Ibuprofen may ward off altitude sickness

The anti-inflammatory drug ibuprofen can reduce acute altitude sickness suffered by a quarter of the millions of Americans who travel to the mountains to ski or hike, according to a clinical study published Tuesday.


Grant Lipman, the Stanford University researcher who led the study, described altitude sickness as being like "a really nasty hangover."


The symptoms include headache, fatigue, dizziness, nausea, vomiting and poor appetite.


In the worst cases, altitude sickness can cause cerebral edema, an often fatal brain swelling.


Ibuprofen, an active ingredient in over-the-counter painkillers like Advil, reduced altitude sickness symptoms by 26 percent in a study of 58 men and 28 women, Lipman and his research team reported.


The study was published in the online version of the Annals of Emergency Medicine.


The study participants traveled to an area of the White Mountains northeast of Bishop, California, where they spent the night at 4,100 feet.


At 8 am, they were given either 600 milligrams of ibuprofen or a placebo before heading up a mountain to a staging area at 11,700 feet. There, they were given a second dose at 2 pm.


They then hiked to 12,570 feet, where they received a third dose at 8 pm before spending the night on the mountain.


Of the 44 participants who received ibuprofen, 19, or 43 percent, suffered symptoms of altitude sickness, whereas 29 of the 42 participants who received placebos had symptoms, according to the study.


Sixty-nine percent of the participants who took placebo during the ascent developed the headaches, nausea, dizziness, and fatigue that characterize altitude sickness, also known as acute mountain sickness. By contrast, just 43 percent of people who took ibuprofen developed the condition.


The prospect of using an over-the-counter pain reliever to stave off altitude sickness is appealing, the researchers say, because the only two drugs currently approved to prevent and treat the condition, acetazolamide and dexamethasone, are prescription-only and carry a risk of side effects.


In fact, many doctors are reluctant to prescribe acetazolamide or dexamethasone unless a person has experienced altitude sickness before, says Dr. Robert Roach, director of the Altitude Research Center at the University of Colorado Denver School of Medicine, who was not involved in the study.


Ibuprofen appears to be nearly as effective as acetazolamide and dexamethasone, so it may be an option for people traveling to high altitudes who don't yet know if they're susceptible, Roach adds.


In general, he says, 20 percent to 30 percent of people will experience altitude sickness at 7,000 feet, and up to 50 percent will get sick at 10,000 feet.


The study took place in California's White Mountains. Eighty-six men and women who lived close to sea level spent the night at 4,100 feet. In the morning, they drove to an elevation of 11,700 feet and proceeded to hike to 12,570 feet, where they again spent the night.


The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.


The men and women had to be healthy enough to hike at a high elevation, but they weren't necessarily experienced hikers or mountain climbers. That suggests the ibuprofen regimen used in the study could be helpful for everyday tourists on ski or hiking vacations, not just elite climbers, says lead author Grant S. Lipman, M.D., a clinical assistant professor of emergency medicine at the Stanford University School of Medicine.