Diamox / Acetazolamide on Kilimanjaro

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Acetazolamide, or what is commonly sold under the trade name Diamox,  is a drug that is used for various medical treatments – including  glaucoma, sleep apnea, epilepsy and hypertension. It is also used to  help mitigate the effects of altitude sickness.

Using Diamox on Kilimanjaro is a question you are going to face when you start your preparations to reach the Roof of Africa.
 

Diamox (aka Acetazolamide), as it is used for Acute Mountain Sickness (AMS), is a diuretic (i.e., it promotes the production of urine) and a prophylactic (i.e., is used as a preventative medicine – not a cure).

It is also a carbonic anhydrase inhibitor (ahem, what?). Essentially this means that it promotes the excretion, via urine, of bicarbonate – which is why it is useful for altitude sickness.
 

The excretion of bicarbonate increases the acidity of the blood, as bicarbonate is a conjugate base of carbonic acid. Increased acidity in the blood is equated by our bodies as increased CO2. The body responds to the imaginary excess CO2 by breathing deeper and faster to get rid of the CO2. Deeper, faster breathing increases the amount of oxygen received by the blood. This helps with the acclimatization process and helps prevent the onset of AMS symptoms.

Obviously, you should first consult your doctor to check whether Diamox is a suitable drug given your particular medical history. It is not suitable for pregnant women or anyone with kidney or liver disease issues (obviously these people shouldn’t be climbing Kilimanjaro in the first place)

We recommend taking Diamox for 2-3 days 2 weeks before departure to test whether you experience any side effects.

*Frequent urination – everyone experiences this when taking Diamox.  It can result in the development of kidney stones, so it is important that you drink loads of fluids whilst taking the medication.

*Numbness and tingling in the fingers, toes and face – Many people experience this side effect when taking Diamox. The sensation is a little discomforting but not dangerous.

*Taste alterations (some foods might taste weird)
*Nausea, vomiting and diarrhea – this is rare. These side effects should be identified during your test before departing for Kilimanjaro. 

Unfortunately, these side effects are common with AMS and therefore can easily be misdiagnosed as AMS
*Drowsiness and confusion is also possible – again these side effects can be confused with AMS

Typically, Diamox comes in 250mg tablets. Most people take half a  tablet in the morning and half in the evening. You should start taking tablets one day before arriving in Kilimanjaro and continue taking the same dosage for all ascent days. You can cease taking Diamox on descent.