By the way, I just checked the diamox I have. It's extended release so in taking it, one would not be exposed to the full 500mg dose all at once. It's in a capsule, so it's not possible to cut it in half
That's a massive dose, geared for glaucoma patients. I'd definitely check back with the doc and see if he can prescribe 250 mg scored tabs that you can cut. If you wind up stuck with the 500 mg capsules, take a dose or two before you leave to see how it affects you. If you're sensitive to the side effects, you really want to know before you're well up the trail and at high altitude.
The most common side effects are the tingling in the extremeties and messing with the taste of carbonated beverages. It works against AMS at altitude by reducing fluid buildup around the brain and lungs. It does that because it's a diuretic - a powerful one. Expect to pee way more than normal while it's in your system, which can cause your hydration to go sideways on you. When on acetazolamide at altitude, especially a big dose like 500 mg, you need to watch your fluid intake vs output carefully. Cardinal rule: if you're peeing clear and regularly, you're well hydrated. The darker your urine, the more concerned you need to be about hydration. Dehydration is one of several gateways to AMS.
The other risk is too-frequent water intake flushing the minerals out of your system, creating an electrolyte imbalance, which is almost as bad as AMS. You can avoid this by using an additive with your water occasionally. There are a zillion brands out there, but I've been using Camelbak Elixir tablets the last few years.
