Acetazolamide for the prevention of acute mountain sickness--a systematic review and meta-analysis

J Travel Med. 2012 Sep-Oct;19(5):298-307. doi: 10.1111/j.1708-8305.2012.00629.x. Epub 2012 Jul 30.


Background: Acetazolamide has been reported to be effective in the prevention of acute mountain sickness (AMS). Our aim was to conduct a systematic review of randomized, placebo-controlled trials of acetazolamide in the prevention of AMS.

Methods: Studies were identified by searching the MEDLINE, Embase, Cochrane Clinical Trials Register, and databases. Primary end point was difference in incidence of AMS between acetazolamide and placebo groups.

Results: Acetazolamide prophylaxis was associated with a 48% relative-risk reduction compared to placebo. There was no evidence of an association between efficacy and dose of acetazolamide. Adverse effects were often not systematically reported but appeared to be common but generally mild. One study found that adverse effects of acetazolamide were dose related.

Conclusions: Acetazolamide is effective prophylaxis for the prevention of symptoms of AMS in those going to high altitude. A dose of 250 mg/day has similar efficacy to higher doses and may have a favorable side-effect profile.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Acclimatization
  • Acetazolamide / therapeutic use*
  • Acute Disease
  • Altitude Sickness / drug therapy
  • Altitude Sickness / prevention & control*
  • Amines / therapeutic use
  • Brain Edema / prevention & control
  • Carbonic Anhydrase Inhibitors / therapeutic use*
  • Dose-Response Relationship, Drug
  • Humans
  • Mountaineering*
  • Pulmonary Edema / prevention & control
  • Treatment Outcome


  • Amines
  • Carbonic Anhydrase Inhibitors
  • Acetazolamide