Acetazolamide for the Prevention of Acute Mountain Sickness-A Systematic Review and Meta-analysis

Institute of Infection, Immunity and Inflammation, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, UK.
Journal of Travel Medicine (Impact Factor: 1.58). 09/2012; 19(5):298-307. DOI: 10.1111/j.1708-8305.2012.00629.x
Source: PubMed


Acetazolamide has been reported to be effective in the prevention of acute mountain sickness (AMS). Our aim was to conduct a systematic review of randomized, placebo-controlled trials of acetazolamide in the prevention of AMS.
Studies were identified by searching the MEDLINE, Embase, Cochrane Clinical Trials Register, and databases. Primary end point was difference in incidence of AMS between acetazolamide and placebo groups.
Acetazolamide prophylaxis was associated with a 48% relative-risk reduction compared to placebo. There was no evidence of an association between efficacy and dose of acetazolamide. Adverse effects were often not systematically reported but appeared to be common but generally mild. One study found that adverse effects of acetazolamide were dose related.
Acetazolamide is effective prophylaxis for the prevention of symptoms of AMS in those going to high altitude. A dose of 250 mg/day has similar efficacy to higher doses and may have a favorable side-effect profile.

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Available from: Neil Ritchie, Nov 20, 2014
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    • "Compared to the obstructive apneas observed at baseline in OSAS patients, central apneas induced by an ascent to altitude are characterized by the intermittent absence of the drive to breathe [17] and are generated by the brainstem respiratory center as a response to changes in blood gas concentrations [18]. One treatment for central apneas at altitude is acetazolamide, a carbonic anhydrase inhibitor frequently used in the treatment of acute mountain sickness [19], [20]. Acetazolamide prevents central apneas at altitude through metabolic acidosis by its diuretic effects [21]. "
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