Should I take Diamox?

The question I probably get asked the most from people wanting to climb Kilimanjaro or trek Everest Base Camp is: Should I take Diamox?

My answer is always the same: I am not a doctor.

What is Diamox?

Acetazolamide is generally sold under the name Diamox. Diamox is prescribed for conditions such as Glaucoma, Sleep Apnea, Epilepsy & Hypertension. It is also now commonly prescribed to prevent Acute Mountain Sickness (AMS). Diamox is a Diuretic (promotes the production of urine) and a Prophylactic (it is used as a preventative, not a cure. The Complicated bit – Diamox is a Carbonic Anhydrase inhibitor, which in simple terms it promotes the excretion of bicarbonate through urination.

But how does this help with altitude sickness? Excretion of bicarbonate increases the acidity of the blood. Increased acidity in the blood makes our bodies assume we have increased CO2. Our bodies respond to the imaginary excess by breathing quicker and heavier to get rid of the CO2. The rapid breathing increases the amount of oxygen received by the blood, thus helping with the acclimatisation process and at the same time preventing the onset of AMS.

PLEASE NOTE: Diamox does not cure the symptoms of AMS. Once AMS has started, the only way to stop it is to descend.

So should I take Diamox?

The important thing is to consult your GP or travel clinic whilst considering Diamox for your trip. They know your past medical history and can advise. GP’s are now aware of the use Diamox for AMS prevention; this was not so common 10 years ago. Travel clinics are very knowledgeable on the subject as they are dealing with the question more frequently than local GP’s.

Diamox is not suitable for pregnant women or people with liver or kidney issues.

I always advise people to try Diamox for side effects prior to your trip. Take Diamox for two or three days several weeks before your trip and make sure you won’t fall foul of any of the side effects. Diamox generally comes in a 250mg tablet. I recommend ½ after breakfast and ½ after your evening meal.

The side effects of Diamox need to be considered.

• Frequent Urination – this is what we want it to achieve. It is one reason why I advise to take the tablet in two halves. You don’t want to be taking a full tablet before bed.
• Numbness and Tingling in the Fingers, Toes and Face – This is easy to spot and often feels like bad pins and needles. These symptoms are lower with a milder dose.
• Taste Alterations – Foods taste differently than normal
• Photosensivity – (tendency to sunburn more easily) Use hats and sunscreen.
• Nausea, Vomiting, and Diarrhea – this is rare. During your pre-trek test identify these issues. These are also the symptoms of AMS, therefore your guides may misdiagnose you and send you down.
• Confusion and Drowsiness – again these are rare, but also symptoms of AMS.

Diamox should be taken on the day before you start your climb and you should continue until you start to descend.