diamox for acclimitization??

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Re: diamox for acclimitization??

Postby rijaca » Thu Dec 20, 2007 4:07 pm


From your reference ( http://www.ismmed.org/ ):

Acetazolamide Use & Dosage:
For treatment of AMS
We recommend a dosage of 250 mg every 12 hours. The medicine can be discontinued once symptoms resolve. Children may take 2.5 mg/kg body weight every 12 hours.

For Periodic Breathing
125 mg about an hour before bedtime. The medicine should be continued until you are below the altitude where symptoms became bothersome.

I think my friends were prescribed 125 mg/day.
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Re: diamox for acclimitization??

Postby Matt » Thu Dec 20, 2007 4:13 pm

I see where you're coming from, Rijaca, but treatment uses different dosing than prevention.
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Re: diamox for acclimitization??

Postby La Mula » Thu Dec 20, 2007 4:20 pm

With all this being discussed -- really, if anyone is having such troubles at altitude; just get down.
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Re: diamox for acclimitization??

Postby rlw49 » Thu Dec 20, 2007 5:04 pm

I got you covered.
Anaphylaxis at 14000ft would suck Literally and figurtively(sp)
The doses quoted are correct. Docs will often decrease doses based on their past experience. Working on the assumption "Use the least possible to get a desired effect." Ideally, this drug should only be used in people who have had past bad experiences. If you're spending $5,000 to climb Kili on a once-in-a-lifetime trip, you probably want to have Diamox on hand. On a routine trip to a 14er I don't think I would mess with it. The other suggestions hydration,herbs,Vit C, taking it easy, etc. are probably more realistic for the everyday traveler.

On a side note, it looked like Mogens Jensen was using an inhaler which contains salmeterol, on his summit of Everest.
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Re: diamox for acclimitization??

Postby Athos791 » Thu Dec 20, 2007 6:40 pm

rlw49, about your comment on mogens, yes he was using an inhaler, and with my very limited medical knowledge, i do not know how this works, but just wanted to point out that he uses it because he is a chronic asthmatic :D
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Re: diamox for acclimitization??

Postby rollin » Thu Dec 20, 2007 6:44 pm

I have used it a couple times before with no side effects other than carbonated drinks tasting weird.

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Re: diamox for acclimitization??

Postby acwilson » Thu Dec 20, 2007 6:58 pm

del_sur wrote:
acwilson wrote:Aspirin while taking diamox is contraindicated, also. Aspirin can increase the inhibition of carbonic anhydrase, leading to an increased state of metabolic acidosis. [/b] In english, aspirin can increase the actions of diamox, leading to a dangerous accumulation of carbonic acid in you blood. Beware if you combine aspirin with diamox in your high altitude therapy, try ibuprofen instead.

The bolded statement is false, as there is no contraindication to ASA use with diamox, and diamox's intended effect is to inhibit carbonic anhydrase. That's where its beneficial effects in acclimation come from. All NSAIDs reduce the effectiveness of diamox by indirectly reversing the carbonic anhydrase inhibition, but this is not a contraindication. In fact, ASA use would decrease the risk of metabolic acidosis... ASA and ibuprofen are exactly the same in this context, and neither is a great idea in settings where dehydration is a concern.
The title of this abstract kind of says it all. http://jpet.aspetjournals.org/cgi/conte ... 277/3/1464

The drug interactions between ASA and diamox are category D (A being none, D being really bad, X being fatal), as per my Lexi-Drugs software, which is used by physicians and other health care providers. Multiple sources on the web gave the same interactions, so I am standing by the Lexicomp recommendation.
Try http://www.drugs.com/drug_interactions.php, http://www.pdrhealth.com/drugs/rx/rx-mono.aspx?contentFileName=Dia1131.html&contentName=Diamox&contentId=177, and http://www.drugstore.com/pharmacy/drugchecker/interactions.asp?x=46&y=3&drugs=Diamox+Sequels%7C100016%3BAspirin%7C105844&patientdrugs=.

If you'll notice I did say that diamox inhibits CA. The exact mech of action on how ASA increases the effects of diamox are unknown. (The drugs.com link gives a hypothesis about renal clearance which makes the most sense.) Based on your article you would think the two would cancel each other out. You have to remember though that the mech of action of ASA and NSAIDs are different, therefore making the use of ibuprofen, naproxin, and others a safer alternative to ASA when used in conjunction with diamox. If renal clearance of ASA or diamox is reduced, the pH of the blood would be reduced either way resulting in metabolic acidosis, albeit through different chemicals.
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Re: diamox for acclimitization??

Postby CG_old » Thu Dec 20, 2007 7:23 pm

RichAllen wrote:I would have to say that with all this discussion about pros and cons and what's accurate and what's not to:

1. Get in shape.
2. Acclimate
3. Hydrate

Of the 5 people I know who climbed Denali, none used Diamox, all summited, and others in their party who did use it were so dehydrated it was detrimental to their health and summit attempt.

I'm going to say it again. Fitness has ABSOLUTELY NO BEARING on preventing AMS. It's a complete myth. Show me the peer-reviewed journals that show fitness prevents AMS.
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Re: diamox for acclimitization??

Postby rlw49 » Thu Dec 20, 2007 7:27 pm

It would be hard to miss that Mogens was an asthmatic or Tim had broken multiple bones in a cycle wreck. My comment was just an aside, but it never hurts to to get clarification.

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