Climbing Kilimanjaro: Use Diamox or Not?

Diamox, also known as acetazolamide, is a prescription drug used for various purposes, including preventing and treating AMS (Acute Mountain Sickness). The FDA approved this medication back in 1953. Diamox works by acidifying the blood, which triggers increased respiration, thus aiding acclimatization. Research suggests that taking 250 mg of Diamox every 8 to 12 hours before and during rapid altitude ascent leads to milder AMS symptoms.

How Diamox Works

Most of the body’s carbon dioxide resides as bicarbonate in the blood. Diamox helps the body eliminate bicarbonate, making the blood more acidic. The body interprets acidic blood as having excessive carbon dioxide. Consequently, ventilation increases to expel the extra carbon dioxide, leading to deeper and faster breathing. This process, in turn, boosts oxygen intake, accelerating acclimatization. Diamox’s manufacturer reveals that their tests found that those treated with acetazolamide had improved pulmonary function, aiding both those with AMS symptoms and those without. This mechanism ultimately helps prevent and treat altitude sickness. While without Diamox, the body naturally adapts to higher altitudes by increasing breathing rate and depth.

Does Diamox Conceal AMS Symptoms?

Diamox doesn’t hide AMS symptoms; it addresses them. The FDA sanctioned Diamox for preventing and treating altitude sickness. Therefore, feeling better after taking Diamox indicates effective treatment. Diamox is advised as a preventive measure, taken 24-48 hours before ascending and during the climb (until descent). Some use it reactively, taking it only when AMS symptoms arise. Usage should continue until descending below the altitude where symptoms emerged. Diamox serves other purposes, such as treating glaucoma, epilepsy, and fluid retention. Hence, the drug’s effects might extend beyond pulmonary function enhancement.

Choosing Diamox for Kilimanjaro

The decision to use Diamox for AMS prevention is personal. Medications should be chosen carefully, considering potential pros and cons. That’s why our company doesn’t advocate or discourage Diamox usage. The choice rests with the climber. For experienced high-altitude hikers aware of their acclimatization limits, reviewing route profiles and itineraries aids the decision. Those confident in their acclimatization might skip Diamox. For first-timers, it’s tougher. Most wish to summit naturally, but prefer using Diamox over not summiting at all. Consequently, Diamox often makes sense, enhancing summit chances and safety.

Diamox Side Effects

Diamox has side effects, including tingling hands, frequent urination, hearing/taste loss, dizziness, upset stomach, vomiting, and diarrhea. Ironically, Diamox’s side effects sometimes mirror AMS symptoms. This can lead to confusion and abandoning the climb when unnecessary. To avoid this, try Diamox at home for a day or two to gauge its effects. If any side effects resemble altitude sickness or are unacceptable, avoid using it on Kilimanjaro. Acetazolamide comes in extended-release capsules containing 500mg, and regular-release tablets of 125 mg, 250 mg, and 500 mg.