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diamox for acclimitization??

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Re: diamox for acclimitization??

Postby Jon Frohlich » Thu Dec 20, 2007 10:08 am

Add me to the list of those that hated it. I took half a pill on Kilimanjaro the afternoon of the 3rd day and the side effects were so intense they nearly cost me the summit. No thanks. The 'cure' in this case is worse than the disease (at least for me).

La Mula

Re: diamox for acclimitization??

Postby La Mula » Thu Dec 20, 2007 10:22 am

For those that didn't find it to work, it reads like it was relied on improperly.

Most of the problem here isn't really the drug, it's genetics.

Re: diamox for acclimitization??

Postby Jon Frohlich » Thu Dec 20, 2007 10:46 am

La Mula wrote:For those that didn't find it to work, it reads like it was relied on improperly.

Most of the problem here isn't really the drug, it's genetics.


I'm confused by your response. All drugs have side effects. There is no way to know how your body will react without trying the drug. I don't think anyone here is saying that Diamox is a bad drug, just one with some potentially very significant side effects. I'm not sure what you mean by your statement that it was relied on improperly.

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Re: diamox for acclimitization??

Postby kiliclimber7_17_02 » Thu Dec 20, 2007 11:00 am

My son and I used about a quarter of the recommended dose from 15,200 up on Kilimanjaro and from 16,200 (Camp 1) on Aconcagua. We did not have any problems at all but we seem to adjust to altitude pretty well. Probably cause I'm pretty slow. We had been over 14,000 several times just before the trips. We were very careful about hydration and eating well, which may have had the most impact. For me a small dose of melatonin helps me sleep at altitude. The people who over use the stuff seem to really have problems. I have a friend who tried it on a 14er coming from sea level and he did not feel well. You might try a very small dose and see how it goes.

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Re: diamox for acclimitization??

Postby so_il_summit » Thu Dec 20, 2007 11:59 am

I didn't have much trouble at all. I think that I am in very good shape over all. When I came out last, it only took me about a day or two of running around to get used to it, and by the end of the week, i was feeling almost 100 percent, minus a little gasping. I never had trouble sleeping at altitude. I wasn't gonna run a marathon anytime soon, but that wasn't what I was going for.

On the other side of things my brother had the full gambet. He was weak, moving slow, couldn't catch his breath, and even at one point got pretty sick. His attitude about doctors probably put him in a bad spot, but he made it alright, and after a night in denver he felt fine. I was mostly thinking that it might help him. It seems like most people had trouble when they took it just when they where on the mountain, the day they where having trouble.

Aren't you supposed to use it a couple days before, and while you are acclimating, to help the process. I didn't think it was an insta fix, you could take on the side of the mountain.

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Re: diamox for acclimitization??

Postby Eaglevu » Thu Dec 20, 2007 1:31 pm

I appologies if I repeat anything already said on this discussion.

Diamox is more of a sleep aid than a acclimization aid. It helps prevent Shein-Stokes Syndrome by stimulating the respitory system. In other words, your breathing does not become too relaxed while sleeping. More sleep means stronger body and a few more RBC's.

It is also a diaretic, like caffeine and alcohol, as it tends to dehydrate you. You need to consume more water. Perhaps 6+ quarts/day than 5.

My good doctor prescribes only 125mg/day, taken before bed. A 2 day head start is good.
-Eaglevu
(Member of the "EVEREST IS TOO D_MN HIGH!" party.)

CG_old

Re: diamox for acclimitization??

Postby CG_old » Thu Dec 20, 2007 1:39 pm

shaun wrote:This is all just a guess though...does anyone know what the dosing regimin is for this?


We would take 125mg twice a day (or a 250mg time release sequel once a day) starting 3 days before arriving it elevation. You're right about it needing to be taken ahead of time and about it being a carbonic anhydrase inhibitor. In most people it does work when taken correctly, the science is there to back it up.

PS: Someone earlier mentioned AMS being caused by lack of fitness. This is a very popular misconception in climbing and just simply is not true. There is absolutely no correlation between AMS and fitness, actually, to the contrary: There is some evidence to show a HIGHER correlation of AMS in extremely fit individuals. Theories as to why this could be are a)people with greater fitness are better capable of exceeding the recommended daily elevation gain, thus placing themselves at greater risk of AMS and b)highly fit people tend to have very low respiratory rates while sleeping, which can lead to Cheyne-Stokes respiration. In my wife's case, it was (b) which lead to her AMS. She was an extremely fit runner (and smart enough to be well hydrated, etc, etc) who would only get sick while sleeping at altitude, never while moving. For her, Diamox worked wonders as it regulated her serum CO2 levels during sleep, completely eliminating symptoms of AMS.

My guess is Diamox is going to be very beneficial to people in the (b) camp above, and not as useful for those exceeding recommended rates of acclimatization.

- Chris
Last edited by CG_old on Thu Dec 20, 2007 1:42 pm, edited 1 time in total.

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Re: diamox for acclimitization??

Postby Matt » Thu Dec 20, 2007 1:42 pm

jimlup wrote:Ginkgo Biloba has recently been shown to be helpful. I've been using it and had only a minor headache on Harvard summit after 3 days aclimatization from sea level.

http://www.everestnews.com/stories024/peterh.htm

I'm sure diamox is useful too.


Disclaimer: no recommendations below, just assorted opinions and information. Talk it over with your physician.
Gingko is somewhat helpful, but vinpocetine (rx in europe, otc here) far outstrips it in every way, especially in terms of everyday use for memory enhancement. I have recommended it to patients who now swear by it for this purpose.
I find it quite useful for getting back into the swing of things in spring and early summer.
There are some other (rx europe/otc here) drugs that work really well for acclimatizing: piracetam and its analogues, especially. I've found them to be excellent for not only acclimatizing, but keeping a clear head and sharp mind while at altitude.

As far as a regimen for diamox, here is the standard:
500-1000mg per day in three divided doses, starting 24-48 hours before ascent, and continuing 48h into the trip (not really a concern on 14ers). There is an extended release formulation available (diamox sequels) that can be taken twice daily.
Do not take diamox if you have a sulfa (sulfonamide) allergy. Anaphylaxis at 14000ft would suck.
Here's a great reference website, with information for both laypersons and health professionals... http://www.ismmed.org/

One last thing... Salmeterol (Serevent) made a good showing in the New England Journal a few years back.
Here's the abstract: http://content.nejm.org/cgi/content/abs ... 46/21/1631
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Re: diamox for acclimitization??

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

Aspirin while taking diamox is contraindicated, also. Aspirin can increase the inhibition of carbonic anhydrase, leading to an increased state of metabolic acidosis. 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. Alcohol is also another thing to avoid while on this drug-it slows your breathing/drive to breathe, and once again you end up with too much carbonic acid in your blood.

I can see where this stuff might be useful for those traveling to the Himalayas, but for Colorado, I'd stick with the water/rest therapy.
Annie

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Re: diamox for acclimitization??

Postby rijaca » Thu Dec 20, 2007 4:23 pm

del_sur wrote:As far as a regimen for diamox, here is the standard:
500-1000mg per day in three divided doses, starting 24-48 hours before ascent, and continuing 48h into the trip (not really a concern on 14ers). There is an extended release formulation available (diamox sequels) that can be taken twice daily.
Do not take diamox if you have a sulfa (sulfonamide) allergy. Anaphylaxis at 14000ft would suck.
Here's a great reference website, with information for both laypersons and health professionals... http://www.ismmed.org/



del_sur,

Are your dosages correct? I thought I read 125-250 mg/day was the prescribed dosage, and friends that tried diamox during their Kili trip even thought that was too much.
"Spent a little time on the mountain
Spent a little time on the hill"

Re: diamox for acclimitization??

Postby Jon Frohlich » Thu Dec 20, 2007 4:29 pm

rijaca wrote:del_sur,

Are your dosages correct? I thought I read 125-250 mg/day was the prescribed dosage, and friends that tried diamox during their Kili trip even thought that was too much.


I think most of the people I was with did 125mg twice a day. Some things I have seen indicate a benefit at even 60mg x 2.

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Re: diamox for acclimitization??

Postby Matt » Thu Dec 20, 2007 4:52 pm

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.


Sources?
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



rijaca wrote:
del_sur wrote:As far as a regimen for diamox, here is the standard:
500-1000mg per day in three divided doses, starting 24-48 hours before ascent, and continuing 48h into the trip (not really a concern on 14ers). There is an extended release formulation available (diamox sequels) that can be taken twice daily.
Do not take diamox if you have a sulfa (sulfonamide) allergy. Anaphylaxis at 14000ft would suck.
Here's a great reference website, with information for both laypersons and health professionals... http://www.ismmed.org/



del_sur,

Are your dosages correct? I thought I read 125-250 mg/day was the prescribed dosage, and friends that tried diamox during their Kili trip even thought that was too much.


Rijaca,
From the mfr:
Acute Mountain Sickness
Dosage is 500 mg to 1000 mg daily, in divided doses using tablets or sustained-release capsules as appropriate. In circumstances of rapid ascent, such as in rescue or military operations, the higher dose level of 1000 mg is recommended. It is preferable to initiate dosing 24 to 48 hours before ascent and to continue for 48 hours while at high altitude, or longer as necessary to control symptoms.


However, doses for most all drugs need to be individualized to match patient characteristics, and it's hard to say what other factors may have affected your friends. I used diamox once, at a dose of 250mg three times daily, starting 48h before the climb, and it worked fine for me.

Ron, are you reading this?
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A man is rich in proportion to the number of things he can afford to let alone. -HDT
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