Travel Tips
Diamox for Nepal Altitude When and How
Diamox (acetazolamide) is the most commonly prescribed altitude medication for Nepal trekkers. Here is what you need to know before you pack it.
Overview
Diamox (acetazolamide) works by making blood slightly more acidic, which stimulates faster and deeper breathing at altitude. This speeds up the natural acclimatisation process and reduces the likelihood of Acute Mountain Sickness. The standard trekking dose is 125 mg twice daily, though some doctors prescribe 250 mg.
Begin taking Diamox 24 hours before ascending above 3,000 metres and continue for at least 48 hours after reaching your target elevation. Common side effects include increased urination, tingling in the fingers and toes, and a mild metallic taste with carbonated drinks. These are harmless and expected.
Diamox is a sulfonamide derivative, so it is contraindicated in people with sulfa allergies. Anyone with kidney disease, liver disease, or electrolyte imbalances should consult a doctor before use. It is not a substitute for proper acclimatisation — even on Diamox, you must follow the ascend-slowly rule.
You can purchase Diamox at pharmacies in Kathmandu and Pokhara without a prescription, but quality control varies. Bring a verified supply from home if possible. On Sajilo-connected routes across Nepal, medical shops near major trailheads typically stock it, but availability above 3,500 metres is unreliable.
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FAQ
Q: Can Diamox mask altitude sickness symptoms?
A: Diamox does not mask symptoms — it actually prevents them by improving ventilation. If symptoms appear despite Diamox, they are genuine and you should descend.
Q: Should I test Diamox before my trek?
A: Yes. Take a test dose at home to check for allergic reactions or intolerable side effects before you are on a remote trail.
