Steroids and altitude illness

Question:

Hullo,

It was suggested to me by a doctor that taking Cortisone while climbing Aconcagua will prevent mountain sickness.

Although when I mentioned this to the Doctor at Base Camp, he said that this was definitely not a good idea as the mountain is too dry?

Please advise on which one is correct?

Answer:

Hi

Thanks for your question to altitude.org.
There is no evidence for taking Cortisone at altitude, as far as I know. We were wondering if your doctor meant Dexamethasone? Both drugs are steroids, however there is some evidence for the use of Dexamethasone at altitude.
Of course, the best way and safest way to prevent altitude illness is to follow a safe ascent profile.
Dexamethasone is primarily used as a treatment for High Altitude Cerebral Oedema and it has been shown to work as a preventative agent for both Acute Mountain Sickness (AMS) and High Altitude Pulmonary Oedema. Importantly it is not recommended by either the Wilderness Medical Society (WMS) or the UIAA as a first line treatment because of it’s significant side effects. Diamox (Acetazolamide) should be the standard preventative medication for AMS.
WMS guidelines 2010:
“In low-risk situations, prophylactic medications are not necessary and individuals should rely on a gradual ascent profile. Above an altitude of 3000 m, individuals should not increase the sleeping elevation by more than 500 m per day and should include a rest day (ie, no ascent to higher sleeping elevation) every 3 to 4 days. Prophylactic medications should be considered in addition to gradual ascent for use in moderate- to high-risk situations. Acetazolamide is the preferred agent, but dexamethasone may be used as an alternative in individuals with a prior history of intolerance of or allergic reaction to acetazolamide.”
I hope this helps,
Dr Kitty Duncan

| July 4th, 2012 | Posted in Uncategorized |

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