Efficacy of Low-dose Acetazolamide (125 mg BID) for the Prophylaxis of Acute Mountain Sickness: A Prospective, Double-blind, Randomized, Placebo-controlled Trial
- 1 March 2003
- journal article
- clinical trial
- Published by Mary Ann Liebert Inc in High Altitude Medicine & Biology
- Vol. 4 (1) , 45-52
- https://doi.org/10.1089/152702903321488979
Abstract
The objective of this study was to determine the efficacy of low-dose acetazolamide (125 mg twice daily) for the prevention of acute mountain sickness (AMS). The design was a prospective, double-blind, randomized, placebo-controlled trial in the Mt. Everest region of Nepal between Pheriche (4243 m), the study enrollment site, and Lobuje (4937 m), the study endpoint. The participants were 197 healthy male and female trekkers of diverse background, and they were evaluated with the Lake Louise Acute Mountain Sickness Scoring System and pulse oximetry. The main outcome measures were incidence and severity of AMS as judged by the Lake Louise Questionnaire score at Lobuje. Of the 197 participants enrolled, 155 returned their data sheets at Lobuje. In the treatment group there was a statistically significant reduction in incidence of AMS (placebo group, 24.7%, 20 out of 81 subjects; acetazolamide group, 12.2%, 9 out of 74 subjects). Prophylaxis with acetazolamide conferred a 50.6% relative risk reduction, and the number needed to treat in order to prevent one instance of AMS was 8. Of those with AMS, 30% in the placebo group (6 of 20) versus 0% in the acetazolamide group (0 of 9) experienced a more severe degree of AMS as defined by a Lake Louise Questionnaire score of 5 or greater (p = 0.14). Secondary outcome measures associated with statistically significant findings favoring the treatment group included decrease in headache and a greater increase in final oxygen saturation at Lobuje. We concluded that acetazolamide 125 mg twice daily was effective in decreasing the incidence of AMS in this Himalayan trekking population.Keywords
This publication has 8 references indexed in Scilit:
- Pathogenesis of High-Altitude Pulmonary EdemaJAMA, 2002
- High-Altitude IllnessNew England Journal of Medicine, 2001
- SightingsHigh Altitude Medicine & Biology, 2001
- Pharmacological prevention of acute mountain sicknessBMJ, 2001
- Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic reviewBMJ, 2000
- Acetazolamide or dexamethasone for prevention of acute mountain sickness: a meta-analysisJournal of Wilderness Medicine, 1994
- Acetazolamide in the Treatment of Acute Mountain Sickness: Clinical Efficacy and Effect on Gas ExchangeAnnals of Internal Medicine, 1992
- THE INCIDENCE, IMPORTANCE, AND PROPHYLAXIS OF ACUTE MOUNTAIN SICKNESSThe Lancet, 1976