Using Diamox on Kilimanjaro

Since you have been researching your Kilimanjaro climb, we are sure you have come across some information regarding Diamox. We are not doctors, but these are some of the pros and cons that we have seen on Kilimanjaro when clients use Diamox.

Diamox for Kilimanjaro


First of all, let’s discuss what Diamox is and how it works.

Diamox or Acetazolamide is used to prevent and reduce the symptoms of altitude sickness. These symptoms can occur when you climb quickly to high altitudes. This usually occurs above 10,000 feet/3,048 meters. It is particularly useful in situations when you cannot make a slow ascent. 

The best ways to prevent altitude sickness are climbing slowly, stopping for 24 hours during the climb to allow the body to adjust to the new height, and taking it easy the first 1 to 2 days. However, that is not a scenario that is possible on Kilimanjaro. To help with acclimatization, we subscribe to the climb-high sleep-low method and we have you hike very slowly. You’ll hear the guide say “pole, pole” which is Swahili for slow. 

Climb-High Sleep-Low

The climb-high sleep-low method means that during the day we start at one elevation and climb up either a mountain pass or a side hike to a peak and then descend lower to sleep. For example, on the Lemosho route, you’ll start at Shira I camp at 11,600 feet, ascend to Shira Cathedral at 12,800 ft then descend to Shira II at 12,600 feet.

Other Uses of Acetazolamide

Acetazolamide is not only for altitude sickness, it is also used with other medications to treat a certain type of eye problem such as open-angle glaucoma. Acetazolamide decreases the amount of fluid that can build up in the eye. 

Additionally, it is also used to decrease a buildup of body fluids (edema) caused by congestive heart failure or certain medications.

Acetazolamide should only be used for short periods of time. It tends to lose its effectiveness the longer you use it. 

Acetazolamide also treats certain types of seizures such as petit mal and unlocalized seizures.

How to use Diamox

If you choose to take Diamox, you’ll take it by mouth 1-4 times daily. It does cause frequent urination so we recommend taking it once in the morning and once you arrive at camp in the afternoon. That way you’ll avoid getting up several times overnight to pee.

Diamox can be taken with or without food. Drink plenty of fluids. For the dosage, we recommend 125 mg in the morning and 125 mg in the afternoon. You can either have a prescription for 125 mg or break a 250 mg in half. We also recommend taking at least 1 dose before heading to Africa to make sure your body reacts positively to it.

Once on your way to Tanzania, start taking it 1 to 2 days before you start to climb. Continue taking it until you have reached the summit. You can cease taking it once you reach the summit since you’ll descend quickly down below 12,000 ft or more depending on the route you are climbing.

Keep in mind, if you develop severe altitude sickness, you must descend as quickly as possible. The guide will be aware of this and will accompany you down to a lower elevation. Acetazolamide will not protect you from the serious effects of severe altitude sickness. 

Pros of Using Diamox

If reading this scares you, keep reading for the positive reasons to take Diamox.

First of all, your blood oxygen levels may stay higher by using Diamox. For example, without it, your stats will drop each day as you ascend. It should start above 90 at the lower elevations and as you continue up it may drop each day as you get closer and closer to the summit. It may possibly drop into the 70s. 

What does this mean? Low blood oxygen levels can lead to Hypoxemia. Hypoxemia is a below-normal level of oxygen in your blood, specifically in the arteries. Hypoxemia is a sign of a problem related to breathing or circulation and may result in various symptoms, such as shortness of breath.

You can measure this fluctuation with a pulse oximeter. It is a small device that clips to your finger and reads the oxygen in your blood.

pulse oximeter on Kilimanjaro

Normal arterial oxygen is approximately 75 to 100 millimeters of mercury (mm Hg). Values under 60 mm Hg usually indicate the need for supplemental oxygen. Normal pulse oximeter readings usually range from 95 to 100 percent. Values under 90 percent are considered low. Under 90 is common on Kilimanjaro and doesn’t become an issue until it starts dropping into the low 70s or lower.

Furthermore, other pros of using Diamox are a decrease in headaches, tiredness, nausea, dizziness, and shortness of breath.

Cons of Using Diamox

Now that you know some of the pros, what are the side effects of taking Diamox? Some of the more common side effects are dizziness, lightheadedness, and an increased amount of urine, especially during the first few days as your body adjusts to the medication.

Blurred vision or changes in vision is a less common side effect. This can be blurry, up-close vision, that should resolve itself in a few days. Increased sensitivity to the sun, particularly sunburn is another uncommon side effect but it happens as you can see below.

Other rare side effects include dry mouth, drowsiness, loss of appetite, nausea and vomiting, constipation or diarrhea, changes in taste, headache, fatigue, weakness, nervousness, confusion, ringing in your ears, and/or hearing problems.

In the end, It is really up to you if you choose to use Diamox on Kilimanjaro. We are not doctors we are only relaying what we have seen from our clients and personally experienced using Diamox on Kilimanjaro.

Are you ready to book your trip of a lifetime?

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