A Pharmacist Gives Advice About High-Altitude Travel

You may be wondering whether you should take medications with you to prevent high altitude illness before you go on your ski trip or go mountain climbing. You'll be glad to know that most of this type illness is mild and it typically goes away in a few days. Some of the symptoms may include difficulty breathing, headache, and loss of appetite. Acetaminophen or ibuprofen can be taken to relieve headaches, as long as a person has not been told not to take them by a doctor.

Severe and dangerous symptoms may include disorientation, fainting, and an inability to walk straight. If these symptoms occur, the victim should be taken to a lower elevation immediately.

If you have reason to believe that you will have symptoms, there are a couple of things your doctor may give you. A medication called acetazolamide may be taken twice a day to help prevent problems or to treat symptoms. It is also known by the brand name of Diamox. You need to start it a day or so before you start to go into an area of higher elevation and continue to take it for a couple more days after you get there. This medication sometimes causes side effects such as a metallic taste. It can also cause tingling sensations and sometimes causes enough potassium loss to produce muscle cramping. You may be able to head that off by eating high-potassium foods such as orange juice, avocadoes, walnuts, root vegetables, dried apricots and bananas.

If you can't tolerate acetazolamide, you may benefit from a prescription anti-inflammatory medication called dexamethasone. This medication is also sometimes prescribed for severe allergic reactions under the brand name of Decadron. You will probably have to take it every 6 to 12 hours. It will help with high-altitude symptoms but it won't help you to acclimate to higher elevations like the acetazolamide can. Be aware that potassium loss can also occur with dexamethasone.

If you are prescribed one of the two prescription medications above, it would be helpful to know the effects of losing too much potassium (hypokalemia) from your body so that you can contact your doctor if they occur. Symptoms of hypokalemia may include nausea, muscle weakness, irregular heart rate, muscle spasms, lethargy, fatigue, and constipation. Paralysis may occur if the loss is severe.

It is important for people who have heart disease or who are elderly to be aware that going to high altitudes may change the way they feel. Just because their condition is stable at sea level does not mean they won't have trouble at a high-altitude destination. Patients with unstable angina, uncontrolled irregular heart rate (arrhythmia) or heart failure need to be especially careful. They should not exercise if they plan to travel to altitudes above 5,000 feet unless they take time to acclimate to the new conditions over 3 to 5 days or so. Even then, they should get the approval of their doctors.

Patients who have severe heart failure, angina, or disease of the valves of the heart should not travel above 8000 feet.

Those who take medication for a condition called atrial fibrillation may have exacerbations at high altitudes due to the lack of oxygen and resulting increased heart rate. Rapidly climbing may require a higher dose of medications to control the heart rate, and that dosage adjustment would definitely need to be supervised by a physician.

The above precautions do not usually apply to airplane travel unless the flight is longer than 16 hours.

DISCLAIMER: This article is provided for information only. This information is not a substitute for professional medical care by a qualified doctor or other health care professional. I am not responsible or liable, directly or indirectly, for any form of damages whatsoever resulting from the use (or misuse) of information contained in or implied by the information. This information is in no way intended as a recommendation of any drug therapy and is not intended as a diagnosis of any problem you may have.

SOURCE: In part, I consulted the following to verify the facts of this article: No author given. "High Altitude Illness" Pharmacist's Letter 2010;26(2):260204.