Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
The provided UK guidelines (CG150, CG187, NG115, NG245) do not specifically detail pharmacological treatments for the prevention and management of altitude sickness NICE CG150,NICE CG187,NICE NG115,NICE NG245. However, peer-reviewed medical literature provides recommendations for primary care settings Wright et al. 2008Luks & Swenson 2008Joyce et al. 2018.
For the prevention of altitude sickness:
- Acetazolamide is considered the primary prophylactic agent for acute mountain sickness (AMS) Luks & Swenson 2008. It is effective in preventing AMS Wright et al. 2008Joyce et al. 2018.
- Dexamethasone is an alternative prophylactic agent for AMS, particularly for individuals who cannot tolerate acetazolamide Luks & Swenson 2008. It is also effective in prevention Wright et al. 2008Joyce et al. 2018.
- For the prevention of high-altitude pulmonary oedema (HAPE), nifedipine is recommended Wright et al. 2008Luks & Swenson 2008Joyce 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. 2008Luks & Swenson 2008Joyce et al. 2018.
- For high-altitude cerebral oedema (HACE), dexamethasone is a key pharmacological treatment Wright et al. 2008Luks & Swenson 2008Joyce et al. 2018.
- For high-altitude pulmonary oedema (HAPE), pharmacological management includes nifedipine Wright et al. 2008Luks & Swenson 2008Joyce et al. 2018. Tadalafil and sildenafil are also used in the treatment of HAPE Joyce et al. 2018.
Key References
- CG150 - Headaches in over 12s: diagnosis and management
- CG187 - Acute heart failure: diagnosis and management
- NG115 - Chronic obstructive pulmonary disease in over 16s: diagnosis and management
- NG245 - Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)
- (Wright et al., 2008): High hopes at high altitudes: pharmacotherapy for acute mountain sickness and high-altitude cerebral and pulmonary oedema.
- (Luks and Swenson, 2008): Medication and dosage considerations in the prophylaxis and treatment of high-altitude illness.
- (Joyce et al., 2018): Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema.