a corticosteroid (steroid) that has many uses.

Though dexamethasone does not help your body adjust to higher elevations, it is considered an alternative to acetazolamide for altitude sickness prevention in adults. Further, dexamethasone is strongly recommended for the treatment of acute (short-term) altitude sickness with or without brain swelling (cerebral edema) symptoms.

The following table includes information on how to take dexamethasone for altitude sickness.²

Dexamethasone Dosages for Altitude Sickness
Use	Route of Administration	Adult Dosage	Children Dosage Based on per Kilogram (kg) Weight
Prevention of altitude sickness, including brain swelling symptoms	By mouth	2 mg every 6 hours OR 4 mg every 12 hours	Not recommended
Treatment of acute altitude sickness	By mouth, into the muscle, or into the vein	4 mg every 6 hours	0.15 mg/kg every 6 hours; max of 4 mg per dose
Treatment of brain swelling from high altitude	By mouth, into the muscle, or into the vein	8 mg once, then 4 mg every 6 hours	0.15 mg/kg every 6 hours; max of 4 mg per dose

A study also showed that dexamethasone prevented fluid buildup in the lungs. The dosage was 8 mg every 12 hours. Based on this study, dexamethasone can be taken to prevent fluid buildup in the lungs for people who cannot take nifedipine or tadalafil.

5. Ibuprofen

Ibuprofen can also be taken to prevent altitude sickness. Ibuprofen can be taken instead of acetazolamide or dexamethasone, but only if those medications cannot be taken due to allergies or intolerance.²

However, if you are experiencing headaches at high elevations, you can take ibuprofen or acetaminophen for treatment.

When to See a Healthcare Provider

Mild symptoms of altitude sickness include:

• Headaches
• Low appetite
• Nausea and vomiting
• Tiredness¹

These mild symptoms should usually go away after a couple of days. If you have worsening symptoms at rest, however, travel to a lower altitude and seek medical attention.¹

You will also need to immediately see a healthcare provider for serious symptoms of brain swelling or fluid buildup in the lungs. Symptoms can include:¹

• Balance or movement problems
• Breathing problems
• Confusion
• Cough
• Drowsiness
• Extreme tiredness
• Weakness