Altitude Sickness Medication in Ealing – Bramley Pharmacy

Travelling to high altitude soon?
Whether you are trekking the Inca Trail to Machu Picchu, hiking to Everest Base Camp, summiting Mount Kilimanjaro, exploring Aconcagua or the Annapurna Circuit, flying into high cities like La Paz, Cusco, Quito or Lhasa, our pharmacist-led travel clinic in Ealing can help you prepare safely with evidence-based altitude sickness medication and practical prevention advice.

Altitude Illness – What It Is

Altitude illness describes conditions that can occur when people ascend quickly to altitude, usually above 2,500m:

• Acute Mountain Sickness (AMS) – common and usually mild if you stop ascending.
• High Altitude Cerebral Oedema (HACE) – brain swelling; life-threatening.
• High Altitude Pulmonary Oedema (HAPE) – fluid in the lungs; life-threatening.

Oxygen concentration in the air remains ~21%, but barometric pressure falls with altitude, so each breath contains fewer oxygen molecules. The body can adapt with acclimatisation, but if ascent is too rapid, illness can develop.

Key messages

• Most trips to altitude can be enjoyed safely if sensible precautions are taken.
• Severe altitude illness (HACE/HAPE) is an emergency and needs urgent descent.
• Gradual ascent with rest days is the best prevention.
• Ensure your travel insurance covers altitude and helicopter evacuation where relevant (e.g., Kilimanjaro, Everest region).
• People with pre-existing conditions should seek personalised advice before travel.

Risk Areas & Popular Itineraries

High mountain regions include the Himalayas, Andes, Rocky Mountains, Alps, and Caucasus. UK travellers frequently search for altitude tablets when planning:

• Everest Base Camp (5,380m) & Annapurna Circuit (Nepal)
• Mount Kilimanjaro (5,895m, Tanzania)
• Inca Trail (~4,200m max) & Lake Titicaca (Peru/Bolivia)
• Aconcagua (6,960m, Argentina)
• Mount Kinabalu (4,095m, Malaysian Borneo)
• Mount Fuji (3,776m, Japan)

High-altitude city arrivals: Lhasa (3,658m), La Paz (3,630m), Cusco (3,399m), Quito (2,819m), Bogotá (2,644m), Addis Ababa (2,408m), Johannesburg (1,750m).

Who Is at Risk?

• Trip factors: speed of ascent, daily increase in sleeping altitude, maximum altitude.
• Individual factors: previous altitude illness, residence at low altitude, heavy exertion on arrival, some heart or lung conditions.
• Physical fitness does not protect against altitude illness.

How common is AMS?

• 2,000–3,000m: ~9–25% of unacclimatised travellers develop AMS.
• 3,500–4,500m: ~35–50%.
• HACE/HAPE: rare below 2,800m; around 1–2% above 4,000–5,000m.

Wilderness Medicine Society (WMS) AMS Risk Categories

Signs & Symptoms

AMS: typically 6–10 hours after ascent above ~2,500m: headache, nausea, anorexia, dizziness, fatigue, poor sleep. Usually settles in 1–3 days if you rest and do not ascend further.

HACE: confusion, altered consciousness, incoordination (ataxia). Often follows AMS. Emergency.

HAPE: breathlessness on exertion → breathlessness at rest, cough (dry → frothy/blood-stained), chest tightness/wheeze. Can occur without AMS. Emergency.

Other: headaches at altitude are common; periodic breathing at night (hyperventilation/apnoea cycles) is usually benign.

Diagnosis & Treatment

• AMS (mild): stop ascent; rest; consider ibuprofen or paracetamol; anti-sickness medication if required; monitor for 24–48 hours.
• Moderate/severe AMS, HACE or HAPE: immediate descent; seek urgent medical help. Oxygen, portable hyperbaric chamber, dexamethasone (AMS/HACE) or nifedipine (HAPE) may be used by experienced clinicians/guides.

Medication Options We May Prescribe

Acetazolamide (Diamox®) – helps acclimatisation

• Use: prevention; sometimes treatment adjunct.
• Typical dosing: 125mg twice daily, start 24 hours before ascent; continue during ascent and for at least two days after the highest sleeping altitude (then stop if descending).
• Benefits: reduces risk and severity of AMS; speeds acclimatisation.
• Side effects: increased urination, tingling in fingers/toes, nausea, altered taste (fizzy drinks taste flat).
• Avoid: pregnancy (especially first trimester); severe sulfa allergy; caution in significant renal/hepatic disease. Consider a supervised trial dose before travel.

Dexamethasone – for emergency treatment

• Use: moderate/severe AMS or suspected HACE when descent is delayed; not for routine prevention.
• Note: improves symptoms but does not aid acclimatisation; do not re-ascend until fully recovered.

Nifedipine – HAPE prevention/treatment in specific cases

• Use: usually for travellers with previous HAPE risk, under specialist advice.

Ibuprofen / Paracetamol – symptom relief

• Use: relieve headache and discomfort; do not prevent AMS.

Herbal products (e.g. ginkgo, coca) are not recommended for AMS prevention due to insufficient evidence.

Preventing Altitude Illness

General advice

• Above 3,000m, increase sleeping altitude by ≤500m/day and take a rest day every 3–4 days.
• Do not ascend if you have symptoms. Descend if symptoms worsen or are severe.
• Never leave an unwell traveller alone; trek with experienced guides (especially on Kilimanjaro, Everest Base Camp, Annapurna).
• Plan itineraries sensibly if flying directly to high cities (e.g., Cusco, La Paz, Lhasa): schedule rest days early.
• Insurance must cover altitude and emergency evacuation.

Medication strategy

• Low risk: focus on gradual ascent; medication usually unnecessary.
• Moderate/high risk: consider acetazolamide (unlicensed use) alongside a safe itinerary.
• For summit-then-descend routes (e.g., Kilimanjaro): in the absence of symptoms, preventive medication can usually be stopped once descent begins.

Special Groups

Pre-existing conditions

Discuss COPD, angina, congenital heart disease or other significant conditions with our pharmacist or your GP before travel. Access to care at altitude is limited.

Pregnancy

Avoid travel to sleeping altitudes >3,000m in pregnancy; acetazolamide is not recommended (especially first trimester). Seek personalised advice.

Children

Children have similar risk to adults; diagnosis is harder in pre-verbal children. Specialist advice is recommended before considering acetazolamide in children.

Other risks at altitude

Cold injury/frostbite, hypothermia, sun exposure, traveller’s diarrhoea and blisters are common issues on treks such as the Inca Trail and Annapurna. Pack suitable clothing, sun protection and a small first-aid kit.

Why Choose Bramley Pharmacy (Ealing)

• Pharmacist-led travel clinic with same-day appointments.
• Prescription support for altitude sickness prevention when clinically appropriate.
• Travel vaccines and wider travel health services (link to your Travel Clinic and Vaccinations pages).
• Clear, practical plans tailored to Kilimanjaro, Everest Base Camp, Inca Trail, Aconcagua, Annapurna, Kinabalu, Fuji and high-altitude city trips.

Disclaimer: This information is not a substitute for personalised medical advice. Altitude illness can be life-threatening. Always seek urgent help and descend if severe symptoms develop.