In this post, I’m talking about 3 Life Saving Drugs that you must always have with you at high altitude. We call them LSDs — Life Saving Drugs. We have seen time and again that these medicines have come to the rescue of trekkers, even in severe cases of AMS, HAPE and HACE.
The three Life Saving Drugs are Diamox, Nifedipine and Dexamethasone.
Today I’ll give you some insight about these Life Saving Drugs. I’m not giving you a medical discourse on it, but I’ll share some tidbits from what we have experienced over the past 10 years of running treks in the Himalayas. Hopefully, I’ll remove any apprehensions you may have about these medicines.
1. The first Life Saving Drug is Diamox
Diamox has almost become a household name amongst trekkers. And I’m not surprised, because that’s how important Diamox is.
We use it to prevent and also treat Acute Mountain Sickness.
Diamox helps you by making you acclimatise faster. It makes you breathe faster and deeper, taking in more oxygen. It also thins your blood, making it easier for your heart to pump oxygenated blood to parts of your body.
We have seen it come of use mostly above the 10,000 ft mark — both in terms of the preventive course and a curative course. So you don’t really have to go on a preventive course for treks that climb to just around 12,000 ft — Kedarkantha, Dayara, Deoriatal, Brahmatal.
But that does NOT mean you cannot get AMS on these easier treks. Always make it a habit to carry a strip of Diamox with you if you’re going above 10,000 ft.
Go on a curative course at the sign of any mild symptoms of AMS. The dosage depends on your symptoms, but usually start off with 250 mg every 12 hours, or if it’s bad, then every 6 hours. Even if you are already on a preventive course, don’t hesitate to go for another dose if you show signs of AMS.
We have detailed articles and videos about how Diamox works, how to administer it for a preventive course at the bottom of this article. Please go through them for further reading.
I’ve seen two big worries amongst trekkers about using Diamox.
One is that they may have to pee in the middle of the night.
Well, Diamox is a diuretic, it is going to make you pee more often, but that’s how it helps you acclimatise faster. That’s really no reason to not take it, if it helps you stay safe.
The second fear amongst trekkers is the tingling sensation that comes with it — you feel it around your finger tips, your face — I’ve felt it myself, it’s harmless.
But if you’re really worried about it, then for your preventive course, you can take just half a tablet (125 mg). It almost removes all the side effects. However, there’s no perceptible difference between half tablet course and full tablet course we have seen in terms of helping you acclimatise. A half tablet is as effective as a full.
2. The second Life Saving Drug is Nifedipine
You may have heard of Nifedipine, a medicine used to treat High Altitude Pulmonary Edema. Pulmonary edema is when there’s high pressure in your lungs. It causes your body fluids to accumulate in your lungs.
This is where Nifedipine comes in. Nifedipine eases the pressure around your lungs and reduces the fluids that are oozing into it. If gives you some basic relief and enough time to descend to a lower altitude. You’ll see symptoms reducing within 30 minutes after administering the medicine. It is usually administered in 2 stages — 10 mg first, wait for half an hour and then another 10 mg. You should begin to see the effects within 30 minutes to an hour.
I’ve noticed a big hesitation amongst experienced trekkers and even Trek Leaders to administer Nifedipine. They fear that for those trekkers who already have low BP, this might be dangerous.
But that’s a myth.
Nifedipine comes in very controlled doses. It is a medicine that reduces the pressure around your lungs and will not cause you harm in such controlled doses. And in severe cases of HAPE, it’s either Nifedipine or death. So you can make a choice.
3. The third Life Saving Drug is Dexamethasone
Dex is used to treat severe cases of AMS and also High Altitude Cerebral Edema, the rarest form of altitude sickness amongst AMS, HAPE and HACE.
HACE occurs where there’s an inflammation in your brain, and fluids accumulate in your brain.
This is where Dex comes in. It is a medicine that helps reduce the inflammation caused by altitude sickness in your brain. It gives you almost immediate relief. This relief period is basically time for you to evacuate yourself to safety. Since Dex is also a steroid, it gives you a sudden burst of energy to get yourself out of there.
It comes in very small doses in India — around 0.5 mg. It is administered along with Diamox in doses of around 4 mg, depending on the severity of the case.
Interestingly, we have seen that even in cases of mild AMS, Dex is useful in small doses. Since AMS is also a slight inflammation in your body, it helps reduce that. Some studies even recommend using Dex as a preventive course of Diamox.
All in all, we have used and seen the benefits of these Life Saving Drugs for over ten years.
While, Diamox is used for prevention and cure of mild AMS, Nifedipine and Dexamethasone are strictly for emergencies only.
Ideally, you should not let your altitude sickness advance to HAPE and HACE. So take care of yourself.
If you have any doubts, drop in a comment below. I’ll help you out.
Meanwhile, here are a few articles you can read to learn more about altitude sickness, AMS, HAPE and HACE.