Prevention and Treatment of Acute Altitude Illness

Publication Date: June 1, 2019

Last Updated: March 14, 2022

Recommendations

Acute mountain sickness (AMS) and high altitude cerebral edema (HACE)

PREVENTION

Gradual ascent, defined as a slow increase in sleeping elevation, is recommended for AMS and HACE prevention. A specific approach is described further later in the text. (1 – Strong, B)

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Acetazolamide

Acetazolamide should be strongly considered in travelers at moderate or high risk of AMS with ascent to high altitude. ( 1 – Strong , A)

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Acetazolamide can be used in children for prevention of AMS. (1 – Strong, C)

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Dexamethasone

Dexamethasone can be used as an alternative to acetazolamide for adult travelers at moderate or high risk of AMS. (1 – Strong, A)

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Inhaled budesonide

Inhaled budesonide should not be used for altitude illness prophylaxis. (1 – Strong, C)

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Ginkgo biloba

Ginkgo biloba should not be used for AMS prevention. (1 – Strong, C)

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Ibuprofen

Ibuprofen can be used for AMS prevention in persons who do not wish to take acetazolamide or dexamethasone or have allergies or intolerance to these medications. (2 – Weak, B)

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Acetaminophen

Acetaminophen should not be used for AMS prevention. (1 – Strong, C)

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Staged ascent and preacclimatization

When feasible, staged ascent and preacclimatization can be considered as a means for AMS prevention. (1 – Strong, C)

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Hypoxic tents

Hypoxic tents can be used for facilitating acclimatization and preventing AMS, provided sufficiently long exposures can be undertaken regularly over an appropriate number of weeks and other factors, such as sleep quality, are not compromised. (2 – Weak, B)