Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema

Research output: Contribution to journalReview articlepeer-review


External organisations

  • University of Warwick
  • University of Birmingham


Introduction: The physiological responses on exposure to high altitude are relatively well known, but new discoveries are still being made, and novel prevention and treatment strategies may arise. Basic information has changed little since our previous review in this journal 10 years ago, but considerable more detail on standard therapies, and promising new approaches are now available. Areas covered: Herein, the authors review the role of pharmacological agents in preventing and treating high-altitude illnesses. The authors have drawn on their own experience and that of international experts in this field. The literature search was concluded in March 2018. Expert opinion: Slow ascent remains the primary prevention strategy, with rapid descent for the management of serious altitude illnesses. Pharmacological agents are particularly helpful when rapid ascent cannot be avoided or when rapid descent is not possible. Acetazolamide remains the drug of choice for prophylaxis of acute mountain sickness. However, evidence indicates that reduced dosage schemes compared to the current recommendations are warranted. Calcium channel blockers and phosphodiesterase inhibitors remain the drugs of choice for the management of high-altitude pulmonary edema. Dexamethasone should be reserved for the treatment of more severe cases of altitude illnesses such as cerebral edema.


Original languageEnglish
Pages (from-to)1891-1902
Number of pages12
JournalExpert Opinion on Pharmacotherapy
Issue number17
Early online date11 Oct 2018
Publication statusPublished - 22 Nov 2018


  • Acetazolamide, acute mountain sickness, dexamethasone, high altitude, high-altitude cerebral edema, high-altitude pulmonary edema, nifedipine

ASJC Scopus subject areas