Pharmacological prevention of altitude illness, so a few words about Acetazolamide

High-altitude illness is a condition occurring in individuals at high altitudes (above 2500 meters above sea level) resulting from inadequate acclimatization to the unique environment. Initially, the illness manifests as a set of nonspecific symptoms of acute mountain sickness (AMS). Rapid ascent to altitudes above 4000 meters can lead to severe complications, such as high-altitude cerebral edema (HACE) or high-altitude pulmonary edema (HAPE). With appropriate prevention measures, gradual ascent, and the use of medications such as acetazolamide, the risk of developing AMS can be significantly reduced. The mechanism of action of acetazolamide involves increased excretion of bicarbonates by the kidneys, leading to acidification of the blood (a decrease in blood pH). This process stimulates the respiratory center, increasing minute ventilation and improving oxygenation at high altitudes. Clinical studies have demonstrated that using acetazolamide at doses of 125 mg twice daily is effective in preventing AMS. Acetazolamide is well-tolerated, although it may cause side effects such as paresthesia, taste disturbances, or mild diuretic effects. Its use can significantly enhance the body's ability to adapt to high altitudes. In life-threatening conditions such as HAPE and HACE, the treatment primarily relies on other methods. Due to the increasing prevalence of travel to high-altitude regions, physicians and rescue workers are encountering this issue more frequently. The aim of this study is to compile current knowledge on the use of acetazolamide in altitude sickness.