What pharmacological treatments are recommended for the prevention and management of altitude sickness in primary care?

The provided UK guidelines (CG150, CG187, NG115, NG245) do not specifically detail pharmacological treatments for the prevention and management of altitude sickness ¹,²,³,⁴. However, peer-reviewed medical literature provides recommendations for primary care settings (Wright et al., 2008; Luks and Swenson, 2008; Joyce et al., 2018).

For the prevention of altitude sickness:

• Acetazolamide is considered the primary prophylactic agent for acute mountain sickness (AMS) (Luks and Swenson, 2008). It is effective in preventing AMS (Wright et al., 2008; Joyce et al., 2018).
• Dexamethasone is an alternative prophylactic agent for AMS, particularly for individuals who cannot tolerate acetazolamide (Luks and Swenson, 2008). It is also effective in prevention (Wright et al., 2008; Joyce et al., 2018).
• For the prevention of high-altitude pulmonary oedema (HAPE), nifedipine is recommended (Wright et al., 2008; Luks and Swenson, 2008; Joyce et al., 2018). Other agents like tadalafil, sildenafil, and salmeterol have also been identified for HAPE prevention (Joyce et al., 2018).

For the management of altitude sickness:

• For acute mountain sickness (AMS), pharmacological treatment options include acetazolamide and dexamethasone (Wright et al., 2008; Luks and Swenson, 2008; Joyce et al., 2018).
• For high-altitude cerebral oedema (HACE), dexamethasone is a key pharmacological treatment (Wright et al., 2008; Luks and Swenson, 2008; Joyce et al., 2018).
• For high-altitude pulmonary oedema (HAPE), pharmacological management includes nifedipine (Wright et al., 2008; Luks and Swenson, 2008; Joyce et al., 2018). Tadalafil and sildenafil are also used in the treatment of HAPE (Joyce et al., 2018).