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Diamox ( Acetazolamide ) for acclimatization
#6403 08/02/10 11:20 AM
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Steve C Offline OP
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On this link on wpsmb, Bulldog34 wrote:
Originally Posted By: bulldog34
Originally Posted By: MartiniGal
Note that you can't take any of those medications if you are allergic to
sulpha-based medications.


Actually, I think it depends upon your sulfa allergy. My wife has carried an allergy to sulfa drugs for years, but the doctor gave her Diamox anyway since it is in a different category of sulfa than the antibiotics she had a reaction to many years ago. I can't provide the details as to the differences involved but her request for the drug, even though she knew about its sulfa derivation, came as a result of some very useful information Ken and Harvey posted a while back. Ken in particular, I believe, indicated that the classic sulfa allergy may not apply in many cases to acetazolamide. I'm sure they can explain why this isn't a classic "sulfa" drug, but that's beyond my pay grade.

Net result, she took Diamox for the first time a few weeks ago and suffered no reaction (other than the typical irritating side-effects most everyone seems to experience). I would encourage anyone interested in Diamox to discuss with their physician before assuming that a pre-existing sulfa allergy is an automatic disqualifier.

As an aside, she also asked for a couple of dex to take to the Sierra as an emergency AMS drug (she has a history of debilitating AMS at 14,000 feet), and got a firm, flat "no". No amount of benefit could outweigh the downside in her doctor's opinion. Guess the doc's never been in those shoes . . .

Gary, I'm pretty curious...
What dosage did your wife use?
Did she plan on hiking, or why did she take it?

Thanks!

Re: Diamox ( Acetazolamide ) for acclimatization
Steve C #6406 08/02/10 12:13 PM
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Rod Offline
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Funny about dex. Some doctors will give it readily like my family doctor and some like my pain management doctor will not give for any reason.It is a serious drug.

Re: Diamox ( Acetazolamide ) for acclimatization
Steve C #6408 08/02/10 12:18 PM
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Steve, after her really bad event on Pikes Peak a few years ago she's been very wary of getting too high too quickly (scared s%@tless, actually). For our trip to the Sierra a few weeks ago, we planned to spend 5 nights at 8000 feet (Mammoth) and hike in the 11,000 foot range for several days before heading to Whitney for my hike. She had not hiked extensively over 10,000 feet before, and the Pikes Peak reaction at 14,000 feet made her very apprehensive.

Diamox was an obvious aide for her, but she's been "allergic" to sulfa drugs since she was a teen - bad reaction to some antibiotic. After reading the thread here about the whole Diamox/Dex thing, with Ken's medical advice that Diamox isn't strictly a sulfa drug by the classic definition and "allergies" may not apply, I suggested she talk it over with her doctor. Sure enough, after hearing her "sulfa allergy" story, he prescribed it for her.

Many people have a reaction after taking a drug - GI-related issues, headache or some other common ill - and decide that they are allergic to the drug, going forward in life with that belief. It may (or may not) have been the drug that caused their illness/event, but even if it was - with that specific drug at that specific time - that doesn't mean that they are allergic, especially if no classic allergy symptoms appear. That, and there are so many derivatives of sulfa-based drugs, it seems prudent to review with a doctor before dismissing the option out of hand due to a presumed sulfa allergy (which I believe is one of the more common drug allergies out there).

Her dosage was, I believe, half a tablet. She tried it out a few days before we left, just to see if she would have a reaction. Other than the irritating tingling/thrumming side effect, she had no problem. Certainly no allergic reaction.

The good news was that she didn't have to rely on it in the Sierra, as we spent a night at 8000 feet (Mammoth) before going for an easy walk at 10,500 the next day (Little Lakes Valley). She acclimated just fine on her own and was able to hike several days around 11K' without issues. She insists she's doing Mt W with me next year, so I'm betting she'll be back to the doc's for more Diamox in 2011 to hike above 11K' for the first time . . .

Re: Diamox ( Acetazolamide ) for acclimatization
Rod #6410 08/02/10 01:44 PM
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Originally Posted By: Rod
Funny about dex. Some doctors will give it readily like my family doctor and some like my pain management doctor will not give for any reason.It is a serious drug.


Rod, I think a lot doctors just don't understand the relative merits of a request for it as an emergency kit option at high elevation. Yeah it's one powerful steroid and has some ugly side effects but, measured against being wobbly and disoriented in high, rugged, long-fall terrain, most of us would see it as no contest versus the real possibility of being badly injured or dying on a big mountain. I think it's especially difficult to grasp for doctors in the eastern half of the country who (1) I assume rarely hear such a request and (2) don't have a frame of reference to truly appreciate the dangers of a bad case of AMS high in the Sierra or Rockies.

Re: Diamox ( Acetazolamide ) for acclimatization
Bulldog34 #6412 08/02/10 05:31 PM
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Originally Posted By: Bulldog34
Originally Posted By: Rod
Funny about dex. Some doctors will give it readily like my family doctor and some like my pain management doctor will not give for any reason.It is a serious drug.


Rod, I think a lot doctors just don't understand the relative merits of a request for it as an emergency kit option at high elevation. Yeah it's one powerful steroid and has some ugly side effects but, measured against being wobbly and disoriented in high, rugged, long-fall terrain, most of us would see it as no contest versus the real possibility of being badly injured or dying on a big mountain. I think it's especially difficult to grasp for doctors in the eastern half of the country who (1) I assume rarely hear such a request and (2) don't have a frame of reference to truly appreciate the dangers of a bad case of AMS high in the Sierra or Rockies.


I think you are exactly right.

personally, I think the drug is exceedingly safe in the dosages and durations we are talking about. Long term = different story. Also different in people with some chronic conditions, such as chronic hepatitis or diabetes. Doesn't mean it can't be used, means one has to know what one is doing.

Dangerous is a relative thing, as you point out. I believe the most common cause of childhood poisoning deaths is still vitamins, although I've not checked in some years. I'd certainly not typify them as dangerous, although apparently they are in certain situations.

Re: Diamox ( Acetazolamide ) for acclimatization
Ken #6444 08/03/10 09:36 PM
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Rod Offline
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Dex sure would be a great back up drug to have in the medicine kit in that special and necessary situation that it might be needed.Ken you made the point in an earlier thread something to the effect that if it could save someones life who cares what the side effects are(my paraphrase).I also think you said the worse problem with a drug is the one that would have saved a life that wasn't used or something like that.I am alright with that.Dex is a drug that could make the difference between someone living or dying.

Last edited by Rod; 08/03/10 09:41 PM.

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