Ibuprofen may ward off altitude sickness

[pvnisher Profile 14er Peak List Not Entered Trip Reports]

http://thechart.blogs.cnn.com/2012/03/20/ibuprofen-may-ward-off-altitude-sickness/?hpt=hp_t3
Ibuprofen has been used for decades to treat pain. Now, research suggests the drug's anti-inflammatory properties also may help prevent the piercing headaches and other symptoms of altitude sickness.

A small new study, published this week in the Annals of Emergency Medicine, found that people who took four 600-milligram doses of ibuprofen over a 24-hour period in which they ascended to 12,570 feet above sea level were less likely to experience altitude sickness than people taking a placebo.

Sixty-nine percent of the participants who took placebo during the ascent developed the headaches, nausea, dizziness, and fatigue that characterize altitude sickness, also known as acute mountain sickness. By contrast, just 43% of people who took ibuprofen developed the condition.

Health.com: Surprising headache triggers

The prospect of using an over-the-counter pain reliever to stave off altitude sickness is appealing, the researchers say, because the only two drugs currently approved to prevent and treat the condition, acetazolamide and dexamethasone, are prescription-only and carry a risk of side effects.

In fact, many doctors are reluctant to prescribe acetazolamide or dexamethasone unless a person has experienced altitude sickness before, says Robert Roach, Ph.D., director of the Altitude Research Center at the University of Colorado Denver School of Medicine, who was not involved in the study.

Ibuprofen appears to be nearly as effective as acetazolamide and dexamethasone, so it may be an option for people traveling to high altitudes who don't yet know if they're susceptible, Roach adds.

In general, he says, 20% to 30% of people will experience altitude sickness at 7,000 feet, and up to 50% will get sick at 10,000 feet.

Health.com: The 10 most slimming vacations

The study took place in California's White Mountains. Eighty-six men and women who lived close to sea level spent the night at 4,100 feet. In the morning, they drove to an elevation of 11,700 feet and proceeded to hike to 12,570 feet, where they again spent the night.

The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.

The men and women had to be healthy enough to hike at a high elevation, but they weren't necessarily experienced hikers or mountain climbers. That suggests the ibuprofen regimen used in the study could be helpful for everyday tourists on ski or hiking vacations, not just elite climbers, says lead author Grant S. Lipman, M.D., a clinical assistant professor of emergency medicine at the Stanford University School of Medicine.

"We weren't just looking at people who went to Nepal," says Lipman, an avid climber himself. "This [study] was done in our own backyard, so it's very translatable."

Health.com: Essentials for healthy hiking

Experts aren't certain what causes altitude sickness. One hypothesis is that lower oxygen levels at high elevations lead to leaks in the blood-brain barrier, which can cause the brain to swell. Ibuprofen, a non-steroidal anti-inflammatory drug, reduces swelling.

Long-standing advice to prevent altitude sickness includes ascending gradually; drinking lots of fluids; avoiding alcohol for the first day or two at altitude; avoiding medications that can affect breathing, such as sleeping pills and sedatives; and eating lots of carbs, which some researchers believe can improve respiratory function, Lipman says.

In rare cases, altitude sickness can cause potentially fatal brain swelling. Milder, more common symptoms usually go away in a few days - but that may be too long to wait for the trekker or skier with precious little vacation time, Lipman says.

[Upwardlybound Profile 14er Peak List (19)]

I just read that report online. Interesting. For years, we've taken "preventative advil" before climbs and hikes. It certainly helps with muscle soreness, but perhaps it has more beneficial results.

[peter303 Profile 14er Peak List (34) Trip Reports]

Bad, bad advice. Ibruprofen masks the effects of dehydration. This has caused kidney damage in some endurance situations.

http://www.atrailrunnersblog.com/2007/04/science-recap-of-use-of-ibuprofen-in.html

[madbuck Profile Website 14er Peak List Not Entered Trip Reports]

Bad, bad advice. Ibruprofen masks the effects of dehydration. This has caused kidney damage in some endurance situations.

http://www.atrailrunnersblog.com/2007/04/science-recap-of-use-of-ibuprofen-in.html

Rather than "masks," I would say that ibuprofen exacerbates the effects of dehydration on the kidneys. The toxicity of ibuprofen to the kidneys makes it an important consideration when the kidneys are compromised for various reasons: dehydration, stress, kidney disease, diabetes, etc.
Yet I don't have a reason to doubt the conclusions of the ibuprofen/altitude study (I think it's an extension of this one) -- ibuprofen has been shown to reduce incidence of AMS.

While personally I prefer not to take anything, I think people should make an informed decision, keeping all of these tradeoffs in mind, based on their previous experience, conditioning, and the conditions of the climb (duration, temperature, etc.).

[Dave B Profile 14er Peak List Not Entered Trip Reports]

This would be something to test at lower altitude first I would think.

Ibuprofen gives me pretty bad tachycardia (and is a common side affect of Vitamin I). My waking heart rate at White Rocks (19,500 ft.; Aconcagua) was 110 bpm. I just don't think the two would be a good combination.

[crestone14ers Profile 14er Peak List (58)]

Been using ibuprofen for well over twenty five of the forty years of climbing and mountaineering and have had zero ill effects from this pharma.

I use it to keep the inflammation and swelling down to a minimum on very long day and multiple hikes. In addition, ibuprofen has helped considerably in minimizing any ill effects due to high altitude sickness.

Being that I almost always end a day or trip of climbing with beers (and martinis), have never experienced any problems with kidneys or liver when taking the combo of ibuprofen and alcohol. This I know for a fact as I take every six months, kidney and liver function blood tests.

Everyone's metabolic and chemical make-up is different and what my body might like in terms of pharma, might not be so agreeable to you and visa-versa.

YMMV. Use what helps you! I'll use what helps me.

[jsdratm Profile Website 14er Peak List (10) 14ers in Winter (2)13er Peak List (18)]

I tend to get headaches at high altitude even when I'm not dehydrated (urine is clear). Has anyone else had similar issues and do the headaches go away eventually? If I take ibuprofen it will probably eliminate the headaches, but I don't want to ignore a health issue.

[MtHurd Profile 14er Peak List (57) 14ers in Winter (4)13er Peak List (29)]

The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.

So you take 12 ibuprofen pills every 6 hours. So you have permanent liver damage but at least you don't have a headache! Did Advil sponsor the study?

[Yikes Profile 14er Peak List (58) 14ers in Winter (23)13er Peak List (45)Trip Reports]

I tend to get headaches at high altitude even when I'm not dehydrated (urine is clear). Has anyone else had similar issues and do the headaches go away eventually? If I take ibuprofen it will probably eliminate the headaches, but I don't want to ignore a health issue.

My headaches usually start on the way down. I'm drinking enough that I'm pissing every 30 minutes, so I don't think I'm dehydrated. Sure, the headaches go away, but not fast enough, usually by bedtime. The drive home always sucks.

Sounds like a high dose of ibuprofen, but it wouldn't be daily, only on occassional weekends. How does the measured liver damage compare to beer drinkers who have half dozen or more beers per weekend?

[madbuck Profile Website 14er Peak List Not Entered Trip Reports]

The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.

So you take 12 ibuprofen pills every 6 hours. So you have permanent liver damage but at least you don't have a headache! Did Advil sponsor the study?

No, that would be 3 standard 200mg pills every 6 hours. That's higher than the standard U.S. OTC dosage (400mg), but similar to an often prescribed dosage (600mg or 800mg).

Just to be clear, since the liver was mentioned a few times: ibuprofen is less of a risk to liver damage than acetaminophen. Although ibuprofen in very high doses can be toxic to liver cells, the larger threat (that I think people are thinking about) is taking acetaminophen with alcohol, especially for people with liver disease.
People more concerned about liver damage should consider avoiding acetaminophen.
For ibuprofen and long hikes, the possibility of kidney failure is probably more of a realistic concern than liver damage.

Pick your poison, I suppose!

[tmathews Profile 14er Peak List Not Entered]

The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.

So you take 12 ibuprofen pills every 6 hours. So you have permanent liver damage but at least you don't have a headache! Did Advil sponsor the study?

No, that would be 3 standard 200mg pills every 6 hours. That's higher than the standard U.S. OTC dosage (400mg), but similar to an often prescribed dosage (600mg or 800mg).

Just to be clear, since the liver was mentioned a few times: ibuprofen is less of a risk to liver damage than ibuprofen. Although ibuprofen in very high doeses can be toxic to liver cells, the larger threat (that I think people are thinking about) is taking acetaminophen with alcohol, especially for people with liver disease.
People more concerned about liver damage should consider avoiding acetaminophen.
For ibuprofen and long hikes, the dehydration/kidney damage issue is probably more of a realistic concern than liver damage.

Pick your poison, I suppose!

ibuprofen is less of a risk to liver damage than ibuprofen.

[madbuck Profile Website 14er Peak List Not Entered Trip Reports]

Fixed it, thanks!