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 (about 8200 feet). Once above 3000 m (about 9840 feet), the altitude at which one sleeps should not be increased by more than 500 m (about 1600 feet) in 24 hours. In addition, a rest day should be taken every 3-4 days.[29]​​

In those patients who are prone to 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 pretravel 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]

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