Should I use Diamox?

Should you use Diamox while trekking at high altitude?

Diamox will always appear as a most asked question for anyone looking to trek to Everest Base Camp or climb Kilimanjaro and for good reason. Most people have never heard of it before and will be cautious about taking any drug while trekking or climbing in a remote region of the world. These trips mean a lot to people, and nobody wants to take an unnecessary risk.

So, what is Diamox?

Acetazolamide, sometimes sold under the name brand name and commonly know as Diamox was developed to treat glaucoma and epilepsy and is now commonly prescribed to aid a person’s acclimatation to high altitude.

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How does it work?

Diamox is a Carbonic Anhydrase Inhibitor, which causes your blood to become more acidic by excreting bicarbonate (by making you pee a lot) and when the blood gets acidic it believes that it has more carbon dioxide in it. The body gets rid of this excess carbon dioxide in a simple way, you start to breathe deeper and faster, getting rid of the carbon dioxide and in doing so taking in more oxygen. More oxygen greatly reduces the risk of developing altitude sickness and helps the body acclimatise. Simple, right?

If you are like me the above won’t mean much, I know paracetamol gets rid of head aches but I’m not sure how. The most important thing is I know it works and its safe for me to take. So, I recommend you speak to a travel clinic, these guys specialise in travel medicine and will determine if it is safe for you to take.

How and when to take Diamox

It is recommended you take Diamox for a couple of days while at home to make sure you don’t experience any horrible side effects.

Diamox generally comes in 250mg tablets, and the usual dose is ½ a pill in the morning with breakfast and ½ a pill with your evening meal. This is almost always sufficient to aid in your acclimatisation and help prevent serious altitude issues such as AMS, HAPE and HACE. Most people will take Diamox proactively right at the beginning of their trip and continue to take it until they come back down to the point where they started. Other trekkers and climbers may choose to start without taking Diamox and then start taking it if they feel unwell or if their guide recommends it.

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Should you take Diamox?

For the vast majority of people Diamox is safe and only increases your chances of having an enjoyable and successfully trip. I took Diamox while climbing Kilimanjaro and immediately noticed some mild pins and needles in my face and an increased need to pee, all of which stopped immediately when I stopped taking it. I think that is a small price to pay to reach the summit of Kilimanjaro and it gave me peace of mind that I was doing everything I could do to stay healthy while achieving everything I set out to.

It is important to understand that Diamox helps the body acclimatise but it is not a cure, and you still have to follow all the normal rules for acclimatisation:

Stay Hydrated – 3 to 4 litres of water a day (even more important if taking Diamox)

Walk Slowly – Don’t overexert yourself, trek your own trek

Gain Altitude Gradually – Don’t fly straight to high altitude, increase it gradually with adequate acclimatisation days

Eat Well – Maintain a high calorie diet to fuel your body

Avoid Alcohol – Do not dehydrate yourself.

(Once the symptoms of AMS have started there are only 3 ways to stop it, Descent, Descent, Descent!)

Ultimately, everyone will have a different opinion on what’s best for them and it’s a personal decision, just be honest with your guide about what you are doing and follow their advice. Our guides also carry with them, oximeters and heart rate monitors so they gauge how your body is dealing with the altitude. They're very experienced and that's one of the reasons we have a very high success rate in getting people to Everest Base Camp or to the summit if Kilimanjaro.

Im a big beleiver in the quote "knowledge dispels fear" So I hope this blog and my experience have helped. Any high altitude trek is supposed to an enjoyable and enriching experience so just enjoy yourself and have a great time!

Dave Carpenter

Head of Operations & Painted Yeti

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Written By

David Carpenter

Head of Ops & Painted Yeti