March 24, 2019
Acute Mountain Sickness: An OTC Preventive

Acute Mountain Sickness: An OTC Preventive

by Berkeley Wellness  

If you are planning a trip to a high-altitude destination, taking acetaminophen may help reduce your risk of developing acute mountain sickness (AMS), according to a study in the journal Wilderness & Environmental Medicine. AMS occurs most often at 8,000 feet or higher above sea level when people are not acclimatized to the altitude, resulting in headaches, shortness of breath, dizziness, fatigue, intestinal upset, irritability, and trouble sleeping.

Previous research has shown that ibuprofen reduces AMS, due to its anti-inflammatory action—as much as acetazolamide, the prescription drug of choice for AMS prevention. The new randomized clinical trial compared the two over-the-counter pain relievers in 225 partially acclimatized people trekking at elevation above 14,000 feet in Nepal, who took either ibuprofen (600 milligrams) or acetaminophen (1,000 milligrams) three times a day until they reached 16,000 feet.

Though 25 people in the acetaminophen group (22 percent) developed AMS compared to 18 (16 percent) in the ibuprofen group, the difference was not statistically significant—plus there was no significant difference in severity of symptoms in those who did get AMS, leading the investigators to conclude that “any differences [between the two drugs], should they exist, are likely small and of questionable clinical importance.” Unlike ibuprofen and other nonsteroidal anti-inflammatory drugs, acetaminophen works primarily through its analgesic action. That it helped in the study means that AMS may involve other pathways besides inflammation.

Note that because the study participants started taking the drugs when already at high altitude, it's not known what their effect would be at lower altitude, where most hikers begin their treks.

Also see Avoiding Altitude Sickness.