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Notes from first time using Diamox

Discussion of medical or rescue topics related to climbing and mountaineering.

Re: Notes from first time using Diamox

Postby Tonka » Fri Oct 21, 2011 2:53 am

We're doing Kili in December and have decided to not even consider taking Diamox. My girlfriend warned me about the 4 hour erection rule and the lack of medical care so now I have to rule out the Viagra also :(
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Re: Notes from first time using Diamox

Postby radson » Fri Oct 21, 2011 3:20 am

ok i'll ask..."the 4 hour erection rule"?
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Re: Notes from first time using Diamox

Postby kylenicolls » Thu Nov 03, 2011 5:16 am

"If an erection persists for more than 4 hours call you doctor immediately." Or something like that, is my guess.
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Re: Notes from first time using Diamox

Postby Tonka » Thu Nov 03, 2011 3:07 pm

radson wrote:ok i'll ask..."the 4 hour erection rule"?

There is talk that viagra also works in helping with altitude. Basically it increases blood flow.
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Re: Notes from first time using Diamox

Postby markhallam » Sun Dec 04, 2011 6:16 am

Hello all

I just wanted to set the record straight on use of Diamox, with a brief word on current guidelines from UIAA medical advisors (plus from my own experience):

They don't recommend routine use of Diamox (aka Acetozolamide) unless 1) you are known to be susceptible to AMS or 2) such as a rescue worker, having to make a fast ascent. It is useful to treat AMS symptoms (making sure dehydration etc addressed as well) - and then may be given at the dose of one tablet twice per day (unless allergic to sulphonamide antibiotics). But at this high dose you will experience the side effects of tingling, strange taste and peeing a lot.

If you are taking Diamox to prevent AMS the first thing to note is that it isn't a substitute for a proper accimatisation program - such as (again) recommended by UIAA (climb as high as you like but don't increase your sleeping height by more than 300m (1000ft) per day above about 3000m (10,000ft approx) - and have a rest day every 3rd day).

I climbed Aconcagua at the beginning of this year and had no AMS. I summited on my 14th day into the park - so given my end point was roughly 14,000ft above my start this pretty much matched the 1000ft per day rule. I carried Diamox but didn't intend to use it other than need. As it happened although I didn't get AMS I did suffer with uncomfortable Cheyn-Stokes breathing at night above 4200m, so I took half a tablet just at night - which worked fine - and wasn't enough to provoke side effects.

If you want to know more here is a link to the article I wrote on Expedition Medicine:


Incidentally, on the subject of Coca and high altitude my advise is DON'T!! The active ingredient is basically cocaine - which does give a lift and the illusion of extra energy etc. But at a cost - which is suppression of appetite and of the desire to drink. I saw someone using Coca on Aconcagua and he put himself and his team mates in danger when on several occasions he went down with dehydration and hypothermia (he could have died as low down as 5000m, just getting to Camp 1 - got into a terrible state, but didn't learn his lesson - and kept doing same thing all the way up - summited but then had to be half carried down by his 2 companions, who were exhausted enough by their own efforts).

Cheers, Mark
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Re: Notes from first time using Diamox

Postby artrock23 » Mon Apr 15, 2013 6:39 am

This weekend I got to try Diamox (as treatment for AMS) for the first time.

Although it didn't completely eliminate the AMS symptoms i've always gotten whenever exerting myself at altitudes over 10Kft (mostly just really bad headaches), it did lessen the severity considerably. Is it worth the side effects (for me: higher than usual urine output and tingling in the fingers)? Absolutely.
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Re: Notes from first time using Diamox

Postby Budha » Fri May 03, 2013 12:10 am

I popped Diamox for a few days to hike up Whitney and my only side affect was a tingling right hand for 20 minutes. I'll definately take it again.
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Re: Notes from first time using Diamox

Postby peninsula » Sun Jul 14, 2013 2:51 pm

I tried Diamox 12 years ago after my son experienced terrible nausea and headaches on our first father-son trip into the Sierra. A medical friend made the suggestion I give it a try. I figured if my son was going to take it, I'd try it as well as I'd always get headaches and insomnia the first day or two. We test dosed in advance to make sure there were no significant side effects. Tingling fingers, mild "ear ringing", and vivid dreams were noticed, but otherwise all was okay.

Long story short, it did the trick. I've used Diamox ever since. Headaches are eliminated by 90% and the first night is with a good night's sleep. I could acclimate more slowly, but choose not to take the necessary additional time. I start with half a tab three to four times over 24 hours prior to ascending, and continue that dose for another 24 to 32 hours before stopping. I'm always drinking excessive amounts of water whether I'm on Diamox or not, so increased urine volume is not an issue if one drinks plenty of water as we all should when in the mountains, especially the first day or two. Taking a snack every three or four hours the first day also seems to help, but I generally have no appetite and must make myself eat.

Lastly, Diamox is a diuretic and will increase urine volume making increased water intake all the more important. On any diuretic, urine will become dilute and take on a paler color, but it should not be cloudy. The mention of cloudy urine in the opening of this thread suggests something else may have been complicating the user's experience.
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