Anyone have any recommendations for getting Diamox without a RX? I'm heading to Silverton in a few weeks and I currently live at sea level. I've had issues with altitude before so I was hoping to take their recommendation and get some diamox for the day before and during the trip if needed. I went to my primary doc and he gave me the heisman stating that he wouldn't give me a prescription for a hypothetical condition and that he was unfamiliar with the drug, etc, etc. I don't blame him but now I'm trying to figure out other options.
- topicAltitude Sicknesstagged by System, 4/15/09
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Altitude Adaptation And Acute Mountain Sickness
Last edited: 10/14/13
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Diamox - Cross Post to General
I, too, have been affected by altitude in the past, and have tried Diamox.
As an alternative, I used Ginko Biloba on my last trip in 2006 and experienced no problems that time. As a result I'll be using it again next month.
There is anecdotal evidence that it may help some people, but it's not as yet clinically proven for AMS (dp - feel free to pitch in here). However, as it's not RX, it's much easier to get hold of.
If you search elsewhere on EPIC Ski, you'll find the thread giving dosage etc. From memory, it's 120mg twice a day - but check first.
Hope whatever you end up doing, the altitude doesn't affect it.
Can you get a referral to an ENT?? They know and understand AMS/Diamox a lot better than a regular doc. Mine immediately said, "sure" to the Rx while my regular MD had to ask about it. But at least she was willing to ask questions to learn more.
I can't say that I blame your doctor. I think any MD who presecribes medicines that they are not familiar with for conditions they know nothing about is pretty foolish. HOWEVER, what he SHOULD have done was to get you a referral to someone who DOES!!
Where are you in Massachusetts? If you are in Boston, the Tufts travel medicine clinic might be a good bet (at NEMC on Washington St near Chinatown- 3 block walk from the Boylston stop on the green line). I am not sure why LCS suggested an ENT doc, as I don't know what that has to do with AMS. As cardweg suggested you can try ginkgo (120 mg twice a day beginning 2 days before ascent). Although you don't need a prescription, the efficacy is controversial, but it works for many. Acetazolamide (Diamox) is well proven, on the other hand, and is the standard treatment and prophylaxis. 250 twice a day beginning 24 hours before ascent is the usual dose- you don't need the higher 500mg dose. However, I would avoid self prescribing. There are some side effects (tingling of the extremities that some people find very disturbing, and you should't drink carbonated beverages- they will taste awful. People with sulfa allergies should NOT use it, as they cross react to this drug).
My 2 cents FWIW (I'm not a doc):
Instead of getting your doctor to prescribe a drug that could be problematic, why not schedule an extra day or so in the area in order to give your body time to manufacture more of those oxygen bearing blood cells (are those the white ones, I forget)? One strategy might be to spend the first few nights at lower elevation (Durango maybe?) Going high during the day and spending the night at lower elevations is a classic strategy for acclimation.
I asked my doctor to proscribe Diamox for me when I was heading for the Himalayas and he was reluctant to do so. He said there could be problems with the drug that could be dangerous absent some medical supervision and, if I began to experience symptoms of altitude sickness why not just return to lower altitude, a proven remedy? He also recommended a period of gradual acclimation. I recall stopping for a few days at 12,000 ft before going over an 18,000 ft pass just to give the body time. This seemed to work well. This doctor was a former flight surgeon by the way and very familiar with Diamox.
I used to take diamox when I lived in New York and visited CO or Utah. Although I never had any problems, this time I'm going with acclimation. I've been down in Raleigh for three weeks. When I get to Denver, I'm spending two days at an airport hotel before going back to Summit. Diamox might be the easier solution, but at this point, I'm not sure of how many drugs I want in my system.
BTW, gingko never worked for me, so I guess everybody is different. Now when I see Dr. Badesch and he perscribes viagra....:)
I've never taken Diamox personally. As I mentioned above, I was discouraged from taking it along on a trip to be used on an as-needed basis. I think the Dr. was mostly concerned that I would be far from any possible medical care and that taking it without a medical examination might lead to problems. I suppose there could be altitude induced medical issues for which Diamox is not appropriate.
Acclimation is a familiar issue for mountaineers and quite a bit has been written on the subject. Descending seems to almost always be the sure fix for altitude sickness apparently.Spending the day at altitude and descending to spend the night at an appreciably lower altitude is often said to be a good technique for tricking your body into manufacturing the additional white blood cells it needs at higher altitude. Some of the literature indicates the importance of keeping well hydrated. Some of the advice often given may very well be apocryphal. Spending the day you arrive in the mountains acclimating and avoiding strenuous exercise at higher elevations is the frequently recommended program that I've usually ignored with the result I seem to experience headaches and discomfort.
Perhaps benign for you. It nearly killed a friend of mine on Killimanjaro. Anyone sensitive to Sulfa should not take it.
FYI info on Diamox>>>>
Diamox Sequels (acetazolamide)
Used for glaucoma AND altitude sickness prevention 500 mg PO qd-bid.
Give first dose 24-48 hours before ascent, last dose 48 hours after peak ascent or until symptoms resolved. As with any drug you should have your MD prescribe.
(Plain Diamox brand has been discontinued in USA)
250 mg bid (2x/day) is equally effective as 500mg with fewer side effects. As previously stated, see a knowledgeable physician. If you have never had problems before and you are not going very high very rapidly I would not recommend prophylaxis. By the way, an excellent paper (from my department, actually) was published in the most recent issue of Wilderness and Environmental Medicine about ginkgo that may point to the reason why the data appear to be in so much conflict:
Leadbetter G, et al: Ginkgo biloba does- and does not- prevent acute mountain sickness. Wilderness and Environmental Medicine 20:66-71, 2009
old discussion for sure but always good to see there are any clinical updates? Ginkgo works great for me ( I take 120 BID starting 3 days prior) but it would be great if anyone knew of any new studies.
Hi Finn- take a look at the citation in my post above yours- that is the latest thing that I know of on Ginkgo. I am not sure if you can get full text from the journal website without a subscription; if not, pm me your email and I will send you a pdf.
- Diamox - Cross Post to General
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