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A randomized controlled trial of the lowest effective dose of acetazolamide for acute mountain sickness prevention

American Journal of Medicine Jul 01, 2020

Lipman GS, Jurkiewicz C, Burnier A, et al. - Whether a reduced dose of acetazolamide is as efficacious as standard dosing with fewer side effects for the prevention of acute mountain sickness, was determined in this double-blind, randomized, controlled noninferiority trial. Researchers compared acetazolamide 62.5 mg twice daily with the standard dose acetazolamide 125 mg twice daily initiating the evening before ascent from 1240 m (4100 ft) to 3810 m (12,570 ft) over 4 hours. The incidence of acute mountain sickness (ie, headache, Lake Louise Questionnaire ≥3, and another symptom) was assessed as the primary outcome. This study involved 106 participants. Findings revealed that acetazolamide 62.5 mg twice daily was not as effective as 125 mg twice daily for prevention of acute mountain sickness. Experts suggest that acetazolamide 62.5 mg twice daily should not be advised for acute mountain sickness prevention because it was found to be associated with increased risk and afforded no demonstrable symptomatic or physiologic advantages.

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