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Ibuprofen – a new preventive altitude medication ?

April 8, 2012

Lot of buzz lately over a small study in Colorado , where Ibuprofen gave good results in preventing/minimising altitude sickness. Ibuprofen is a easily available over the counter NSAID medication , which could be seen as both promising and worrying . This is one small well designed study : nowhere near enough to support any new guidelines . And of course it will be used without that support . This is a short summary of questions and what is known to day :

What has been proven ?

In a situation designed to produce AMS ( rapid ascent to the same altitude as Lhasa and exertion ) the people that were on Ibuprofen did better than the placebo group.

Is this a cure ?

No : without Ibuprofen roughly two out of three developed AMS , and with it one out of two . The difference was not dramatic , AMS score was lowered by one point.
In other words the basic mechanism remains : in every group that goes outside safety guidelines you will see AMS.

An over the counter medication … that must be brilliant , and without risks .. right ?

It´s brilliant from the aspect of being easily available worldwide . The NSAID group comes with it´s own risks though , the main one being a higher risk for ulcers and gastro-intestinal bleeding. This risk is proportional to the dose given … which in this case is double as high as in normal use. Managing risk would start with not using Ibuprofen for extended periods , and avoiding other GI bleeding risk factors , that start with

* high altitude..

Other relative risk factors for ulcers and GI bleeding are
* ASA ( Aspirin etc. )
* steroids like dexamethason , another key drug used in treating AMS.

Anyone who already is in the risk zone for ulcers , should at least take a long think over how to minimise ulcer and GI bleeding factors , together with a good doc.  And obviously : anyone on anti-coagulants should look to other  options first.

How will this work in combination with Diamox ?

No well known interaction , and little to no practical experience of the combination Diamox and high doses of NSAID`s . Let somebody else supply the experience and mistakes here.

On the practical side : normal doses of Ibuprofen make you sweat , and higher doses makes you sweat more. I took a 600 mg test dose at work , and was glad I could change clothes two hours later.

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