Prevention of acute mountain sickness depends on ascent rate and drug dose

Many drugs have been used to prevent acute mountain sickness, but data on efficacy and harm are lacking. Dumont et al (p 267) systematically searched randomised trials on the prevention of acute mountain sickness. After reviewing 33 such trials, they suggest that dexamethasone 8-16 mg or acetazolamide 750 mg should be considered for prophylaxis when ascent is faster than 500 metres a day. Contrary to widespread belief, acetazolamide 500 mg is not efficacious. When the rate of ascent is lower than 500 metres a day, prophylaxis is not worth while.

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Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review

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