Primary prevention

In the vast majority of cases, acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE) can be prevented by ascending slowly once above altitudes >2500 m. Once above 3000 m, the altitude at which one sleeps should not be increased by more than 500 m in 24 hours. In addition, a rest day should be taken every 3-4 days.[29]​​

In those patients who are prone to acute mountain sickness (AMS) or intend to ascend quickly, acetazolamide or dexamethasone may be given prophylactically.[37][38][39] Acetazolamide is preferred, but if a patient is intolerant or allergic, dexamethasone may be given.[29][40][41]

Systematic reviews assessing the effectiveness of less commonly-used prophylactic medications (e.g., selective serotonin receptor agonists, N-methyl-D-aspartate receptor antagonists, endothelin-1 receptor antagonists, anticonvulsants and spironolactone), and miscellaneous or non-pharmacological interventions (including ginkgo biloba), have been unable to determine efficacy or safety, because of the small number of studies available and their limited quality.[29][42][43][44]

Nifedipine has been shown to reduce the incidence of HAPE in individuals with a previous history of radiographically documented HAPE.[45]

Individuals with existing medical conditions should consult a physician to discuss pre-travel planning in order to decrease risk of high-altitude illness. Discussions should cover whether their conditions are stable, whether any dose adjustments are necessary, and whether the destination has available medical resources.[1][6]

Use of this content is subject to our disclaimer