UKC

Has anyone got a link to info re Diamox that I can take along to my GP.(I realise there is plenty of stuff out there but want something in black and white) ?

Any decent info may be of more use than me trying to explain the why's and wherefores

Thanks all.

In reply to Newbuild100:

I assume you want it for altitude. Perhaps use the NHS's own blurb.

http://www.nhs.uk/Conditions/Altitude-sickness/Pages/Treatment.aspx
http://www.nhs.uk/Conditions/Altitude-sickness/Pages/Prevention.aspx

In reply to Newbuild100:

it isn't licensed for that use, so it will depend how comfortable your doctor is in prescribing it off license.

In reply to Newbuild100:

http://www.altitude.org/altitude_handbook.php

There's this as well, I think it mentions Diamox somewhere in the booklet, or elsewhere on the website.

In reply to Newbuild100:

Tricky, as it is not a "black and white" subject. Its not licensed for altitude, and most GPs will have little or no experience of prescribing it for this purpose.

I recently persuaded my GP to prescribe me some diamox. I spent a fair bit of time researching my cause on: http://www.basecampmd.com/page/mission.shtml I went to see him fully prepped, and had to "prove" I knew what I was talking about- mostly by pointing out his error when he suggested it could mask AMS symptoms (it doesn't).

For info- my GP was willing to prescribe it for me because I was working at altitude, I demonstrated that I understand how the drug works, and what the risks are, and a working knowledge of AMS, plus the usual preferred options of slow ascent or descent if unwell are less available to me than ordinary trekkers. He said that he had recently turned down a "recreational" user who wanted it for a "holiday" trip.

I believe my GP over-prescribed the dosage, giving me 250mg to be taken twice a day. A bit of research on here and chatting with experienced guides suggest that a dose of 125mg twice daily is more suitable for prophylactic use, it has side affects, including being a strong diuretic, which in themselves are quite unpleasant. I haven't done my trip yet, but did a test run at sea level, and this dosage seemed to avoid the side effects.

Good luck.

In reply to Newbuild100:
my friend is a GP and knows nothing about it. after quizzing her and showing her these things, she says probably best going to a travel clinic, as they might know more - so you might be hard pressed to find one. Some GP's will refuse as its not mentioned as a use under the drug details.
she also said it would be a private prescription so you'd have to pay for the drug and the prescription. although its not that expensive.

In reply to Newbuild100:

What you haven't shared is why you want it.

Acclimatisation is about having an appropriate itinerary to allow this to happen naturally.

Have you been to altitude before?

I'm not a fan of using it prophalyticaly.

Care to expand on your need?

An informed GP would ask all of the above.

In reply to Kimberley: Sorry for any confusion.

Yes, ive been to altitude twice before (5000 meters ish each time).
Had good programme of acclimitisation each time, but still suffered a bit each time.
Im going higher this time (october)and once again a decent acclimitisation programme will be done.
Im armed with quite a lot if info gathered over the years re diamox/acclimitisation but may need something mnore when i go the GP's

In reply to Newbuild100: I never had any problem, my doctor suggested it when I told him I was going to Everest, mind you he had once been the doctor the the UK ski team so knew about these things.
Next time I went to the Himalaya it was a different doctor but he was quite ok when I asked for it because I'd been prescribed it before.

In reply to parkovski:

Interesting - the NHS has got round to suggesting Nifedipene for HAPE, only a couple of years after it's been rejected by mountaineers as more dangerous than the condition it's supposed to treat.

In reply to Snoweider: I think your GP may be wrong about the dose too, but only because the scientific evidence suggests 750mg to be effective, not 500mg! Interestingly the basecampmd site suggests 250mg twice daily as per your GPs suggestion.

b

In reply to Newbuild100:
I never had an issue getting it from my doctor, suppose it depends on the doctor, however after a few days at altitude I stopped using it. Not because it had any adverse effect, but just as a test to see if it was helping me. I never noticed any differance without it in all honesty BUT we are all differant. Some people were not taking it to start with as they wanted to use it as a last resort, they obviously then had to wait a few days for it to kick in after they started suffering but then they felt the benefits of taking it.
The one thing I would say is as long as you listen to your body and the guides who tell you to climb high and sleep low and spend quality time acclimatising you should be fine. I listened intently too what the expedition leaders and doctor out there and the sherpa's when on everest told me and did exactly what they advised after all they are the ones who know better than your own gp back home in his /her surgery not that Im knocking them.

In reply to Newbuild100:

You might find this free downloadable booklet designed for the layman useful on Diamox (Acetazolamide) and other aspects of high altitude medicine:

http://medex.org.uk//medex_book/about_book.php

Yours,

David Hillebrandt

In reply to AndyC
"Interesting - the NHS has got round to suggesting Nifedipene for HAPE, only a couple of years after it's been rejected by mountaineers as more dangerous than the condition it's supposed to treat."

Please be certain of your medical facts prior to posting. I would like to see your evidence for this comment.

I believe that Nifedipine 20mg s/r is a safe and potentially lifesaving treatment for HAPE to buy time for the essential descent.

I base this on recent consensus papers by UIAA Medcom and Wilderness Medicine Society:

http://www.theuiaa.org/medical_advice.html

and

http://www.wemjournal.org/article/S1080-6032(10)00114-6/fulltext#sec4.1.2

I await your reply with interest

David Hillebrandt

In reply to Newbuild100:

Just to backup what David has said (not that he needs my reinforcement!), the medex booklet is very useful, though looking at it from the download does weird things to the page order.
You may see different recommendations for dose of diamox, but 125mg twice daily (half a 250mg tab) seems to be as effective for prevention with less side effects. Always worth taking a dose before you leave to see how you feel on it, and drink some fizzy drink after so you won't think somethings gone wrong at altitude!

I don't think you can expect any particular GP to be happy and experienced in the use of diamox, and it is an off-licence use, but maybe leaving in the medex booklet a week before your appointment with a short message might help.

Likewise I wasn't aware that anyone was recommending against nifedipine. Some may feel unsure or inexperienced in its use maybe.