Altitude sickness

Acetazolamide tablets (formerly Diamox) for altitude sickness, forced acclimatisation and altitude sleep disturbance. Medicine on prescription from NHS pharmacy.

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Acetazolamide 250mg

Acetazolamide 250mg (Diamox)

28-112 tablets from £27.00

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Prices

TabletsQuantityCost
Acetazolamide 250mg28 tablets£27.00
Acetazolamide 250mg56 tablets£49.50
Acetazolamide 250mg112 tablets£92.00
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Dr Fox charges a small prescription fee per order.

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Dr Fox prices are 25%-50% lower cost than other online clinics.

If you have your own private paper prescription please post to our pharmacy (details).

Acetazolamide is prescription only medicine. You are required to answer medical questions before completing order. A doctor will review your information and issue a prescription online to our pharmacy.

Prescription fees

Dr Fox supplies medicine on prescription and charges a small prescription fee based on the order value of each prescription.

Prescriptions are issued by our doctors online and sent electronically to our pharmacy.

If you have your own private paper prescription please post to our pharmacy (details).

Dr Fox prices are 25%–50% lower than other UK online clinics.

Order valuePrescription fee
up to £10£1.00
up to £20£3.00
up to £50£5.00
up to £100£8.00
over £100£10.00
Comparative costs of Acetazolamide 250mg from UK online clinics (12 November 2015) - qualifying notes
  1. The prices shown are listed by the online clinics named after a customer first enters consultation information and is offered prescriptions. It is possible these clinics may have special offers or lower prices for repeat supplies.
  2. Prices may change and are, to the best of our knowledge, accurate on the date stated.
  3. Dr Fox does NOT claim to provide a superior service to any of the online clinics listed. All the clinics listed, as far as we can tell, comply with all regulation and, as far as we can tell, operate to high ethical standards.
  4. Dr Fox adds a small prescription fee not included in the table (between £1 and £10 depending on value of the order).
  5. To amend the information in this table please contact us
  6. The prices listed in the table do not identify the cost of prescription medicine as online clinics charge a single fee to cover services which includes advice, consultations, prescriptions and dispensing and supply of treatments.
Acetazolamide 250mgDr FoxHealth Expresstreated.comEuroclinixOnline Clinic
28 tablets£27.00£49.95£51.00 (30 caps)£49.95£49.95
UK delivery£2.90includedincludedincludedincluded

Medical information

Important

Please do not order without reading and understanding this medical information.
Print information to take with you

Most trekkers and climbers do not need, and should not take acetazolamide tablets (Diamox).

  • Altitude problems are unlikely below 2,500 metres (8,000 feet).
  • Anybody can suffer from illness caused by altitude. Nobody is immune to it.
  • The best way to reduce the risk is to acclimatise and be prepared to descend.

Acclimatise

Ascend slowly with overnight stops at regular intervals.

  • People planning to ascend over 3,000 metres (10,000 feet) should spend a night at an intermediate elevation below 3,000 metres before they start to ascend.
  • Above 3,000 metres ascend only 300-500 metres (1,000-1,500 feet) a day to each next new sleep height.
  • If more than 500 metres (1,500 feet) of ascent is required in the day, descend back to 500 metres to sleep (climb high, sleep low).
  • For every 1,000 metres (3,000 feet) of ascent stop for 2 nights sleep before going higher.

Symptoms of mild early acute mountain sickness

Stop ascending until feeling better.

  • Headache not relieved by paracetamol and drinking a litre of water (early symptom of acute mountain sickness)
  • Fatigue and weakness.
  • Dizziness and light-headedness.
  • Difficulty sleeping.

Do not ascend if these symptoms develop. Stop until the symptoms resolve (usually 24-48hrs) or descend. Descending will usually make the symptoms go more quickly.

Ascent can be continued when these symptoms subside, usually after 24-48 hrs.

  • Do not keep ascending.
  • It helps to drink plenty.
  • Avoid alcohol and sedatives.

Emergencies requiring immediate descent

Two sets of symptoms requiring immediate descent:

  1. Fluid on the lungs
    Showing up as struggling to breath, extreme fatigue, rattling breathing, coughing, blue or grey lips and fingernails, drowsiness, collapse, confusion and death. This condition is known as HAPE (High Altitude Pulmonary Oedema). The cardinal feature is extreme shortness of breath – being short of breath when everybody else has got their breath back.
  2. Fluid on the brain
    Showing up as changes in behaviour, lethargy, and loss of coordination (unable to walk in a straight line). This can progress to coma and death. This condition is known as HACE (High Altitude Cerebral Oedema). The cardinal feature is cognitive impairment (inability to think straight and carry out normal tasks).

These two conditions are emergencies requiring immediate descent, even if this is in the night. The descent needs to be at least 500-1,000 metres (1,500-3,000 feet) and as soon as is possible. Delay can be fatal.

In addition to descent, treatment includes oxygen, steroids and hyperbarric oxygen (oxygen delivered in a high pressure chamber).

Notes about HACE and HAPE

  • Can come without any warning.
  • Can develop rapidly over a period of hours.
  • Often start at night, although can come on in the day.
  • There may be no preceding symptoms or warning.
  • Can affect people who have ascended previously to the same height without problems.
  • Can affect people who have followed the guidelines for acclimatisation.
  • Can affect people who are taking acetazolamide.
  • Can affect fit and unfit people and indigenous people including porters.

About acetazolamide

Acetazolamide increases the amount of urine produced and changes the acidity of the blood. The net effect is to improve breathing and reduce fluid around the brain and in the lungs.

Acetazolamide is not licensed to prevent and treat altitude sickness, although it has long been used for this purpose.

Acetazolamide side effects

Most people taking acetazolamide for short courses experience no side effects.

Side effects reported include: a 'tingling' feeling in the fingers and toes, some loss of appetite, taste disturbance, flushing, thirst, headache, dizziness, fatigue, irritability, and depression.

Uses of acetazolamide

  1. In the mild acute mountain sickness (headache, fatigue, light headedness, difficulty with sleep) symptoms resolve more quickly with acetazolamide. The symptoms usually go by themselves in around 24-48 hrs. This usually reduces to around 12-24 hrs with acetazolamide.
  2. Taking acetazolamide will reduce the likelihood of altitude sickness in people who are forced to ascend without proper acclimatisation. Serious illness and even death are still possible. acetazolamide is not a substitute for acclimatisation.
  3. Acetazolamide improves the pattern of breathing during sleep at altitude and thus quality of sleep. During sleep at altitude the breathing pattern alters; rapid breaths are followed by prolonged pauses. This is not dangerous but tends to lead to poor sleep.

We do not recommend taking acetazolamide for people planning to undertake routine ascents. Most people who acclimatise properly do not need it. Taking acetazolamide can give a false sense of security.

Acetazolamide dosage

  1. For the treatment of mild early acute mountain sickness (headache, fatigue, light headedness, difficulty with sleep): Acetazolamide 250mg (one tablet) twice daily until symptoms resolve, when planned ascent can be resumed.
  2. Where rapid ascent without proper acclimatisation cannot be avoided: Acetazolamide 250mg (one tablet) twice daily, started the day before ascent or as soon as possible after starting to ascend and continue for 2-3 days after final altitude is reached.
  3. For disturbed breathing pattern during sleep: Acetazolamide 125mg (half a tablet) twice daily. Continue until descent to an altitude where sleep is no longer a problem. Acetazolamide is not a sedative.

Notes

Stopping acetazolamide does not cause a rebound in symptoms. The symptoms will not be worse than they would have been if acetazolamide had not been taken in the first place.

Taking acetazolamide for early symptoms does not mean it is OK to keep ascending. Do not ascend until symptoms resolve completely, usually 24-48 hrs.

Acetazolamide does not mask serious underlying symptoms. It treats the cause, not the symptoms. If a person feels better on acetazolamide it is because their condition has improved.

Take a trial dose of half a tablet 3-4 days before travel to check for possible adverse reactions.

Treat altitude with respect. Do not imagine that a strong person can simply battle through. People who climb and hike in high places have a reputation for pushing themselves. When it comes to altitude; planning ahead, taking one's time and responding to one's own body are virtues.

Further information

If you wish to discuss with our site doctors please contact via info@doctorfox.co.uk or telephone +44 (0)117 2050198.

Buy treatment

Dr Fox supplies acetazolamide tablets on prescription – you are required to answer a short medical questionnaire before your order can be completed.

  1. Medical questions
  2. Choose treatment
  3. Complete order

Diamox is a brand name for acetazolamide 250mg tablets [details]

The Diamox brand is no longer being sold in the UK (April 2015). We continue to use the name Diamox for acetazolamide tablets because this is the name people recognise. We supply only UK licensed acetazolamide from UK pharmacies.

Answer medical questions to order(altitude sickness)

Have you read the altitude sickness medical information?

 Please read altitude sickness medical information IN FULL.
Medical information in printable format (pdf).

Are you allergic to Diamox (acetazolamide) or sulpha containing medication?

If you are not sure please check with your regular doctor before ordering Diamox (acetazolamide).

Are taking any of the following medications?

  • Phenytoin or carbamezepine (anti-epileptic drugs)
  • Anti-coagulants (blood thinning drugs such as warfarin)
  • Medication to lower blood sugar (diabetic tablets)
  • Diuretics (tablets taken to remove fluid from the body)
  • Regular aspirin (more than occasional 1 or 2 aspirin every few days)

Do you plan to take acetazolamide whilst pregnant?

Have you been diagnosed with kidney or liver disease?

For organised groups; have you been advised to obtain Diamox (acetazolamide) by your group organisers?

For non-organised groups please answer 'Yes'.

Are you aware taking Diamox (acetazolamide) does NOT replace acclimatisation?

Above 3,000 metres (10,000 feet) ascend no more than 300-500 metres (1,000-1,500 feet) per day. For every 1,000 metres (3,000 feet) of ascent stop 2 nights before ascending further.

Are you aware Diamox (acetazolamide) is not advised where normal acclimatisation recommendations are followed?

Proper acclimatisation is the way to deal with altitude.

Are you aware people taking Diamox (acetazolamide) can still get mountain sickness including the very serious HAPE and HACE?

See the medical information for details.

Are you aware the sleep disturbance of altitude is treated with 125mg (half a tablet) Diamox (acetazolamide) twice daily?

Are you aware for early mild acute mountain sickness (headache, fatigue, dizziness, loss of appetite) the Diamox (acetazolamide) dose is 250mg (one tablet) twice daily?

Taking Diamox (acetazolamide) will help with these symptoms. The important thing is not to ascend until the symptoms resolve.

Are you aware in situations where rapid forced ascent cannot be avoided the dose of Diamox (acetazolamide) is 250mg (one tablet) twice daily?

Ascent of more than 500 metres (1,500 feet) a day above 3,000 metres (10,000 feet) is dangerous with or without Diamox (acetazolamide).

Are you aware confusion, loss of co-ordination and extreme shortness of breath are serious symptoms requiring immediate descent and also possible, steroids, oxygen, hyperbarric oxygen and acetazolamide?

Do the following apply to you?

  • I am over 18
  • The medication is for my own use
  • I will read the patient information leaflet supplied with the medication
  • I agree to the terms and conditions

The order process

Answer short medical questionnaire

Choose treatment, register, and pay

Doctor issues prescription online

Medicine posted direct from pharmacy


Independent reviews

“Great service quick uncomplicated good price”20/09/2016 – Mike H., Newcastle upon Tyne

“Answered questionnaire, ordered product. Product is competitively priced and delivered speedily - absolutely no criticism of any kind from me - product works every time.”08/09/2016 – Lionel E., Wigan

“I have used Dr Fox three times now and I find the service easy to use, with good products and delivery usually by return. I also feel confident about using the site and believe that they would only market products that were of reputable origin and safe to use.”22/08/2016 – Robin S., London

“very cautious about buying medicines online but Dr Fox seemed a credible retailer with a good reputation. Thankfully that turned about to be true. Ordering is relatively quick (even quicker to do a repeat order) and simple. The service has been good and I've had no reason to contact them even after many orders.”21/08/2016 – Andy B., Reading

“Impressively fast service to Malta. Also very helpful when I needed to ask a question. Very highly recommended.”17/08/2016 – Anonymous

“As this was the first time i had bought online, i was wary. So i checked the batch number with the manufacturer to make sure my medicine was legitimate and it was. I will definitely use again.”17/04/2016 – Anonymous

“I am perfectly satisfied. Dr Fox is cheaper than the other online pharmacies I know of. Still the service and delivery were perfect.”01/10/2015 – George G., London

“No complaints re: product or service. I've used this service many times and Dr Fox has been faultless.”01/10/2015 – Max B. Newcastle-upon-Tyne

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